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April 1963


Arch Dermatol. 1963;87(4):495-501. doi:10.1001/archderm.1963.01590160087020

Essential Cold Urticaria. Presented by Dr. Thomas B. Fitzpatrick.

An American boy, aged 16, was in excellent health until February, 1961, when he was admitted to the hospital with a diagnosis of ruptured appendix. He received 1,000,000 units of penicillin for 10 days before appendectomy was performed. During his febrile postoperative course it was noted that alcohol sponging resulted in cutaneous wheals; following his discharge, erythema, pruritus, and urticaria occurred in areas of skin exposed to cold.

Application of ice for 15 seconds results in urticaria lasting 1½ minutes after removal of the ice. Application for longer periods results in more severe and persistent urticaria lasting from 45 minutes to 4 hours. There is no involvement of the mucous membranes on swallowing cold liquids.

The hemoglobin was 14.1 gm. and white blood cells 4,900, with polymorphonuclear leukocytes 4.8, large lymphocytes 2, small lymphocytes 35, eosinophils 2, monocytes 7, and basophils

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