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Angioedema is described throughout the internet and medical research as an allergic response with a rapid swelling just below the surface level of the skin and tissues of the nose, mouth and digestive/pulmonary tracts. Angioedema mostly affects the face, airway, hands and feet.  However, Angioedema can occur anywhere on the body and areas exposed to cold internally.

Where the swelling obstructs the airway leading to breathing issues, Epinephrine treatment and followup with a physician is recommended.  In the case of hereditary angioedema, treatment with epinephrine has not been shown to be helpful.

In areas where swelling is minimal, the urticarial looking reaction has not itching.  This is because there are no nerve endings in the deep layers of tissues where the reaction occurs.  Another differentiation from urticaria is that once the lesions resolve, usually within 24 hours, a watermark effect is left behind.  This is soft tissue scarring below the surface of the skin.  The scarring can last from 24 to 48 hours.  Once cleared up no lasting effects remain.

Angioedema can also occur in the digestive tract.  This is seen following consumption of cold drinks or food which lead to nausea, vomiting and/or diarrhea within an hour or two of consumption.

Link to external website for further research:
https://rarediseases.org/rare-diseases/urticaria-cholinergic/
https://en.wikipedia.org/wiki/Angioedema
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/allergy/urticaria-and-angioedema/Default.htm
http://medical-dictionary.thefreedictionary.com/cold+urticaria-angioedema
http://www.sciencedirect.com/science/article/pii/073567579390058J
http://www.dermnetnz.org/reactions/angioedema.html
http://www.turner-white.com/pdf/hp_jul02_urticaria.pdf

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Nuggets of Wisdom

Yes, there is such a thing as having an allergic type reaction to temperatures. This is defined as a physical urticaria. Other physical urticarias include Solar, Aquagenic, Pressure, Vibration and Exercise.

Most reactions are pseudo-allergic. By definition, an allergy involves inhaling or consuming an allergen. Physical urticarias have no known allergen. Despite the terminology and medical definitions, systemic reactions can be life threatening.

Cold has an arbitrary definition based on an individual feeling. For a person with a cold urticaria, cold can be defined as any temperature cooler than their own body temperature.

You do not have to be cold to have a reaction to the cold; contact with cold can trigger a reaction.

You can have an allergic type reaction to both cold and heat simultaneously.

Most reactions considered anaphylactic are really anaphylactoid by definition.

Moving to a warmer climate as a treatment for Cold Urticaria is a myth. Warmer climates present their own issues for those with Cold Urticaria.

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