Pokrzywka z zimna jest typowym schorzeniem dla okresu zimowego, a nieraz występuje także wczesną wiosną i późną jesienią. Zmiany skórne w postaci rozsianych i swędzących pęcherzy pojawiają po zadziałaniu czynnika termicznego – niskiej temperatury otoczenia, powietrza, wody, kontaktu z produktami mrożonymi.
Pokrzywka z zimna może mieć postać nabytą lub rzadziej – wrodzoną. Przyczyną choroby jest nadmierne wydzielanie histaminy przez organizm. Układ immunologiczny odbiera chłód jako działanie wrogie i próbuje się przed nim ochronić poprzez wydzielanie histaminy. Pokrzywka z zimna może być również efektem infekcji wirusowej lub objawem tocznia układowego.
Jak objawia się pokrzywka z zimna?
Swędzące pęcherze mogą pojawiać się w miejscach, które były narażone na niskie temperatury. Zmiany mają kolor bladoróżowy, są lekko wyniosłe ponad skórę i obejmują obrzęk górnej warstwy skóry. Rzadko zmianom towarzyszą objawy uogólnione, np. bóle głowy, omdlenia czy zaburzenia oddychania. W postaci wrodzonej choroby, pacjenci mogą również doświadczać gorączki, bólów stawów czy zwiększenia leukocytów we krwi.
Pęcherze pojawiają się krótko po zadziałaniu czynnika termicznego. Charakteryzują się silnym świądem i mogą utrzymywać się do kilku godzin. Po pewnym czasie znikają i nie pozostawiają po sobie żadnych śladów na skórze.
Objawy pokrzywki z zimna najczęściej ustępują, gdy temperatura na zewnątrz osiąga wyższe wartości. W przypadku większości chorych zmiany pojawiają się jeszcze w marcu lub w kwietniu, jeżeli wiosna jest późna. Pęcherze mogą również powstawać latem, np. w wyniku działania silnego wiatru. W przypadku jedzenia lodów nagłe ochłodzenie może powodować obrzęk warg lub krtani, a w konsekwencji może dojść do śmierci z uduszenia. Latem dużym zagrożeniem dla chorych są również naturalne, niepodgrzane zbiorniki wodne. W przypadku skoku do takiej wody może dojść do uwolnienia w krótkim czasie dużej ilości histaminy, co może doprowadzić do utraty przytomności i utonięcia.
W jaki sposób przebiega leczenie pokrzywki z zimna?
Diagnostyka choroby najczęściej polega na 15 minutowym teście z kostką lodu lub zanurzeniem przedramienia w chłodnej wodzie na 10 minut. Dzięki temu lekarz jest w stanie określić, czy zmiany skórne mają związek z niską temperaturą. Nie zawsze test jest jednak wiarygodny, gdyż u niektórych pacjentów potrzeba ochłodzenia większej części ciała, by doszło do wystąpienia zmian skórnych.
Leczenie schorzenia może być trudne, a w przypadku długo panujących niskich temperatur – wręcz niemożliwe. W praktyce klinicznej stosuje się leki łagodzące objawy, np. antyhistaminowe, czasem w połączeniu z neuroleptykami. W nielicznych przypadkach efekty przynosi terapia naświetleniami PUVA lub leczenie lekiem antyleukotrienowym.
Jak zapobiegać powstawaniu zmian skórnych?
W leczeniu pokrzywki z zimna bardzo ważne jest zapobieganie powstawaniu pęcherzy. Chorzy powinni przede wszystkim unikać kąpieli w zimnej wodzie, ponieważ stwarza to ryzyko ciężkich reakcji ogólnoustrojowych, a także zgonu. Ważne jest również ubieranie odpowiedniej odzieży, która ochroni przed działaniem niskich temperatur.
Innym sposobem jest również systematyczne hartowanie organizmu, co pozwoli mu zaadaptować się do zimnych warunków. Na przykład przed opuszczeniem budynku chory może 2-10 minut przebywać na chłodnej klatce schodowej.
Źródła: alergia.org.pl, mp.pl
Przeczytaj także: Odczyn alergiczny – objawy, rozpoznanie i leczenie
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