Results and relevance of critical temperature threshold testing in patients with acquired cold urticaria

Abstract

Background Acquired cold urticaria (ACU) is a physical urticaria characterized by local skin reactions after cold exposure. Objective markers of disease severity and activity would be helpful. Unfortunately, such markers are not yet available, even though stimulation time and temperature thresholds are promising candidates. Objectives We assessed and correlated critical temperature thresholds (CTTs) with disease severity and activity in patients with ACU. Methods CTTs were determined in 45 patients with ACU by TempTest-based cold contact stimulation tests (Emo Systems GmbH, Berlin, Germany), and ACU severity and activity were assessed using Likert scales. Results Patients with ACU exhibited mean +/- SEM CTTs of 17 +/- 6 degrees C (range 4-27 degrees C). These thresholds and their changes correlated with the severity (r = 0.53, P < 0.05) and activity of disease (r = 0.64, P < 0.05), respectively. Conclusions These findings indicate that temperature threshold measurements may be used for assessing disease severity and activity as well as the efficacy of therapeutic measures including novel treatment approaches for cold urticaria.

Management of Childhood Urticaria: Current Knowledge and Practical Recommendations

“…Specific tools have been validated for cold (Peltier element-based provocation device TempTest ® ) and dermographic (calibrated dermographometer) urticaria, which have also been tested on children (3,39,46,47). In dermographic and cold urticaria, extended testing for suspected causes or for differential diagnosis may be considered, according to history (Table II) (3).…”

Temperature Thresholds in Assessment of the Clinical Course of Acquired Cold Contact Urticaria: A Prospective Observational One-year Study

“…With the cold stimulation time threshold (CsTT) we could also evaluate the wheal induced by 4.0°C stimulation at different exposure times. Therefore, in addition to the diagnosis of ACU, assessment of CsTT and CTT is recommended to define the severity of the condition (16,17,19).…”

Acquired cold urticaria: Clinical features, particular phenotypes, and disease course in a tertiary care center cohort

“…1,2,4 In addition, objective methods, such as the TempTest (Emosystems, Berlin, Germany)da Peltier elemente based provocation device used for the evaluation of the critical temperature threshold (CTT) and the cold stimulation time threshold (CsTT)dare helpful for assessing ACU severity and monitoring therapy efficacy. [5][6][7] There is a small percentage of patients that are classified as having atypical ACU; they have identical clinical manifestations but these cannot be reproduced by standard CSTs. Therefore, the diagnosis of atypical ACU relies largely on the patient's clinical history.…”