Cholinergic Urticaria

Cholinergic Urticaria
Body Parts: Head Upper Limbs Chest Back
Medical Subjects: Skin

What Is Cholinergic Urticaria

What disease is cholinergic urticaria?

Cholinergic urticaria is a form of urticaria. It is mainly caused by some related factors, such as fever, exercise, emotional stress, hot bath, hot drink and spicy food.

The main performance is the skin small protrusions, 1 ~ 3 mm in diameter, the surrounding skin will be red, will fade in a short period of time.

Is cholinergic urticaria common?

Cholinergic urticaria is more common, accounting for 5% of chronic urticaria. It usually occurs between the ages of 10 and 30 years. It can happen for both male and female, basically without gender difference.

Is cholinergic urticaria and thermal urticaria the same disease?

Hot urticaria is divided into two categories, generalized and localized. Cholinergic urticaria is sometimes referred to as "generalised thermal urticaria".

However, localized thermal urticaria was not associated with cholinergic urticaria. Localized thermal urticaria is a rare condition that only develops when warm stimuli are in direct contact with the skin, producing wheals at the site of contact within minutes.


What Is The Etiology Of Cholinergic Urticaria

What is the reason of cholinergic urticaria?

Cholinergic urticaria is generally caused by nerve fibers in the sweat glands.

Any trigger for increased core body temperature could trigger cholinergic urticaria. When the body temperature rises, the skin reacts to heat and sweat. The most common triggers are high-temperature environments (such as hot baths, hot climates), strenuous exercise, and emotional stress.

In which population is cholinergic urticaria common?

Cholinergic urticaria may develop if the body has an autoimmune response to an antibody to autosweat, immunoglobulin G.

Cholinergic urticaria may be more easily obtained if there is concomitant urticaria caused by eczema, asthma, other allergies such as pollen, or other causes such as certain foods, medications, skin pressure, or cold weather.

Can cholinergic urticaria be inherited?

There is insufficient evidence that cholinergic urticaria is hereditary.


What Symptom Does Cholinergic Urticaria Have

What are the common manifestations of cholinergic urticaria?

Manifestations of cholinergic urticaria are usually confined to the skin. Most occur within 6 minutes of exposure to the etiology. It will gradually disappear after about 30 minutes to 2 hours.

The skin usually presents as small red protrusions with a diameter of about 1 to 3 mm. There is a flush around the protrusions and they may look swollen. this is called a wheal. As the reaction progresses, the flush may merge to form a large area of erythema. Additionally, the rash may generally be accompanied by pruritus, tingling, burning, or localized burning.

Where does cholinergic urticaria often occur?

Cholinergic urticaria can occur anywhere on the skin. It usually occurs in the chest, face, upper back and arms.

What serious consequences can cholinergic urticaria cause?

Systemic symptoms may occur if the associated mediators in the rash area are released in large quantities and into the body.

Systemic symptoms have a relatively small probability and may be one or more manifestations, such as headache, dizziness, decreased blood pressure, mucosal edema, dyspnea, accelerated heartbeat, shortness of breath, diarrhea and abdominal pain.


How To Check For Cholinergic Urticaria

How is cholinergic urticaria diagnosed?

Cholinergic urticaria depends mainly on history and presentation, and the doctor asks the patient about the rash presentation, duration, and possible related factors.

The presence of typical precipitating factors and lesions of typical cholinergic urticaria is usually sufficient to confirm the diagnosis of cholinergic urticaria.

What check does the diagnosis of cholinergic urticaria need to do?

A history and rash check-up are generally all that is required, and no additional tests are required. The following checks may be helpful for further evaluation:

  • Run or cycle for about 15 minutes under your doctor's guidance to see if you get a rash from sweating. If present, symptoms can aid in the diagnosis of cholinergic urticaria.
  • Immerse the trunk and extremities in hot water at 42 C for up to 15 minutes while recording changes in body temperature to ensure a minimum of 1 C increase. If present, symptoms can aid in the diagnosis of cholinergic urticaria.

Which disease is cholinergic urticaria more easily confused with? How to distinguish them?

Cholinergic urticaria is easily confused with localized thermal urticaria and motor systemic anaphylaxis.Cholinergic urticaria is easily confused with localized thermal urticaria and motor systemic anaphylaxis.

  • Localized thermal urticaria: It only occurs when direct contact with the skin is stimulated by heat. The contact area produces a cloud within minutes. Antihistamines are generally ineffective for localized thermal urticaria.

  • Motor systemic allergic reaction: Unlike cholinergic urticaria, exercise or exertion is the only predisposing factor for motor systemic allergic reactions. The wheals for motor systemic anaphylaxis are generally larger than those for cholinergic urticaria.


How To Prevent Cholinergic Urticaria

Can cholinergic urticaria be prevented? How to prevent this disease?

Can basically and effectively prevent cholinergic urticaria. Preventive measures are to identify and avoid the causes of cholinergic urticaria. This is also an effective measure to avoid the recurrence of cholinergic urticaria.

How does cholinergic urticaria patient prevent to cause other disease?

Avoiding contact with precipitating factors and timely medication can reduce other complications to a certain extent.

In addition, if there are serious reactions, such as shortness of breath or dyspnea, the doctor may prescribe epinephrine needles, which are always ready to improve breathing, control swelling and save lives.


How To Treat Cholinergic Urticaria

Cholinergic urticaria should see which branch?


Can cholinergic urticaria heal oneself?

In a single episode of cholinergic urticaria, symptoms persist for approximately 30 minutes to 2 hours and resolve on their own. But if the etiology and predisposing factors are touched again, the disease will recur.

How does cholinergic urticaria treat?

The control of cholinergic urticaria is firstly to identify and avoid the known precipitating factors, and secondly to symptomatic treatment with medication to reduce the symptoms such as rash and pruritus.

  • Avoid precipitating factors: possible precipitating factors include fever, exercise, stress, hot baths, hot drinks, and spicy diets. Some measures that may be useful are: wet the skin with a towel soaked in cold water; Take a cold bath; Use a fan to cool; Let the temperature of the home is appropriate; Wear loose clothes; Try to avoid disturbing situations and keep calm. Stop or reduce training when a rash occurs.

  • Pharmacotherapy: Antihistamines are used to treat allergies and may help control the condition and reduce discomfort such as rash and itching. The available drugs include cetirizine, loratadine, oxazine, diphenhydramine, and fexofenadine. Taking antihistamines daily is more effective than taking them on demand. If the antihistamines don't work, you can change them under doctor's instruction or recommend short-term use of glucocorticoids to help control the symptoms.

Does cholinergic urticaria need to be hospitalized?

Hospitalization is not required if only skin manifestations are present. Hospitalization monitoring and treatment may be required if there are life-threatening systemic symptoms, such as dyspnea.

What are the common side effects of the treatment of cholinergic urticaria?

Antihistamines, such as cetirizine and loratadine, are generally safe with few side effects. However, oxazine and diphenhydramine are the first generation antihistamines, which may cause drowsiness, loss of concentration, fatigue and dizziness.

Glucocorticoid is not routine treatment, and only needs short-term use in some cases, with low risk of side effects. High-dose or long-term use of glucocorticoids may cause obesity, increased blood glucose, hypertension, edema, hypokalemia, mental excitement, peptic ulcer, etc.

Can cholinergic urticaria be cured completely?

Treatment of cholinergic urticaria is not guaranteed. The prognosis of this disease is generally good. According to available data, symptoms can persist repeatedly for anywhere from 3 to 16 years, with an average duration of 7.5 years, and about one third of people last for more than 10 years.


What Should Cholinergic Urticaria Patient Notice In Life

What should the patient of cholinergic urticaria notice on food?

Pay special attention to hot drinks and spicy foods.

In theory, thermal and spicy stimuli could trigger cholinergic urticaria. If the actual situation does induce symptoms, it needs to be targeted to avoid. If hot drinks and spicy diets do not cause cholinergic urticaria, this need not be avoided.

What should the patient of cholinergic urticaria notice in life?

Be aware of factors that may cause or exacerbate cholinergic urticaria.

In addition to the hot drinks and spicy diets mentioned above, there may be exercise, fever, hot baths, and stress. If there are certain predisposing factors, they need to be avoided as much as possible.

Can cholinergic urticaria take part in exercise appropriately?

Strenuous exercise in a hot environment generally induces cholinergic urticaria, which needs to be appropriately avoided. If moderate intensity exercise does not induce cholinergic urticaria, then strict avoidance is not necessary.

Does cholinergic urticaria need reexamination? How to review?

Cholinergic urticaria requires reexamination. It is mainly because the doctor asks about the treatment and the degree of symptom control during treatment. Medication regimens were adjusted according to symptom control. No additional tests are generally required.

Does cholinergic urticaria affect reproduction?

Cholinergic urticaria does not affect fertility.

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