Physical and Cholinergic Urticaria

  • B. M. Henz


Physical urticaria is defined as localized or generalized urticaria or angioedema of the skin or the mucous membranes in response to different specific physical stimuli. In cholinergic urticaria, a reflex-type, pinpoint size whealing reaction or angioedema arises in response to a rise in body core temperature. Reasons for the over-reaction of the skin to normally tolerated stimuli remain unexplained. In most cases, an associated mast-cell degranulation has been identified, in some an underlying immunoglobulin (Ig)E-dependent sensitization and, in rare cases, a genetic predisposition to the disease itself or to associated diseases, including atopy.


Migration Inhibitor Factor Allergy Clin Immunol Chronic Urticaria Cold Urticaria Cholinergic Urticaria 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Baart de la Faille H, Rottier PB, Baart de la Faille-Kuyper EH (1975) Solar urticaria. A case with possible increase of skin mast cells. Br J Dermatol 92:101–107CrossRefGoogle Scholar
  2. Barlow RJ, Warburton F, Watson K, Black AK, Greaves MW (1993) Diagnosis and incidence of delayed pressure urticaria in patients with chronic urticaria. J Am Acad Dermatol 29:954–958PubMedCrossRefGoogle Scholar
  3. Björkner B (1981) Occupational cold urticaria from contact spray. Contact Dermatitis 6:338–339CrossRefGoogle Scholar
  4. Breathnach SM, Allen R, Milford Ward A, Greaves MW (1983) Symptomatic dermographism: natural history, clinical features, laboratory investigations and response to therapy. Clin Exp Dermatol 8:463–476PubMedCrossRefGoogle Scholar
  5. Cap JP, Schwanitz HJ, Czarnetzki BM (1985) Die Wirkung von Ketotifen bei der Urticaria factitia und der Urticaria cholinergica im gekreuzten Doppelblindversuch. Hautarzt 36: 509–511PubMedGoogle Scholar
  6. Casale TB, Keahey TM, Kaliner M (1986) Exercise-induced anaphylactic syndromes: insight into diagnostic and pathophysiologic features. JAMA 255:2049–2053PubMedCrossRefGoogle Scholar
  7. Collins P, Ahamat R, Green C, Ferguson J (1996) Plasma exchange therapy for solar urticaria. Br J Dermatol 134: 1093–1097PubMedCrossRefGoogle Scholar
  8. Czarnetzki BM, Galinski C, Meister R (1984a) Cutaneous and pulmonary reactivity in cholinergic urticaria. Br J Dermatol 110:587–591PubMedCrossRefGoogle Scholar
  9. Czarnetzki BM, Meentken J, Rosenbach T, Pokropp A (1984b) Clinical, pharmacological and immunological aspects of delayed pressure urticaria. Br J Dermatol 111:315–323PubMedCrossRefGoogle Scholar
  10. Czarnetzki BM, Breetholdt B, Traupe H (1986) Evidence that water acts as a carrier for an epidermal antigen in aquagenic urticaria. J Am Acad Dermatol 15:623–627PubMedCrossRefGoogle Scholar
  11. Czarnetzki BM, Cap H-P, Forck G (1987) Late cutaneous reactions to common allergens in patients with delayed pressure urticaria. Br J Dermatol 117:695–701PubMedCrossRefGoogle Scholar
  12. Czarnetzki BM, Zwadlo-Klarwasser G, Bröcker E-B, Sorg C (1989) Immunohistochemical demonstration of migration inhibitor factor (MIF) in different types of urticaria. J Invest Dermatol 93:471–474PubMedCrossRefGoogle Scholar
  13. Davis KC, Mekori YA, Köhler PF, Schocket AL (1986) Cold urticaria and virus infection: a clinical and serological study in 39 patients. Br J Dermatol 114:311–318CrossRefGoogle Scholar
  14. Doeglas HMG (1975) Reaction to aspirin and food additives in patients with chronic urticaria, including the physical urticarias. Br J Dermatol 110:382–388Google Scholar
  15. Dover JS, Black AK, Ward AM, Greaves MW (1988) Delayed pressure urticaria. Clinical features, laboratory investigations, and response to therapy of 44 patients. J Am Acad Dermatol 18:1289–1298PubMedCrossRefGoogle Scholar
  16. Duke WW (1926) Physical allergy as a cause of dermatoses. Arch Dermatol Syphilis 13:176–186CrossRefGoogle Scholar
  17. Engler R, Squire E, Benson P (1995) Chronic sulfasalazine therapy in the treatment of delayed pressure urticaria and angioedema. Ann Allergy 74:155–159Google Scholar
  18. Estes S, Young C (1981) Delayed pressure urticaria: an investigation of some parameters of lesion induction. J Am Acad Dermatol 5:25–31PubMedCrossRefGoogle Scholar
  19. Fitzgerald DA, Heagerty AHM, English JSC (1995) Cold urticaria as an occupational dermatosis. Contact Dermatitis 32: 240–241CrossRefGoogle Scholar
  20. Haas N, Toppe E, Henz BM (1998) Microscopic morphology in different types of urticaria. Arch Dermatol 133:41–46CrossRefGoogle Scholar
  21. Harris A, Burge SM, George SA (1997) Solar urticaria in an infant. Br J Dermatol 136:105–107PubMedCrossRefGoogle Scholar
  22. Hasei K, Ichihashi M (1982) Solar urticaria. Determinations of action and inhibition spectra. Arch Dermatol 118:346–350PubMedCrossRefGoogle Scholar
  23. Haustein UF, Kirchhoff B (1984) Die Behandlung der erworbenen Kälteurtikaria mit Ketotifen. Dermatol Wochenschr 170: 536–537Google Scholar
  24. Henquet CJM, Martens BPM, Van Vloten WA (1992) Cold urticaria: a clinico-therapeutic study in 30 patients, with special emphasis on cold desensitization. Eur J Dermatol 275–77Google Scholar
  25. Henz BM, Jeep S, Ziegert FS, Niemann J, Kunkel G (1996) Dermal and bronchial hyperreactivity in urticarial dermographism. Allergy 51:171–175PubMedGoogle Scholar
  26. Henz BM, Zuberbier T, Grabbe J, Monroe E (eds) (1997) Urticaria — clinical, diagnostic and therapeutic aspects. Springer, Berlin Heidelberg, New YorkGoogle Scholar
  27. Hertl M, Merk HF (1994) Occurrence of cold urticaria in insect venom allergic individuals. Allergol J 3:379–381Google Scholar
  28. Hölzle E, Hadshiew IM (1996) Mechanisms of solar urticaria. Curr Opin Dermatol 3:185–189CrossRefGoogle Scholar
  29. Horio T, Fujigaki K (1988) Augmentation spectrum in solar urticaria. J Am Acad Dermatol 18:1189–1193PubMedCrossRefGoogle Scholar
  30. Houser DD, Arbesman CE, Kohi ITO, Wicher K (1970) Cold urticaria (immunologic studies). Am J Med 49:23–33PubMedCrossRefGoogle Scholar
  31. Hudson-Peacock MJ, Farr PM, Diffey BL, Goodship THJ (1993) Combined treatment of solar urticaria with plasmapheresis and PUVA. Br J Dermatol 128:440–442PubMedCrossRefGoogle Scholar
  32. Husz S, Toth-Kase I, Kiss M, Dobozy A (1994) Treatment of cold urticaria. Int J Dermatol 33:210–213PubMedGoogle Scholar
  33. Illig L, Kunick J (1969) Klinik und Diagnostik der physikalischen Urtikaria. Hautarzt 20:167–178PubMedGoogle Scholar
  34. Ive H, Lloyd J, Magnus IA (1965) Action spectra in idiopathic solar urticaria. A study of 17 cases with a monochromator. Br J Dermatol 77:229–243PubMedCrossRefGoogle Scholar
  35. Kobza-Black A, Keahey TM, Eady RAJ, Greaves MW (1981) Dissociation of histamine release and clinical improvement following treatment of acquired cold urticaria by prednisone. Br J Clin Pharmacol 12:327–331CrossRefGoogle Scholar
  36. Kojima M, Horiko T, Nakamura Y, Aoki T (1986) Solar urticaria. The relationship of photoallergen and action spectrum. Arch Dermatol 122:550–555Google Scholar
  37. Kontou-Fili K, Maniatakou G, Demaka P, Gonianakis M, Palaiogolos G, Aroni K (1991) Therapeutic effects of cetirizine 2HCl in delayed pressure urticaria: clinicopathologic findings. J Am Acad Dermatol 24:1090–1093PubMedCrossRefGoogle Scholar
  38. Laufer P, Laufer R (1983) Solar urticaria in cystic fibrosis. Cutis 31:665–666PubMedGoogle Scholar
  39. Leenutaphong V (1993) Solar urticaria induced by UVA and inhibited by visible light. J Am Acad Dermatol 29:337–340PubMedCrossRefGoogle Scholar
  40. Lemanske RF, Bush RK (1982) Cold urticaria in infectious mononucleosis JAMA 247:1604PubMedCrossRefGoogle Scholar
  41. Lin RY, Schwartz RA (1993) Cold urticaria and HIV infection. Br J Dermatol 129:465–467PubMedCrossRefGoogle Scholar
  42. Michaelsson G, Ros AM (1971) Familial localized heat urticaria of delayed type. Acta Derm Venereol 51:279–283PubMedGoogle Scholar
  43. Möller A, Henning M, Zuberbier T, Czarnetzki BM (1996) Epidemiologie und Klinik der Kälteurtikaria. Hautarzt 47:510–514PubMedCrossRefGoogle Scholar
  44. Neittaanmäki H (1985) Cold urticaria. Clinical findings in 220 patients. J Am Acad Dermatol 13:636–643PubMedCrossRefGoogle Scholar
  45. Neittanmäki H, Myöhänen T, Fräki JE (1984) Comparison of cinnarizine, cyproheptadine, doxepin, and hydroxyzine in treatment of idiopathic cold urticaria: usefulness of doxepin. J Am Acad Dermatol 11:483–489CrossRefGoogle Scholar
  46. Orfan NA, Kolski GB (1993) Physical urticarias. Ann Allergy 171:205–215Google Scholar
  47. Rajka G, Mørk NJ (1985) Clinical observations on the mechanism of delayed pressure urticaria. In: Champion RH, Greaves MW, Kobza Black A, Pye RJ (eds) The urticarias. Churchill Livingstone, Edinburgh, pp 191–193Google Scholar
  48. Ratanen T, Suhonen R (1980) Solar urticaria. A case with increased skin mast cells and good therapeutic response to an antihistamine. Acta Derm Venereol Suppl (Stockh) 60:363–365Google Scholar
  49. Reinauer S, Leenutaphong V, Hölzle E (1993) Fixed solar urticaria. J Am Acad Dermatol 29:161–165PubMedCrossRefGoogle Scholar
  50. Schafer CM (1995) Physical urticaria. Immunol Allergy Clin N Am 15:679–699Google Scholar
  51. Shaw D (1988) Cold urticaria and employment. J Soc Occup Med 38:89PubMedCrossRefGoogle Scholar
  52. Shelley WB, Shelley ED (1985) Adrenergic urticaria: a new form of stress-induced hives. Lancet 11:1031–1033CrossRefGoogle Scholar
  53. Sigler RW, Evans R, Horakova Z, Ottesen E, Kaplan AP (1980) The role of cyproheptadine in the treatment of cold urticaria. J Allergy Clin Immunol 65:309–312PubMedCrossRefGoogle Scholar
  54. Sussman GL, Harvey RP, Schocket AL (1982) Delayed pressure urticaria. J Allergy Clin Immunol 70:337–342PubMedCrossRefGoogle Scholar
  55. Tennenbaum JI, Lowney E (1973) Localized heat and cold urticaria: new phenomenon occurring in the same individual. J Allergy Clin Immunol 51:57–59PubMedCrossRefGoogle Scholar
  56. Tyson CJ, Czarny D (1981) Cold-induced urticaria in infectious mononucleosis. Med J Aust 1:33–35PubMedGoogle Scholar
  57. Villas-Martinez F, Contreras FJ, Lopez-Cazana JM, Lopez-Serrano MC, Martinez-Alzamora F (1992) A comparison of new nonsedating and classical antihistamines in the treatment of primary acquired cold urticaria (AUC). J Invest Allergol Clin Immunol 2:258–262Google Scholar
  58. Wanderer AA (1995) The spectrum of cold urticaria. Immunol Allergy Clin N Am 15:701–723Google Scholar
  59. Warin RP (1987) A simple out-patient test for delayed pressure urticaria (letter). Br J Dermatol 116:742–743PubMedCrossRefGoogle Scholar
  60. Willis I, Epstein JH (1974) Solar vs heat-induced urticaria. Arch Dermatol 110:389–392PubMedCrossRefGoogle Scholar
  61. Wise RD, Malkinson FD, Luskin A, Gewurs AT, Zeitz HJ (1978) Localized heat urticaria. Arch Dermatol 114:1079–1080PubMedCrossRefGoogle Scholar
  62. Wong RC, Rairley JA, Ellis CN (1984) Dermographism: a review. J Am Acad Dermatol 11:643–652PubMedCrossRefGoogle Scholar
  63. Zuberbier T, Böhm M, Czarnetzki BM (1993) Food intake in combination with a rise in body temperature: a newly identified cause of angioedema. J All Clin Immunol 91: 1226–1227CrossRefGoogle Scholar
  64. Zuberbier T, Althaus C, Chantraine-Hess, Czarnetzki BM (1994) Prevalence of cholinergic urticaria in young adults. J Am Acad Dermatol 31:978–981PubMedCrossRefGoogle Scholar
  65. Zuberbier T, Aberer W, Burtin B, Rihoux J-P, Czarnetzki BM (1995) Efficacy of cetirizine in cholinergic urticaria. Acta Derm Venereol Suppl (Stockh) 75:147–149Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • B. M. Henz

There are no affiliations available

Personalised recommendations