Abstract
Summary Two female patients with a rare combination of localized heat urticaria and cold urticaria are described. One patient had localized heat urticaria combined with delayed cold urticaria and the other patient had localized heat urticaria in combination with idiopathic (primary acquired) cold urticaria. Increased histamine concentration was measured in suction blister fluid samples collected immediately after the heal challenge in both patients. Doxepin effectively suppressed the whealing response on the heat challenged skin. These results suggest that histamine is the main mediator in heat urticaria reactions.
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