S. McDonald, K.-E. Thai
Acquired idiopathic cold urticaria is a form of physical urticaria provoked by cold exposure. Antihistamines represent ﬁ rst line therapy, however, symptom control may be difﬁ cult to achieve. Limited data suggest that danazol may be an effective alternative therapy for cholinergic urticaria but its effectiveness in cold urticaria is unknown. We report a case of a 61-year-old woman with a 2.5-year history of acquired immediate cold urticaria. Despite treatment with high-dose antihistamines, monteleukast, hydroxychloroquine, methotrexate and cyclosporin, she continued to experience debilitating symptoms. Treatment with danazol resulted in marked and rapid improvement in the control of her urticaria. As far as the authors are aware this is the ﬁ rst report of danazol being effective in the treatment of acquired idiopathic cold urticaria.