Temperature Threshold of a Case of Cold Contact Urticaria Evaluated with TempTest^®

Abstract

　A 19-year-old woman was referred to our hospital because of the development of itchy wheals and flare upon exposure to coldness for 10 years. She had been treated with several antihistamines, but none were effective. We diagnosed her symptoms as cold contact urticaria with a positive ice cube test and her disease history. We treated her with medications classified as supplementary medications, including an antileukotrien and cyclosporine, which is classified as an experimental medication, in addition to various antihistamines. However, none of them brought her substantial improvement of the symptoms beyond seasonal fluctuations. In order to make objective evaluations of her disease severity and the effects of treatments, we measured her critical temperature threshold under treatments with different medications using TempTest^® 4.0, an electronic device designed for monitoring thresholds to induce symptoms of cold contact urticaria. Both wheals and flare with itching were induced when she stopped all medications, whereas only flare with clear margins and no wheals were seen when she took any antihistamine. Thus, the effectiveness of the treatment was successively visualized by this device, resulting in better satisfaction with and adherence to medication by the patient.