This patient was not dermatographic on scratch testing, but the pattern of exacerbation following intercourse or wearing pants was highly suggestive of a physical urticaria
generally occurs as a result of a physical stimulus and the most common form is dermographism.
The duration of CU varies considerably and nearly 20% of patients remain symptomatic 20 years after onset, especially, physical urticaria
tend to persist the longest, often for many years.
Following patients were excluded: patients on oral corticosteroids for past 1 month patients on oral anti-histamines for past 72 hours pregnant and lactating women patients with urticarial vasculitis patients with a history of type I hypersensitivity patients with physical urticaria
other than simple dermographism.
Cold urticaria is a type of physical urticaria
where exposure to cold leads to the formation of wheals.