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CURRENT Medical Diagnosis & Treatment 2013
Chapter 37. Disorders Related to Environmental Factors
Sections: Cold & Heat, Disorders due to Heat, Thermal Burns, Electrical Injury, Radiation Exposure, Near Drowning, Environmental Disorders Related to Altitude, Dysbarism & Decompression Sickness, High-Altitude Illness, Safety of Air Travel & Selection of Patients for Air Travel.
Topics Discussed: disorders of environmental origin; environmental exposure.
Excerpt:"The human body maintains a steady temperature through the balance of internal heat production and environmental heat loss. Heat exchange between the body and environment occurs via four common processes: radiation, evaporation, conduction, and convection. In extreme temperatures, the body’s thermoregulation may fail. This results in the body’s internal temperature moving toward the temperature of the external environment. Cold urticaria is a hypersensitivity to cold exposure (ie, wind,
freezer compartments, water) resulting in histamine release. The hypersensitivity
usually presents as localized redness, burning, pruritus, and urticaria in
the exposed areas, or the response may progress to generalized systemic
reaction, shock, and death. This condition may be familial or acquired.
Familial cold urticaria is an autosomal dominant inflammatory disorder
(including the Muckle-Wells syndrome), manifested as a burning sensation of
the skin occurring about 30 minutes after exposure to cold. Acquired
cold urticaria may be associated with medication (ie, griseofulvin)
or with infection. Cold urticaria may occur secondarily to cryoglobulinemia
or as a complication of syphilis. Most cases of acquired cold urticaria
are idiopathic. For diagnosis, an ice cube..."
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