Abstract
Acquired cold urticaria is a chronic physical urticaria characterized by wheals in response to exposure to cold temperatures. Therapy is dependent on antihistaminics, yet patients with severe symptoms may be unresponsive to doses of second-generation antihistamines, which are typically used to treat allergic rhinitis. One approach that has been used successfully for more than 30 years is to prescribe four to eight tablets of cyproheptadine daily. However, side effects of somnolence and increased appetite can be limiting. Aims
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