A Question of Health

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MY SKIN has become very sensitive to cold. If I hold a cold saucepan or take anything out of the freezer my skin appears to swell up and becomes tense. Is there a medical explanation?

You have developed cold urticaria. This is caused by a release of powerful chemicals that make the skin swell and turn red, in reaction to cold. Histamine, the chemical released in hay fever and other allergies, is one of these. A severe attack could be caused by going into a cold swimming- pool, for example, and could even lead to a drop in blood pressure, and fainting. Antihistamines can be used to treat urticaria, but you should take care to avoid contact with cold things, particularly in the winter. Urticaria can also be caused by simple physical pressure on the skin.

ON TWO occasions I

have experienced extraordinarily vivid dreams. I now realise that each time, I had eaten some roasted cashew nuts just before going to bed. Could there be a connection?

I have scoured the medical literature and can find no mention of a link, but that doesn't mean there isn't one. Cashew nuts contain a number of substances closely related to chemical transmitters in the brain. Your dreams may be affected by these. If the dreams are not unpleasant, why not conduct a personal experiment to see whether they occur every time you eat cashews? Vivid dreams don't seem to have come to the attention of medical researchers, but there are many reports of people developing rashes after contact with cashew nuts.

IS THERE a vaccine for pneumonia?

There is a vaccine that provides some protection against infection with the pneumococcus, which is one of the common causes of pneumonia. It is not a perfect vaccine; it acts against only 23 strains of the bacterium, and there are many other strains. But some people are at high risk of getting a pneumococcal infection and for them it is much better than nothing. The high-risk groups are those with sickle cell disease, those who have had their spleens removed, sufferers from chronic heart, lung or kidney disease, and diabetics.

Please write to A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e-mail them to health@independent. co.uk. Dr Kavalier regrets that he cannot respond personally to readers