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May 1978

Primary Acquired Cold Urticaria

Arch Dermatol. 1978;114(5):803-804. doi:10.1001/archderm.1978.01640170097044

To the Editor.—  Wanderer and his colleagues (Archives 113:1375-1377, 1977) demonstrated that cyproheptadine hydrochloride is a useful drug in the management of patients with primary acquired cold urticaria. However, I think that they denigrated the method of what is termed "cold desensitization" as a means of treatment. It is quite true that if this type of therapy is carried out carelessly then systemic reactions can occur. On the other hand, when the therapy is used with care for a few days, it can maintain patients in a completely symptom-free state.We reported our use of this method with one patient a few years ago.1 Since then, a number of other cases also have been treated successfully. Spontaneous remission is well recognized in the physical urticarias, and it is perhaps advisable to leave a small area of skin untreated. This can be used from time to time as a

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