Cold Urticaria Preventing Clearance For Scientific Diving.

CU is an uncommon but under-reported and under-recognized condition with potentially fatal consequences for swimmers and divers. Although symptom management focuses on antihistamines, corticosteroids and omalizumab (Xolair®) may prove helpful. Nonetheless, the risk of anaphylaxis remains, so CU should be a disqualifying condition for divers. Associated and causative conditions require specialist evaluation, with many patients reporting spontaneous resolution within several years. Hyperbaric physicians should be aware of CU as a disqualifying condition and an etiology of a post-diving rash that could be mistaken for skin manifestations of decompression sickness.