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Last updated: September 29, 2025View editorial policy

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Differential Diagnosis for Cold Sensitivity

  • Single most likely diagnosis
    • Raynaud's phenomenon: This condition is characterized by a sudden and temporary narrowing of the arteries, often in response to cold temperatures or stress, leading to discoloration and pain in the fingers and toes. The presence of cold sensitivity is a hallmark symptom.
  • Other Likely diagnoses
    • Cold agglutinin disease: An autoimmune disorder where the body produces antibodies that attack red blood cells at cold temperatures, leading to hemolysis and potentially causing cold sensitivity.
    • Cryoglobulinemia: A condition where abnormal proteins in the blood precipitate out at cold temperatures, potentially causing a range of symptoms including cold sensitivity.
    • Hypothyroidism: Some individuals with hypothyroidism may experience increased sensitivity to cold, among other symptoms like fatigue and weight gain.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Buerger's disease (Thromboangiitis obliterans): A rare disease of the arteries and veins in the arms and legs, which can cause cold sensitivity, pain, and potentially lead to gangrene if not treated promptly.
    • Scleroderma (Systemic sclerosis): An autoimmune disease that affects the skin and connective tissue, potentially causing cold sensitivity due to Raynaud's phenomenon, which is often one of the first symptoms.
    • Acrocyanosis: A condition characterized by persistent blue discoloration of the hands and feet due to poor circulation, which can be exacerbated by cold temperatures.
  • Rare diagnoses
    • Erythromelalgia: A disorder characterized by burning pain, heat, and redness in the hands and feet, which can sometimes be triggered by cold temperatures.
    • Cold-induced urticaria: A rare condition where hives or itchy skin occur in response to cold temperatures.
    • Paroxysmal cold hemoglobinuria: A rare autoimmune disorder that causes the destruction of red blood cells after exposure to cold temperatures, leading to anemia and potentially other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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