Publications

Cold urticaria is a skin condition character- ized by rapid appearance of itchy wheals and occasionally angioedema in response to cold stimulation. Antihistamines do not suf- ficiently protect all patients from symptoms, even when used in higher than standard doses. In these patients, desensitization to cold can be beneficial. The aim was to inves- tigate whether desensitization can lower temperature thresholds and reduce release of histamine in the skin. Cold urticaria pa- tients were subjected to desensitization and assessed for skin responses to cold stimula- tion and codeine before and after. Histamine levels mediated by cold and codeine were determined by cutaneous microdialysis be- fore and after desensitization in patients and healthy controls. Desensitization to cold resulted in protection from cold-induced symptoms and lower temperature thresh- olds in six out of nine patients. Desensitiza- tion also prevented histamine release after skin exposure to cold. Surprisingly, skin his- tamine levels and release after codeine in- jection were found to be normal in desensi- tized patients.