Background: Cold urticaria is caused by a cold environment to the body. Grade 1 cold urticaria is a local area reaction. A localized cold urticaria is uncommon.
Case Report: A 35-year-old male always developed a localized urticaria by a cold environment on the right side of his neck since he was 28 years old. An ice cube test on the affected area of his neck was positive (wheal and flare). The number of eosinophils in the patient and two controls after cold exposure increased in parallel with increasing volume of histamine. When the patient covered his neck with clothing in a cold environment, he did not develop urticaria.
Conclusions: This case is an uncommon finding as it shows grade 1 cold urticaria developing on the same and limited area on cold exposure.

Keywords: Histamine, eosinophil, cold urticaria