Q: My son has a nut allergy and recently turned blotchy and puffy after we administered ice to his leg after a soccer injury. We’re sure he did not have any contact with nuts. I’ve heard cold urticaria-can this be it?
A: Tricky question, and it depends on what the rash looked like. Urticaria (hives) and swelling does usually signify an allergic reaction to something, but there is no way to say for sure what the reaction was to in this case. You can get urticaria triggered by cold (or heat), so this is possible and can be tested for. I would suggest the next time you see your allergist you ask them to do a supervised cold provocation test (brief exposure to an ice cube) to see if any hives are formed. (Your son will need to be off antihistamines for a few days prior to testing as these can interfere with the formation of hives.) In the meantime, you could avoid icing any injuries and just go with rest, elevation, compression and anti-inflammatories if required.
For more advice from Dr. Friedman, be sure to check out these questions:
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