Lyme disease can throw up all kinds of confusing symptoms. This is especially true in its chronic form, which has earned it the nickname “The Great Imitator.” Lyme represents a major challenge for both patients and doctors alike. On the one hand, late-stage Lyme disease has no defined set of symptoms, with most manifestations of the disease being generalized and patient-specific. On the other hand, chronic Lyme is not considered a legitimate disorder by most official medical bodies, meaning that research and studies on the effects of the disease are limited.
Many doctors don’t fully understand the effects of chronic Lyme, and as such, diagnosis is often compromised due to confusing symptoms. One of these disparate symptoms is called cold urticaria, which essentially translates an allergy to the cold. But can Lyme disease cause urticaria?
What is Lyme Disease?
Lyme disease is the name for a prevalent infection in humans transferred via tick bite. The bacteria that causes Lyme is called Borrelia burgdorferi, and it is transferred through the saliva of the tick. The tick species that carry the Borrelia strain are the black-legged or deer tick in the U.S., and the castor bean tick in Europe. They make their habitat in grass and woodlands, attaching onto humans through physical contact only. Ticks cannot run, jump, fly, or hop, nor do they typically infest houses.
Lyme was named after the town of Old Lyme, Connecticut, where it was first discovered in 1975. Since that time, a pervasive myth about Lyme is that it can only be caught in the Northeastern states. However, Lyme cases have been identified in every mainland state in the U.S., and incidence numbers continue to rise. The CDC estimates 300,000 new cases per year.
Symptoms of Acute Vs. Chronic Lyme
Acute Lyme refers to the beginning stages of the disorder, typically the first couple of months. Symptoms at this stage resemble the flu, with fever, headache, fatigue, and general malaise commonly reported. The distinctive symptom of Lyme is a bullseye rash, which forms at the site of the tick bite. However, this often goes unnoticed unless people explicitly realize they’ve been bitten.
Acute Lyme is easily treated by antibiotics, but if the infection is left to develop, the chronic form will eventually emerge. This represents an interplay between infection symptoms and inflammation symptoms and is much harder to treat. The range of symptoms associated with chronic Lyme is far-reaching and intimidating. It all hinges on where exactly the disease has permeated. Joint and muscle pains and fatigue are common complaints thanks to inflammation, while neurological issues, cardiac complications, and gastrointestinal problems are all possible secondary symptoms.
What is Cold Urticaria?
Can Lyme disease cause an allergy to the cold? And what is cold urticaria, exactly? Essentially, it is a chronic, reactive skin disorder and the most common form of physical urticaria, commonly known as hives. In other words, it is a physical reaction to the cold. It may occur after exposure to cold weather, cold water, or anything that lowers body temperature significantly.
The condition comes in two main forms: acquired and hereditary. The former comes on quicker and lasts for a shorter time, while familial urticaria is slower to present but can last longer, up to 48 hours.
Symptoms of Cold Urticaria
The symptoms of cold urticaria are similar to presentations of other skin disorders. The skin will usually turn red, begin to itch, and develop welts on the surface. For some patients, this can be accompanied by fever, fatigue, headache, anxiety, and even fainting. Pain in the joints is also common, while internally the level of white blood cells will increase excessively.
These symptoms may appear as soon as thirty minutes after exposure and can persist for up to two days. The reaction that triggers urticaria begins in the exposure phase, but symptoms usually present during the rewarming phase. It is not truly known what causes cold urticaria in the acquired form, but there is a 50% chance of inheriting the condition from an infected parent.
Can Lyme Disease Cause Cold Urticaria?
The link between Lyme and cold urticaria is not a well-studied one, but a recent study investigated cyclical bouts of urticaria in a patient with disseminated (i.e. chronic or late-term) Lyme disease. This study found that the patient’s widespread urticaria was the initial presentation of the Lyme disease. It underlined that physicians need to be cognizant of atypical presentations of Lyme, as there are other ways it can affect the skin apart from the traditional bullseye rash. It is also worth noting that this patient caught Lyme disease in Florida – far from the historical Lyme danger zone of the Northeast.
So in conclusion, yes, Lyme disease can cause cold urticaria. Although it is a rare presentation of the disease, it gives some insight into the problems Lyme causes doctors in the diagnosis phase. Prevention is often the best form of treatment, and when it comes to Lyme, this point cannot be overstated.
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