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$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.