Cold urticaria: case series and literature review
Keywords:
Urticaria, angioedema, anaphylaxis, histamine antagonists, cryoglobulinemia, cold temperatura
Abstract
Cold urticaria is one of the five most common causes of chronic urticaria and is grouped as a physical urticaria. It can occur after exposure to cold, either through solid objects, air or liquids. Patients may have symptoms of urticaria, angioedema, respiratory distress and even anaphilaxis when the skin is exposed to a cold environment, such as handling refrigerated objects, swimming in cold water or entering an air-conditioned room. Five cases of cold urticaria are presented, followed by a brief literature review.Downloads
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References
1. Siebenhaar F, Staubach P, Metz M, Magerl M, Jung J, Maurer M. Peltier effect-based temperature challenge: An improved method for diagnosing cold urticaria. J Allergy Clin Immunol. 2004;114:1224-5.
2. Kontou-Fili K, Borici-Mazi R, Kapp A, Matjevic LJ, Mitchel FB. Physical urticaria: Classification and diagnostic guidelines. Allergy. 1997;52:504-13.
3. Siebenhaar F, Weller K, Mlynek A, Magerl M, Altrichter S, Vieira Dos Santos R, et al. Acquired cold urticaria: Clinical picture and update on diagnosis and treatment. Clin Exp Dermatol. 2007;32:241-5.
4. Moller A, Henning M, Zuberbier T, Czarnetzki-Henz BM. Epidemiology and clinical aspects of cold urticaria. Hautarzt. 1996;47:510-4.
5. Zuberbier T, Bindslev-Jensen C, Canonica W, Grattan CE, Greaves MW, Henz BM, et al. EAACI/GA2LEN/EDF guideline: Definition, classification and diagnosis of urticaria. Allergy. 2006;61:316-20.
6. Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: The autologous serum skin test in urticaria. Allergy. 2009;64:1256-68.
7. Wanderer AA GK, Wasserman SI, Farr RS. Clinical characteristics of cold-induced systemic reactions in acquired cold urticaria syndromes: Recommendations for prevention of this complication and a proposal for a diagnostic classification of cold urticaria. J Allergy Clin Immunol. 1986;78:417.
8. Wanderer AA. Cold urticaria syndromes: Historical background, diagnostic classification, clinical and laboratory characteristics, pathogenesis, and management. J Allergy Clin Immunol. 1990;85:965-81.
9. Visitsuntorn N, Tuchinda M, Arunyanark N, Kerdsomnuk S. Ice cube test in children with cold urticaria. Asian Pac J Allergy Immunol. 1992;10:111-5.
10. Siebenhaar F, Staubach P, Metz M, Magerl M, Jung J, Maurer M. Peltier effect-based temperature challenge: An improved method for diagnosing cold urticaria. J Allergy Clin Immunol. 2004;114:1224-5.
11. Casale TB, Sampson HA, Hanifin J, Kaplan AP, Kulczycki A, Lawrence ID, et al. Guide to physical urticarias. J Allergy Clin Immunol. 1988;82:758-63.
12. Fernando SL. Cold-induced anaphylaxis. J Pediatr. 2009;154:148.
13. Alangari AA, Twarog FJ, Shih MC, Schneider LC. Clinical features and anaphylaxis in children with cold urticaria. Pediatrics. 2004;113:e313-7.
14. Wanderer AA, Hoffman HM. The spectrum of acquired and familial cold-induced urticaria/urticaria-like syndromes. Immunol Allergy Clin North Am. 2004;24:259-86.
15. Kivity S, Schwartz Y, Wolf R, Topilsky M. Systemic cold-induced urticaria -clinical and laboratory characterization. J Allergy Clin Immunol. 1990;85:52-4.
16. Wanderer AA. Systemic cold urticaria (atypical acquired cold urticaria). J Allergy Clin Immunol. 1991;87:137-8.
17. Miller SD, Pritchard D, Crowley JP. Blood histamine levels following graded cold challenge in atypical acquired cold urticaria. Ann Allergy. 1992;68:27-9.
18. Kaplan AP. Unusual cold-induced disorders: Cold-dependent dermatographism and systemic cold urticaria. J Allergy Clin Immunol. 1984;73:453-6.
19. Kaplan AP, Garofalo J. Identification of a new physically induced urticaria: Cold-induced cholinergic urticaria. J Allergy Clin Immunol. 1981;68:438-41.
20. Back O, Larsen A. Delayed cold urticaria. Acta Derm Venereol. 1978;58:369-71.
21. Ting S, Mansfield LE. Localized cold-reflex urticaria. J Allergy Clin Immunol. 1985;75:421.
22. Czarnetzki BM, Frosch PJ, Sprekeler R. Localized cold reflex urticaria. Br J Dermatol. 1981;104:83-7.
23. Doeglas HM, Rijnten WJ, Schroder FP, Schirm J. Cold urticaria and virus infections: A clinical and serological study in 39 patients. Br J Dermatol. 1986;114:311-8.
24. Morais-Almeida M, Marinho S, Gaspar A, Arede C, Loureiro V, Rosado-Pinto J. Cold urticaria and infectious mononucleosis in children. Allergol Immunopathol (Madrid). 2004;32:368-71.
25. Lin RY, Schwartz RA. Cold urticaria and HIV infection. Br J Dermatol. 1993;129:465-7.
26. Miralles JC, Lopez FR, Sanchez-Gascon F, López C, Negro JM. Cold urticaria associated with acute serologic toxoplasmosis. Allergol Immunopathol (Madr). 2005;33:172-4.
27. Kranke B, Mayr-Kanhauser S, Aberer W. Helicobacter pylori in acquired cold urticaria. Contact Dermatitis. 2001;44:57-8.
28. Barranco P, Lopez C. Cold urticaria associated with serologic markers of hepatitis B and cryoglobulinemia. Allergol Immunopathol (Madr). 1987;15:167-9.
29. Ito A, Kazama T, Ito K, Ito M. Purpura with cold urticaria in a patient with hepatitis C virus infection-associated mixed cryoglobulinemia type III: Successful treatment with interferon-beta. J Dermatol. 2003;30:321-5.
30. Nuutinen P HI, Ackermann L. Histamine, but not leukotriene C4, is an essential mediator in cold urticaria wheals. Acta Derm Venereol. 2007;87:9-13.
31. Samsoe-Jensen T. Cold urticaria; report of a case: Passive transfer and in vitro experiments with skin cells. Acta Derm Venereol. 1955;35:107-10.
32. Sherman WB, Seebohm PM. Passive transfer of cold urticaria. J Allergy. 1950;21:414-24.
33. Wanderer AA, Maselli R, Ellis EF, Ishizaka K. Immunologic characterization of serum factors responsible for cold urticaria. J Allergy Clin Immunol. 1971;48:13-22.
34. Inoue S, Teshima H, Ago Y, Nagata S. Cold urticaria associated with immunoglobulin M serum factor. J Allergy Clin Immunol. 1980;66:299-304.
35. Newton HJ, Ang DK, van Driel IR, Hartland EL. Molecular pathogenesis of infections caused by Legionella pneumophila. Clin Microbiol Rev. 2010;23:274-98.
36. Honeyman MC, Stone NL, Falk BA, Nepom G, Harrison LC. Evidence for molecular mimicry between human T cell epitopes in rotavirus and pancreatic islet autoantigens. J Immunol. 2010;184:2204-10.
37. Arias-Santiago SA, Almazan-Fernández FM, Burkhardt-Pérez P, Naranjo-Sintes R. Cold urticaria associated with Epstein-Barr virus mononucleosis. Actas Dermosifiliogr. 2009;100:435-6.
38. Mathelier-Fusade P, Leynadier F. Acquired cold urticaria after jellyfish sting. Contact Dermatitis. 1993;29:273.
39. Capulong MC, Tomikawa M, Tahara K, Akasawa A, Iikura Y. Cold stimulation test and histamine release in primary acquired cold urticaria. Int Arch Allergy Immunol. 1997;114:400-3.
40. Sabroe RA, Fiebiger E, Francis DM, Maurer D, Seed PT, Grattan CE, et al. Classification of anti-FcepsilonRI and anti-IgE autoantibodies in chronic idiopathic urticaria and correlation with disease severity. J Allergy Clin Immunol. 2002;110:492-9.
41. Wasserman SI, Soter NA, Center DM, Austen KF. Cold urticaria. Recognition and characterization of a neutrophil chemotactic factor which appears in serum during experimental cold challenge. J Clin Invest. 1977;60: 189-96.
42. Grandel KE, Farr RS, Wanderer AA, Eisenstadt TC, Wasserman SI. Association of platelet-activating factor with primary acquired cold urticaria. N Engl J Med. 1985;313:405-9.
43. Rosenkranz AR, Wekkeli M, Hippmann G, Benda H, Jarisch R, Gotz M. Cold urticaria as a model of mediator release: Platelet factor 4, eosinophil cationic protein and histamine. Allergy. 1992;47:366-70.
44. Asero R, Tedeschi A, Lorini M. Histamine release in idiopathic cold urticaria. Allergy. 2002;57:1211-2.
45. Husz S, Tóth-Kása I, Kiss M, Dobozy A. Treatment of cold urticaria. Int J Dermatol. 1994;33:210-3.
46. Wanderer AA, St Pierre JP, Ellis EF. Primary acquired cold urticaria. Double-blind comparative study of treatment with cyproheptadine, chlorpheniramine, and placebo. Arch Dermatol. 1977;113:1375-7.
47. Bonadonna P, Lombardi C, Senna G, Canonica GW, Passalacqua G. Treatment of acquired cold urticaria with cetirizine and zafirlukast in combination. J Am Acad Dermatol. 2003;49:714-6.
48. Dubertret L, Pecquet C, Murrieta-Aguttes M, Leynadier F. Mizolastine in primary acquired cold urticaria. J Am Acad Dermatol. 2003;48:578-83.
49. Juhlin L. Inhibition of cold urticaria by desloratadine. J Dermatolog Treat. 2004;15:51-9.
50. Siebenhaar F, Degener F, Zuberbier T, Martus P, Maurer M. High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. J Allergy Clin Immunol. 2009;123:672-9.
51. Magerl M, Schmolke J, Siebenhaar F, Zuberbier T, Metz M, Maurer M. Acquired cold urticaria symptoms can be safely prevented by ebastine. Allergy. 2007;62:1465-8.
52. Visitsunthorn N, Tuchinda M, Vichyanond P. Cold urticaria in Thai children: Comparison between cyproheptadine and ketotifen in the treatment. Asian Pac J Allergy Immunol. 1995;13:29-35.
53. Villas F, Contreras FJ, López JM, López MC, Martínez F. A comparison of new nonsedating and classical antihistamines in the treatment of primary acquired cold urticaria (ACU). J Investig Allergol Clin Immunol. 1992;2:258-62.
54. Magerl M, Borzova E, Gimenez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias--EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy. 2009;64:1715-21.
55. Metz M, Scholz E, Ferrán M, Izquierdo I, Giménez-Arnau A, Maurer M. Rupatadine and its effects on symptom control, stimulation time, and temperature thresholds in patients with acquired cold urticaria. Ann Allergy Asthma Immunol. 2010;104:86-92.
56. Di Leo E, Nettis E, Cassano N, Foti C, Delle Donne P, Vena GA, et al. Treatment of acquired cold urticaria with rupatadine. Allergy. 2009;64:1387-8.
57. Neittaanmaki H, Myohanen T, Fraki JE. Comparison of cinnarizine, cyproheptadine, doxepin, and hydroxyzine in treatment of idiopathic cold urticaria: Usefulness of doxepin. J Am Acad Dermatol. 1984;11:483-9.
58. Neittaanmaki H, Fraki JE. Combination of localized heat urticaria and cold urticaria. Release of histamine in suction blisters and successful treatment of heat urticaria with doxepin. Clin Exp Dermatol. 1988;13:87-91.
59. Boyce JA. Successful treatment of cold-induced urticaria/anaphylaxis with anti-IgE. J Allergy Clin Immunol. 2006;117:1415-8.
60. Black AK, Keahey TM, Eady RA, Greaves MW. Dissociation of histamine release and clinical improvement following treatment of acquired cold urticaria by prednisone. Br J Clin Pharmacol. 1981;12:327-31.
61. Toth-Kasa I, Jancso G, Obal F Jr, Husz S, Simon N. Involvement of sensory nerve endings in cold and heat urticaria. J Invest Dermatol. 1983;80:34-6.
2. Kontou-Fili K, Borici-Mazi R, Kapp A, Matjevic LJ, Mitchel FB. Physical urticaria: Classification and diagnostic guidelines. Allergy. 1997;52:504-13.
3. Siebenhaar F, Weller K, Mlynek A, Magerl M, Altrichter S, Vieira Dos Santos R, et al. Acquired cold urticaria: Clinical picture and update on diagnosis and treatment. Clin Exp Dermatol. 2007;32:241-5.
4. Moller A, Henning M, Zuberbier T, Czarnetzki-Henz BM. Epidemiology and clinical aspects of cold urticaria. Hautarzt. 1996;47:510-4.
5. Zuberbier T, Bindslev-Jensen C, Canonica W, Grattan CE, Greaves MW, Henz BM, et al. EAACI/GA2LEN/EDF guideline: Definition, classification and diagnosis of urticaria. Allergy. 2006;61:316-20.
6. Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: The autologous serum skin test in urticaria. Allergy. 2009;64:1256-68.
7. Wanderer AA GK, Wasserman SI, Farr RS. Clinical characteristics of cold-induced systemic reactions in acquired cold urticaria syndromes: Recommendations for prevention of this complication and a proposal for a diagnostic classification of cold urticaria. J Allergy Clin Immunol. 1986;78:417.
8. Wanderer AA. Cold urticaria syndromes: Historical background, diagnostic classification, clinical and laboratory characteristics, pathogenesis, and management. J Allergy Clin Immunol. 1990;85:965-81.
9. Visitsuntorn N, Tuchinda M, Arunyanark N, Kerdsomnuk S. Ice cube test in children with cold urticaria. Asian Pac J Allergy Immunol. 1992;10:111-5.
10. Siebenhaar F, Staubach P, Metz M, Magerl M, Jung J, Maurer M. Peltier effect-based temperature challenge: An improved method for diagnosing cold urticaria. J Allergy Clin Immunol. 2004;114:1224-5.
11. Casale TB, Sampson HA, Hanifin J, Kaplan AP, Kulczycki A, Lawrence ID, et al. Guide to physical urticarias. J Allergy Clin Immunol. 1988;82:758-63.
12. Fernando SL. Cold-induced anaphylaxis. J Pediatr. 2009;154:148.
13. Alangari AA, Twarog FJ, Shih MC, Schneider LC. Clinical features and anaphylaxis in children with cold urticaria. Pediatrics. 2004;113:e313-7.
14. Wanderer AA, Hoffman HM. The spectrum of acquired and familial cold-induced urticaria/urticaria-like syndromes. Immunol Allergy Clin North Am. 2004;24:259-86.
15. Kivity S, Schwartz Y, Wolf R, Topilsky M. Systemic cold-induced urticaria -clinical and laboratory characterization. J Allergy Clin Immunol. 1990;85:52-4.
16. Wanderer AA. Systemic cold urticaria (atypical acquired cold urticaria). J Allergy Clin Immunol. 1991;87:137-8.
17. Miller SD, Pritchard D, Crowley JP. Blood histamine levels following graded cold challenge in atypical acquired cold urticaria. Ann Allergy. 1992;68:27-9.
18. Kaplan AP. Unusual cold-induced disorders: Cold-dependent dermatographism and systemic cold urticaria. J Allergy Clin Immunol. 1984;73:453-6.
19. Kaplan AP, Garofalo J. Identification of a new physically induced urticaria: Cold-induced cholinergic urticaria. J Allergy Clin Immunol. 1981;68:438-41.
20. Back O, Larsen A. Delayed cold urticaria. Acta Derm Venereol. 1978;58:369-71.
21. Ting S, Mansfield LE. Localized cold-reflex urticaria. J Allergy Clin Immunol. 1985;75:421.
22. Czarnetzki BM, Frosch PJ, Sprekeler R. Localized cold reflex urticaria. Br J Dermatol. 1981;104:83-7.
23. Doeglas HM, Rijnten WJ, Schroder FP, Schirm J. Cold urticaria and virus infections: A clinical and serological study in 39 patients. Br J Dermatol. 1986;114:311-8.
24. Morais-Almeida M, Marinho S, Gaspar A, Arede C, Loureiro V, Rosado-Pinto J. Cold urticaria and infectious mononucleosis in children. Allergol Immunopathol (Madrid). 2004;32:368-71.
25. Lin RY, Schwartz RA. Cold urticaria and HIV infection. Br J Dermatol. 1993;129:465-7.
26. Miralles JC, Lopez FR, Sanchez-Gascon F, López C, Negro JM. Cold urticaria associated with acute serologic toxoplasmosis. Allergol Immunopathol (Madr). 2005;33:172-4.
27. Kranke B, Mayr-Kanhauser S, Aberer W. Helicobacter pylori in acquired cold urticaria. Contact Dermatitis. 2001;44:57-8.
28. Barranco P, Lopez C. Cold urticaria associated with serologic markers of hepatitis B and cryoglobulinemia. Allergol Immunopathol (Madr). 1987;15:167-9.
29. Ito A, Kazama T, Ito K, Ito M. Purpura with cold urticaria in a patient with hepatitis C virus infection-associated mixed cryoglobulinemia type III: Successful treatment with interferon-beta. J Dermatol. 2003;30:321-5.
30. Nuutinen P HI, Ackermann L. Histamine, but not leukotriene C4, is an essential mediator in cold urticaria wheals. Acta Derm Venereol. 2007;87:9-13.
31. Samsoe-Jensen T. Cold urticaria; report of a case: Passive transfer and in vitro experiments with skin cells. Acta Derm Venereol. 1955;35:107-10.
32. Sherman WB, Seebohm PM. Passive transfer of cold urticaria. J Allergy. 1950;21:414-24.
33. Wanderer AA, Maselli R, Ellis EF, Ishizaka K. Immunologic characterization of serum factors responsible for cold urticaria. J Allergy Clin Immunol. 1971;48:13-22.
34. Inoue S, Teshima H, Ago Y, Nagata S. Cold urticaria associated with immunoglobulin M serum factor. J Allergy Clin Immunol. 1980;66:299-304.
35. Newton HJ, Ang DK, van Driel IR, Hartland EL. Molecular pathogenesis of infections caused by Legionella pneumophila. Clin Microbiol Rev. 2010;23:274-98.
36. Honeyman MC, Stone NL, Falk BA, Nepom G, Harrison LC. Evidence for molecular mimicry between human T cell epitopes in rotavirus and pancreatic islet autoantigens. J Immunol. 2010;184:2204-10.
37. Arias-Santiago SA, Almazan-Fernández FM, Burkhardt-Pérez P, Naranjo-Sintes R. Cold urticaria associated with Epstein-Barr virus mononucleosis. Actas Dermosifiliogr. 2009;100:435-6.
38. Mathelier-Fusade P, Leynadier F. Acquired cold urticaria after jellyfish sting. Contact Dermatitis. 1993;29:273.
39. Capulong MC, Tomikawa M, Tahara K, Akasawa A, Iikura Y. Cold stimulation test and histamine release in primary acquired cold urticaria. Int Arch Allergy Immunol. 1997;114:400-3.
40. Sabroe RA, Fiebiger E, Francis DM, Maurer D, Seed PT, Grattan CE, et al. Classification of anti-FcepsilonRI and anti-IgE autoantibodies in chronic idiopathic urticaria and correlation with disease severity. J Allergy Clin Immunol. 2002;110:492-9.
41. Wasserman SI, Soter NA, Center DM, Austen KF. Cold urticaria. Recognition and characterization of a neutrophil chemotactic factor which appears in serum during experimental cold challenge. J Clin Invest. 1977;60: 189-96.
42. Grandel KE, Farr RS, Wanderer AA, Eisenstadt TC, Wasserman SI. Association of platelet-activating factor with primary acquired cold urticaria. N Engl J Med. 1985;313:405-9.
43. Rosenkranz AR, Wekkeli M, Hippmann G, Benda H, Jarisch R, Gotz M. Cold urticaria as a model of mediator release: Platelet factor 4, eosinophil cationic protein and histamine. Allergy. 1992;47:366-70.
44. Asero R, Tedeschi A, Lorini M. Histamine release in idiopathic cold urticaria. Allergy. 2002;57:1211-2.
45. Husz S, Tóth-Kása I, Kiss M, Dobozy A. Treatment of cold urticaria. Int J Dermatol. 1994;33:210-3.
46. Wanderer AA, St Pierre JP, Ellis EF. Primary acquired cold urticaria. Double-blind comparative study of treatment with cyproheptadine, chlorpheniramine, and placebo. Arch Dermatol. 1977;113:1375-7.
47. Bonadonna P, Lombardi C, Senna G, Canonica GW, Passalacqua G. Treatment of acquired cold urticaria with cetirizine and zafirlukast in combination. J Am Acad Dermatol. 2003;49:714-6.
48. Dubertret L, Pecquet C, Murrieta-Aguttes M, Leynadier F. Mizolastine in primary acquired cold urticaria. J Am Acad Dermatol. 2003;48:578-83.
49. Juhlin L. Inhibition of cold urticaria by desloratadine. J Dermatolog Treat. 2004;15:51-9.
50. Siebenhaar F, Degener F, Zuberbier T, Martus P, Maurer M. High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. J Allergy Clin Immunol. 2009;123:672-9.
51. Magerl M, Schmolke J, Siebenhaar F, Zuberbier T, Metz M, Maurer M. Acquired cold urticaria symptoms can be safely prevented by ebastine. Allergy. 2007;62:1465-8.
52. Visitsunthorn N, Tuchinda M, Vichyanond P. Cold urticaria in Thai children: Comparison between cyproheptadine and ketotifen in the treatment. Asian Pac J Allergy Immunol. 1995;13:29-35.
53. Villas F, Contreras FJ, López JM, López MC, Martínez F. A comparison of new nonsedating and classical antihistamines in the treatment of primary acquired cold urticaria (ACU). J Investig Allergol Clin Immunol. 1992;2:258-62.
54. Magerl M, Borzova E, Gimenez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias--EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy. 2009;64:1715-21.
55. Metz M, Scholz E, Ferrán M, Izquierdo I, Giménez-Arnau A, Maurer M. Rupatadine and its effects on symptom control, stimulation time, and temperature thresholds in patients with acquired cold urticaria. Ann Allergy Asthma Immunol. 2010;104:86-92.
56. Di Leo E, Nettis E, Cassano N, Foti C, Delle Donne P, Vena GA, et al. Treatment of acquired cold urticaria with rupatadine. Allergy. 2009;64:1387-8.
57. Neittaanmaki H, Myohanen T, Fraki JE. Comparison of cinnarizine, cyproheptadine, doxepin, and hydroxyzine in treatment of idiopathic cold urticaria: Usefulness of doxepin. J Am Acad Dermatol. 1984;11:483-9.
58. Neittaanmaki H, Fraki JE. Combination of localized heat urticaria and cold urticaria. Release of histamine in suction blisters and successful treatment of heat urticaria with doxepin. Clin Exp Dermatol. 1988;13:87-91.
59. Boyce JA. Successful treatment of cold-induced urticaria/anaphylaxis with anti-IgE. J Allergy Clin Immunol. 2006;117:1415-8.
60. Black AK, Keahey TM, Eady RA, Greaves MW. Dissociation of histamine release and clinical improvement following treatment of acquired cold urticaria by prednisone. Br J Clin Pharmacol. 1981;12:327-31.
61. Toth-Kasa I, Jancso G, Obal F Jr, Husz S, Simon N. Involvement of sensory nerve endings in cold and heat urticaria. J Invest Dermatol. 1983;80:34-6.
How to Cite
1.
Sánchez JM, Ramírez RH, Tamayo LM, Chinchilla CF, Cardona R. Cold urticaria: case series and literature review. biomedica [Internet]. 2011 Mar. 7 [cited 2024 Jul. 3];31(2):168-77. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/298
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