|
Dermatographism
| • | may be regarded as an exaggerated triple response of Lewis |
| • | persists approximately 2-3 years before resolving |
| • | vulvodynia has been reported as a manifestation of dermatographism |
| • | = the physical urticaria most responsive to anti-histamines |
cholinergic Urticaria
| • | may be the most common form of physical urticaria |
| • | triggers = heat, exercise, spicy foods (i.e. sweating) |
| • | pathogenesis – appears to be related to acetylcholine liberated from peripheral nerves |
| • | characteristic – minute, punctate (1-3mm) wheals surrounded by erythema |
| • | treatment: avoid triggers and stay cool! |
Cold Urticaria
| • | tx of choice = cyproheptadine (Periactin) |
Solar Urticaria
Delayed Pressure Urticaria
| • | “delayed” 3 to 6 hours after pressure stimulus (vs. vibratory urticaria: minutes) |
| • | pruritic or painful, erythematous, deep swelling |
| • | distribution – palms, soles, buttocks, waist-band, and under shoulder strap |
Adrenergic urticaria
| • | = a form of stress induced urticaria |
| • | develop after coffee, chocolate, or “strong emotions” |
physical urticaria: time after stimulus:
delayed pressure 3 to 6 hours
cold-induced 10 to 15 minutes
solar minutes
aquagenic minutes
|