Suckage

Things that suck:

1. My wings keep getting stuck on my chair. (This is why fairies and angels don't work in offices.)

2. It's starting to get colder, which means hives! Great long welts and hives and me spending hours in bed, trying not to itch.

3. Coworkers are going to Sushi Republic for lunch. Me, I need to go to Target and get a long-sleeved shirt and candy for three kids.

(no subject)

Cold Urticaria

kmonkey mentioned something about my cold allergy, and for whatever reason it's prompted me to write this post. I have coworkers, family, friends that think it's just something cute and funny. *g* Believe me, it's damn funny to say "I'm allergic to the cold". The reality, though, is annoying as crap. And I don't have the bad kind (where swimming can lead to death - I kid you not).

So here's a basic primer.

What is cold urticaria?

Cold urticaria is a relatively uncommon physical urticaria (hives). There are two forms of cold urticaria, a rare familial (hereditary) form and a more common acquired form. With both forms an urticarial rash develops after being exposed to cold, cold water, and cold objects.

All indications are that mine is acquired. This is my hope, at least. My mother is allergic to the cold, but hers manifests differently. Her fingers turn white at the tips and then she starts breaking out and itching on her legs or hands. But JUST her legs or hands. For me it's total body. My ankles, back of my neck and upper lip are the precursors to a full fledged breakout. They'll start itching some. When it starts getting worse, exposed skin on all of my body (except my arms, usually) will get so itchy that a minor scratching will lead to weals.

Cold urticaria is caused by exposure to cold. Why the cold stimulus causes the activation of mast cells and subsequent release of histamine and other inflammatory mediators remains unknown.

Incidentally, there's also a heat version of this. Basically, the body responds in some really bizarre way that doctors don't understand to a stimulus.

Swimming in cold water is the most common cause of a severe cold urticarial reaction. Because of the potential risk of a severe reaction and subsequent drowning, all patients with cold urticaria should be supervised during aquatic activities.

I tested this one earlier in the summer on a cool night. I'm pleased to say that while I'm still not going to attempt a polar plunge, I do not seem to have a reaction to swimming.

What are the clinical features of cold urticaria?

The onset of rash after exposure to cold differs between the acquired and hereditary forms.

1. In the acquired form, symptoms become obvious in 2-5 minutes after exposure and last for 1-2 hours.
2. In the hereditary form, symptoms may not become obvious until 9 to 48 hours after exposure and may last for up to 24-48 hours.

For me, the symptoms tend to last for a couple of hours, until I've warmed up substantially (by crawling into bed while wearing many layers of clothing). Due to the recovery time, I'm inclined to think mine is acquired and not hereditary, despite my mother's allergy.

Signs and symptoms of cold urticaria include:

1. Itchy weals (urticaria) and angioedema that may be localised (affecting certain parts of the body) or generalised (rash over the whole body).
2. In some cases systemic symptoms may develop
o Shortness of breath, wheezing
o Abdominal pain, gastrointestinal ulcers
o Rapid and irregular heartbeat
3. In very severe cases hypotension (drop in blood pressure), shock, collapse and even death may occur.

Number one is all I've ever had, thankfully. But I'm not going to Alaska in December any time soon.

Acquired cold urticaria most often affects young adults between 18 and 25 years. It is commonly associated with the physical urticarias dermographism and cholinergic urticaria. The condition lasts for an average of 5-6 years.

This was new information I found today, which pleases me muchly. I've had the allergy for a couple of years now (onset was in February of 2006). I'm hoping that it does mean there's an end in sight. (My mother still has the allergy.)

I also have dermographism (also called 'markable skin'). That makes the physical effects of the allergy look really, really nasty. I get large weals anywhere I scratch, but most commonly on the backs of my knees, on my butt and on my back. The butt ones are almost funny.

Cold urticaria is a cold allergy, but it can sound deceiving. It has to do with the body producing histamine when the body temperature drops rapidly (hence getting out of the water after swimming or swimming in cold water causing severe reactions). One case study I found detailed a young woman who developed the allergy when she went off to college. She had grown up in Boston and moved to Florida for college. The theory, though, is that the change in climate was the trigger. My body will eventually even out some (also helped by me dressing warmly all the time and changing into flannel when I get home), but at the start of any season when fronts are moving in, I can have the allergic reaction. When random cold fronts move through in the summer I can break out.

Source 1, Source 2