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Cholinergic Urticaria, Treatment for Chronic Cholinergic Urticaria
What is Cholinergic Urticaria?
Cholinergic urticaria is a relatively common disorder of the immune system characterized by an immediate skin reaction to heat, emotional stress, and/or exercise.Cholinergic urticaria occurs in both men and women, but it seems to be more common in men than in women. Cholinergic urticaria is one of the physical urticarias brought on by a physical stimulus. Although the physical stimulus might be considered to be heat, the actual precipitating cause is sweating.
Cholinergic urticaria is the rash caused by sweating results in a distinct red rash consisting of hives that are 2-5 mm in diameter. It occurs after exercise even though sweating due to stress can provoke a attack.
What causes Cholinergic Urticaria ?
Here are the list of common causes ofCholinergic Urticaria
- Allergic or non-allergic; massive histamine release from mast cells in superficial dermis
- Drug reaction (any drug) either from allergy or idiosyncrasy
- Food or food additive allergy
- Inhalant, contact, or ingestant allergy
- Transfusion reaction
- Insect bite, sting
- Physical trauma (heat, cold, sunlight, etc.)
- Emotional stress (reported; little supporting evidence)
Infection - viral upper respiratory infections (especially in children) and infectious mononucleosis, viral hepatitis; bacterial (strep throat, sinusitis, dental abscess, otitis); vaginitis; fungal (tineas); helminthic; protozoan. Helicobacter pylori has been increasingly associated with, and its eradication may stop, chronic urticaria.
Cholinergic Urticaria Treatment:
There is no medical cure for Cholinergic Urticaria. The condition can be controlled with strong medications. Cholinergic Urticaria sometimes gets better on its own and can even disappear completely after a few years.
- UV light has been beneficial in some patients, but one must be circumspect about contraindications to UV light.
- Danazol can be beneficial ostensibly because it elevates antichymotrypsin levels.
- For patients with both cold urticaria and cholinergic urticaria, ketotifen (where available) may be helpful. About 62% of patients experience a reduction in wheals, and 68% of patients report reduced itching. Cardiorespiratory symptoms also reportedly respond to ketotifen.
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