Localized Cold Urticaria to the Face in a Pediatric Patient: A Case Report and Literature Review

Abstract

We present a curious case of localized cold urticaria restricted to the face in a 10-year-old girl. Testing for the condition using an ice cube was positive only in the facial area. After 2 years, the patient continues to experience localized urticaria only on her face on cold exposure. A review of the available published medical literature on cold urticaria was performed using Ovid and PubMed databases. The literature search was not limited to the English language. Only three other cases of cold urticaria localized to the face were identified. Upon review of the published reports on cold urticaria and discussion of classification and diagnostic testing, we conclude that cold urticaria clearly is a rare and poorly understood entity.

Localized facial cold urticaria

“…However, one patient had cold urticaria only to the face after exposure but failed to respond to the ice pack challenge, and it is unclear whether the ice pack was placed at a site other than the face. 3 Our literature search reveals that LCU can involve all ages, has near equal distribution among the sexes, and has variable symptom duration from 8 months to 30 years. In all 6 cases, the urticaria was localized to an area above the neck.…”

“…2 In the 1980s, subcutaneous immunotherapy was introduced, which provided the advantages of avoiding venous access along with the convenience of home infusions. 3 Because clear advantages and drawbacks exist, clinicians must decide which method of administration would most benefit their patients.…”

“…2006;96:497e500. [3] Haque RA, Wagner A, Whisken JA, Nasser SM, Ewan PW. Anaphylaxis to patent blue V: a case series and proposed diagnostic protocol.…”

Localized cold urticaria: an unusual form of cold urticaria

“…M. Relvas, 1,* J. Silva, 2 F. Alves, 1 A. Matos, 3 Literature on this entity is scarce and long-term follow-up has not been reported. We sought to describe the clinico-epidemiological and histological characteristics and long-term follow-up of a series of patients with SJS/ TEN-like CLE.…”

“…Cold urticaria can be familial or acquired, the latter being further classified into primary or secondary to an underlying cause, such as cryoglobulins, infections or drugs. 3 Diagnosis is based on history and a positive cold stimulation test. However, rare and atypical forms of acquired ColdU, with negative results to the usual stimulation tests, have been reported.…”