IGHE and acquired cold urticaria: Acquired cold contact urticaria (ACU) is the second most common subset of chronic inducible urticaria (CIndU), with an estimated annual incidence of 0.05%, a predominance in women, a long duration (4.8–7.9 years), and its management is based on second generation anti-H1 antihistamines (2GA-H1).1, 2, 3 When ACU is refractory to updosed 2GAH1, omalizumab, a monoclonal anti-IgE antibody indicated for the treatment of chronic spontaneous urticaria, is proposed in the 2016 consensus re-commendations for CIndU2 and sometimes successfully used off-label.4