Wednesday, June 01, 2005
This 17-year-old high school student presented for evaluation of hives after exposure to cold air or products. This may have followed an upper respiratory infection. It has been present for only about a month.
EXAMINATION: Dermographia is negative. After applying a cold soda can to her arm for two minutes, she developed an urticarial area exactly in the shape of the can five minutes after the can was removed.
IMPRESSION: This is probably the common form of cold urticaria. Some of these cases follow upper respiratory infection. This is idiopathic.
PLAN: She was warned against swimming in very cold water and she was given hydroxyzine to take half an hour before exposure if she knows that she is going to be in a cold environment or be exposed to cold products. I will do a literature search to see what I can come up with for her.