$Unique_ID{BRK04304} $Pretitle{} $Title{Urticaria, Physical} $Subject{Urticaria, Physical Cold Urticaria Dermographism Dermatographia Autographism Physical Allergy Aquagenic Urticaria } $Volume{} $Log{} Copyright (C) 1986, 1987, 1989, 1992, 1993 National Organization for Rare Disorders, Inc. 250: Urticaria, Physical ** IMPORTANT ** It is possible the main title of the article (Physical Urticaria) is not the name you expected. Please check the SYNONYMS listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Cold Urticaria Dermographism Dermatographia Autographism Physical Allergy 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. Physical urticaria is a condition in which red (erythematous) allergic skin lesions and itching (pruritus) are produced by exposure to cold temperatures, water, or mild trauma. The disorder occurs most commonly in infants. Symptoms The most common symptoms of Physical Urticaria are itching (pruritus) and hives consisting of red rings around white ridges (wheals). Sensitivity to cold is usually manifested by these eruptions on the skin, itching, and swelling under the skin (angioedema). These symptoms develop most typically after exposure to cold is terminated and during or after swimming or bathing. Contraction of the muscles around the bronchi (bronchospasm) and even histamine-mediated shock may occur in extreme cases. If this happens during swimming, drowning may present a danger. Sensitivity to cold can be passively transferred with serum that contains a specific immunoglobulin (IgE) antibody, suggesting an allergic reaction involving a physically altered skin protein as the cause of the allergic reaction. The serum of a few patients with cold-induced symptoms of Physical Urticaria contains cryoglobulins or cryofibrinogen; these abnormal proteins can also be associated with a serious underlying disorder such as a malignancy, a collagen vascular disease, or chronic infection. Cold may aggravate asthma or vasomotor rhinitis, but Cold Urticaria is independent of any other known allergic tendencies. Dermatographia, dermographism or autographism, can be demonstrated by scratching or firmly stroking the skin. Occasionally it is the first sign of an urticarial drug reaction. Physical Urticaria has also occurred following persistent vibration of the skin, and even after exposure to water (aquagenic urticaria). Causes The underlying cause of Physical Urticaria is unknown in most cases. It tends to occur in families, suggesting a possible genetic transmission. Affected Population Cold Urticaria occurs most often in infants, although it sometimes occurs in adults. Related Disorders Cholinergic Urticaria is a condition characterized by red spots on the skin, hives, itching and sometimes abdominal cramps, diarrhea, faintness, weakness and sweating. It is caused by sensitivity to heat, sunlight, exercise, etc. Papular Urticaria, more commonly known as "hives", is characterized by local elevated ridges (wheals) and redness (erythema) of the skin, usually caused by allergic reactions to insect bites , sensitivity to drugs or other environmental causes. Aquagenic Urticaria is an itching condition caused by exposure to water. 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 these disorders, choose "Urticaria" and "Contact Dermatitis" as your search terms in the Rare Disease Database.) Therapies: Standard Protection from the physical cause of the allergy is necessary. Symptoms such as itching and swelling can usually be relieved with an oral antihistamine. Aquagenic Urticaria can be effectively treated with injections of intramuscular Triamcinolone Acetonide, a systemic steroid, that eliminates itching for several months before treatment is again necessary. Therapies: Investigational Clinical trials are underway to study allergic reactions to Aspartame and to describe their reactions. Interested persons may wish to contact: Dr. Andrew Saxon UCLA School of Medicine 10833 LeConte Ave., Rm. 52-175 Los Angeles, CA 825-3718 (213) 825-3718 to see if further patients are needed for this research. This disease entry is based upon medical information available through June 1993. 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 Physical 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, D.C. 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) 496-5717 References THE MERCK MANUAL 15th ed: R. Berkow, et al: eds; Merck, Sharp & Dohme Research Laboratories, 1987. P. 311. 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.