On the other end of the spectrum from Hof are those with a condition known as cold urticaria -- quite literally, an allergy to cold temperatures.
"If you put an ice cube on somebody that has cold urticaria, they're going to have a big welt right where the ice cube was," said Dr. Thomas Casale, chief of allergy and immunology at Creighton University and executive vice president of the American Academy of Allergy, Asthma & Immunology.
Worse, those with the condition can expect to experience similar reactions to bitter winds and cold surfaces. A minor exposure, such as taking a few snowflakes to the face during a blizzard, can result in the formation of itchy, uncomfortable bumps. A major exposure -- such as from diving into a chilly swimming pool -- could theoretically be enough to send the body into a potentially deadly allergic shock.
"There are patients that we've been talking to who have had full-blown vascular collapse and ended up in the emergency room, at death's door," said Dr. Gerald Gleich of the University of Utah, who studies patients who suffer from cold urticaria. "This is a very, very potentially serious problem."
Gleich said that as with other allergies, the hives that occur in those with the condition are brought about by an inappropriate immune response. Specifically, an antibody known as immunoglobulin E is likely to blame, as Gleich's studies have revealed that it is this component of the immune system that is activated when these patients encounter a cold stimulus.
Fortunately, this feature of the condition may also point to possibilities for treatment.
"Many of these patients are taking antihistamines, and some are getting good relief," he said. "We would like to see whether antibodies to immunoglobulin E would block all symptoms in these people. If it does, the FDA [Food and Drug Administration] might be willing to approve it and then we would have a treatment."
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