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Copyright (C) 1986, 1987, 1989 National Organization for Rare Disorders, Inc.

249:
Urticaria, Cholinergic

** IMPORTANT **
It is possible that the main title of this article (Cholinergic
Urticaria) is not the name you expected.  Please check the SYNONYM listing
for alternate names and disorder subdivisions covered by this article.

Synonyms

Information on the following disorders can be found in the Related Disorders
section of this report.

     Physical Urticaria
     Papular Urticaria
     Contact Dermatitis
     Aquagenic Urticaria

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.


Cholinergic Urticaria is a skin disorder caused by sensitivity to heat,
emotional stress, or exercise in susceptible individuals.  It is
characterized by red spots (erythema) resembling hives, itching (pruritus),
and possibly abdominal cramps, diarrhea, faintness, weakness and sweating.

Symptoms

The main symptoms of Cholinergic Urticaria are bright red spots (macules) on
the skin, itching (pruritus), and hives which are usually 2-5 cm in diameter.
Round white ridges form in the center of the macules.  These lesions grow
together into large red areas.  Swelling of eyelids, lips, hands and feet can
occur.  Abdominal cramps, diarrhea, faintness, weakness and sweating may also
be present.

Causes

Cholinergic Urticaria may result from hypersensitivity to heat such as hot
baths, warm rooms and exposure to the sun.  Eating hot foods, physical
exercise, excitement (any stimulation that causes sweating), and possibly
hypersensitivity to acetylcholine, are other causes of Cholinergic Urticaria.

Related Disorders

Physical Urticaria is a condition in which red allergic hives with itching
are produced by exposure to cold temperatures, water or mild trauma.  (For
more information on this disorder, choose "Physical Urticaria" as your search
term in the Rare Disease Database.

Papular Urticaria, more commonly known as "hives", is characterized by
local elevated ridges (wheals) and redness of the skin, with itching, usually
triggered by insect bites, sensitivity to drugs or other environmental
causes.  (For more information on this disorder, choose "Papular Urticaria"
as your search term in the Rare Disease Database.)

Contact Dermatitis is an acute or chronic inflammation of the skin, often
sharply demarcated, produced by substances in contact with the skin to which
a person is allergic.  (For more information on this disorder, choose
"Contact Dermatitis" as your search term in the Rare Disease Database.)

Aquagenic Urticaria is a condition in which red hives with itching are
produced by contact with water.

Therapies:  Standard

The use of drugs or cosmetics should be reviewed with the patient,
particularly if sensitivity to sunlight (photosensitivity) is suspected.
Protection from the cause of the Urticaria is necessary.  When
photosensitivity is present, avoidance of sunlight is important.  The patient
should wear protective clothing such as a hat and a long-sleeved shirt when
outdoors on a sunny day.  Sunscreen preparations may be helpful.  For relief
of itching, an antihistamine may be of benefit.

Hydroxyzine (Atarax) is the preferred drug for Cholinergic urticaria.
Anticholinergic drugs are ineffective at tolerable doses.

Therapies:  Investigational

This disease entry is based upon medical information available through March
1987.  Since NORD's resources are limited, it is not possible to keep every
entry in the Rare Disease Database completely current and accurate.  Please
check with the agencies listed in the Resources section for the most current
information about this disorder.

Resources

For more information on Cholinergic Urticaria, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     (203) 746-6518

     Allergy and Asthma Foundation of America
     1835 K Street, N.W., Suite P-900
     Washington, DC 20006
     (202) 293-2950

     Allergy Information Association
     25 Poynter Dr., Suite 7
     Weston, Ontario, MR9 1K8
     Canada

     NIH/National Institute of Allergy and Infectious Diseases
     9000 Rockville Pike
     Bethesda, MD  20892
     (301) 495-5717

References

CECIL TEXTBOOK OF MEDICINE, 18th ed.:  James B. Wyngaarden, and Lloyd H.
Smith, Jr., Eds.:  W. B. Saunders Co., 1988.  Pp. 1948-51, 2334-5.

THE MERCK MANUAL 15th ed:  R. Berkow, et al:  eds; Merck, Sharp & Dohme
Research Laboratories, 1987.  Pp. 311-2.