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Role of Mast Cell and Basophil in Cold Urticaria with Associated Systemic Reactions

Lennart Juhlin, M.D.; Walter B. Shelley, M.D.
JAMA. 1961;177(6):371-377. doi:10.1001/jama.1961.73040320001004.
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THE INCREASING interest in the auto-immune state has refocused the medical view on the patient who is sensitive to cold. This is the individual who reacts to his own tissue upon cooling. A drop in skin temperature, whether it be produced by a breeze, contact with a cool object, or entering an air-conditioned room, may be followed by erythema, pruritus, and even urticaria. Such cold urticaria, because of its obviousness, is a diagnostic hallmark of the cold hypersensitive state, but it is still only one of a galaxy (Table 1)1-4 of signs and symptoms which may occur. Such patients experience frightening dysphagia after ingesting ice water or chilled foods. Moreover, cold showers, a chilling rain, and the winter wind are particular hazards that they soon learn to avoid also. But as Horton, Brown, and Roth 1 pointed up 25 years ago, swimming in cold water poses the ultimate

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