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Cholinergic urticaria: epidemiology, physiopathology, new categorization, and management

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Abstract

Purpose

The aim of this study was to review the evidence on the epidemiology, physiopathology, categorization, and management of cholinergic urticaria. We specifically focused on several subtypes of cholinergic urticaria and investigated the relationship between cholinergic urticaria and idiopathic anhidrosis.

Methods

Using an integrative approach, we reviewed publications addressing the epidemiology, clinical features, diagnostic approach, physiopathology, subtype classification, and therapeutic approach to cholinergic urticaria.

Results

Multiple mechanisms were found to contribute to the development of cholinergic urticaria. This disorder should be classified based on the pathogenesis and clinical characteristics of each subtype. Such a classification system would lead to better management of this resistant condition. In particular, sweating function should be given more attention when examining patients with cholinergic urticaria.

Conclusions

Because cholinergic urticaria is not a homogeneous disease, its subtype classification is essential for selection of the most suitable therapeutic method.

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Acknowledgements

This work was supported in part by JSPS KAKENHI (Grant No. 15K09742).

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Authors and Affiliations

  1. Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Atsushi Fukunaga, Ken Washio, Mayumi Hatakeyama, Yoshiko Oda, Kanako Ogura & Chikako Nishigori

  2. Division of Dermatology, Nishi-Kobe Medical Center, 5-7-1 Koji-Dai, Nishi-ku, Kobe, 651-2273, Japan

    Ken Washio

  3. Ueda Dermatology Clinic, 1654-5 Harima-cho Nozoe, Nishi-ku, Kako-Gun, 675-0151, Japan

    Tatsuya Horikawa

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  1. Atsushi Fukunaga
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  2. Ken Washio
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  3. Mayumi Hatakeyama
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  4. Yoshiko Oda
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  5. Kanako Ogura
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  6. Tatsuya Horikawa
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  7. Chikako Nishigori
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Correspondence to Atsushi Fukunaga.

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Fukunaga, A., Washio, K., Hatakeyama, M. et al. Cholinergic urticaria: epidemiology, physiopathology, new categorization, and management. Clin Auton Res 28, 103–113 (2018). https://doi.org/10.1007/s10286-017-0418-6

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  • DOI: https://doi.org/10.1007/s10286-017-0418-6

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