Ann Dermatol.  2014 Apr;26(2):189-194. 10.5021/ad.2014.26.2.189.

Clinical Characteristics of Cholinergic Urticaria in Korea

• Kim JE
• Eun YS
• Park YM
• Park HJ
• Yu DS
• Kang H
• Cho SH
• Park CJ
• Kim SY
• Lee JY

• KMID: 2171654
• DOI: http://doi.org/10.5021/ad.2014.26.2.189

Abstract

BACKGROUND
Cholinergic urticaria is a type of physical urticaria characterized by heat-associated wheals. Several reports are available about cholinergic urticaria; however, the clinical manifestations and pathogenesis are incompletely understood.
OBJECTIVE
The purpose of this study was to investigate the clinical characteristics of cholinergic urticaria in Korea.
METHODS
We performed a retrospective study of 92 patients with cholinergic urticaria who were contacted by phone and whose diagnoses were confirmed by the exercise provocation test among those who had visited The Catholic University of Korea, Catholic Medical Center from January 2001 to November 2010.
RESULTS
All 92 patients were male, and their average age was 27.8 years (range, 17~51 years). Most of the patients had onset of the disease in their 20s and 30s. Non-follicular wheals were located on the trunk and upper extremities of many patients, and the symptoms were aggravated by exercise. Eight patients showed general urticaria symptoms and 15 had accompanying atopic disease. Forty-three patients complained of seasonal aggravation. Most patients were treated with first and second-generation antihistamines.
CONCLUSION
Dermatologists should consider these characteristics in patients with cholinergic urticaria. Further investigation and follow-up studies are necessary to better understand the epidemiological and clinical findings of cholinergic urticaria.

Keyword

Cholinergic; Epidemiology; Phenotype; Signs and symptoms; Urticaria

MeSH Terms

Diagnosis
Epidemiology
Histamine Antagonists
Humans
Korea
Male
Phenotype
Retrospective Studies
Seasons
Upper Extremity
Urticaria*
Histamine Antagonists

Figure

• 

  Fig. 1 Clinical photographs of cholinergic urticaria. (A) Typical non-follicular wheals. (B) Follicular wheals. (C) Mixed type of follicular wheals (arrows) and non-follicular wheals (arrowheads). (D) Erythema without wheals. (E) Multiple red spots on the palm without a perilesional halo.

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