Dermatographic urticaria Classification and external resources
Dermatographic urticaria is sometimes called "skin writing".
ICD-10 L50.3 ICD-9 708.3 OMIM 125635 DiseasesDB 12736 eMedicine derm/446
Dermatographic urticaria (also known as dermographism, dermatographism or "skin writing") is a skin disorder seen in 4–5% of the population and is one of the most common types of urticaria, in which the skin becomes raised and inflamed when stroked, scratched, rubbed, and sometimes even slapped.
The symptoms are thought to be caused by mast cells in the surface of the skin releasing histamines without the presence of antigens, due to the presence of a weak membrane surrounding the mast cells. The histamines released cause the skin to swell in the affected areas.
This weak membrane easily and rapidly breaks down under physical pressure causing an allergic-like reaction, in general a red wheal (welt) to appear on the skin. It can often be confused with an allergic reaction to the object causing a scratch, when in fact it is the act of being scratched that causes a wheal to appear. These wheals are a subset of urticaria (hives) that appear within minutes, accompanied by a sensation of burning, and itchiness. The first outbreak of urticaria can lead to others on body parts not directly stimulated, scraped, or scratched. In a normal case, the swelling will reduce itself with no treatment within 15–30 minutes, but, in extreme cases, itchy red weals may last anywhere from a few hours to days.
It has been reported that one artist with dermatographism, Ariana Page Russell, uses her skin as her artistic medium.
The underlying cause of dermographism is not known, and can last for many years without relief. Ninety-five percent of chronic cases are never solved. Sometimes the condition goes away, sometimes it stays forever. It is not a life-threatening disease and is not contagious (transferable to other persons).
Symptoms can be induced by stress, tight or abrasive clothing, watches, glasses, heat, cold, or anything that causes stress to the skin or the patient. In many cases, it is merely a minor annoyance, but in some rare cases symptoms are severe enough to impact a patient's life.
Dermographism can be treated by antihistamines, which prevent histamine from causing the reaction. These may need to be given as a combination of H1 antagonists, or possibly with an H2-receptor antagonist such as cimetidine.
Not taking hot baths or showers may help if it is generalized (all over) and possibly for localized (in a specific area). If not taking showers helps, it may be a condition called shower eczema. If it affects mainly the head, it may be psoriasis. In rare cases, allergy tests may uncover substances the patient is allergic to. Using biodegradable or hypo-allergenic soaps and laundry supplies may help.
Acupuncture and Chinese herbs have long been used to treat urticaria in the Asian world. Results of clinical trials of both acupuncture and Chinese herbs are inconclusive and are possibly a result of the placebo effect, as the trials did not involve a control group.
- Triple response of Lewis
- List of cutaneous conditions
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- ^ Kontou-Fili K, Borici-Mazi R, Kapp A, Matjevic LJ, Mitchel FB (1997). "Physical urticaria: classification and diagnostic guidelines. An EAACI position paper". Allergy 52 (5): 504–13. doi:10.1111/j.1398-9995.1997.tb02593.x. PMID 9201361.
- ^ Hunte, Tracie (March 14, 2008). "Artist: 'I Use My Skin as a Canvas'". ABC News. http://abcnews.go.com/Health/story?id=4446929. Retrieved 2008-10-05.
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- ^ Jianli Che (2006). "The Effect of Acupuncture on Serum IgE Level in Patients with Chronic Urticaria". Journal of Traditional Chinese Medicine 26 (3): 189–190. PMID 17078446. http://d.wanfangdata.com.cn/Periodical_zyzz-e200603012.aspx.
- ^ Chung-Jen Chen MD, Hsin-Su Yu MD PhD (1998). "Acupuncture Treatment of Urticaria". Archives of Dermatolology 134 (11): 1397–1399. doi:10.1001/archderm.134.11.1397. PMID 9828874. http://archderm.ama-assn.org/cgi/content/abstract/134/11/1397.
- ^ Benjamin Kligler, Roberta A. Lee (April 2004). Integrative medicine: principles for practice. 134. McGraw-Hill Professional. pp. 371–377. ISBN 9780071402392. http://books.google.com/?id=-JUcjUGBV6kC.
Urticaria and erythema (L50–L54, 695, 708) Urticaria
(acute/chronic)Allergic urticariaUrticarial allergic eruptionPhysical urticariaOther urticariaEpisodic angioedema with eosinophilia · Hereditary angioedema
ErythemaFigurate erythemaOther erythema
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