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Cholinergic urticaria simulating aquagenic urticaria: A case report with lesions only occurring after contact with hot water
Author(s) -
Zouboulis Christos C.,
Blume Ulrike,
Gollnick Harald,
Orfanos Constantin E.
Publication year - 1995
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.1995.tb00287.x
Subject(s) - medicine , provocation test , cetirizine , dermatology , erythema , discontinuation , hydroxyzine , histamine , anesthesia , surgery , pathology , alternative medicine
A 20‐year‐otd female presented with a 3‐month history of urticaria induced by water. During evaluation she repeatedly developed disseminated, severely itching. 2 to 5 mm large, anemic wheals at the center of indistinctly marginated patches of erythema on the upper part of the body after hot showers, which disappeared within 30 min. This rush was maximally reproducible twice daily. Serum histamine increased from 100 ng/ml to 140 ng/ml 30 min after provocation of the eruption. No lesions occurred after vigorous exertion or cold showers. A cholinergic and not an aquagenic urticaria was diagnosed because (i) the eruption only occurred after hot showers and not after cold showers or exertion to sweating, and (ii) a refractory period was observed. Provocation tests for other types of urticaria were negative. Cetirizine, in an initial dosis of 10 mg/d. followed 1 h later by a hot shower as a hardening regimen, suppressed the urticarial eruption, however, recurrences occurred twice, immediately after discontinuation of the drug.