What Is Cholinergic Urticaria?

Mainly due to exercise, heat, stress, eating hot drinks or alcoholic beverages, the temperature in the deep part of the body rises, causing acetylcholine to act on mast cells and cause disease. It appears as a round papular wind mass with a diameter of 2 to 4 mm and a few degrees of red halo around the stimulation within a few minutes after being stimulated. Conscious itching, tingling, or burning sensation, sometimes only itching without skin lesions, can be resolved within 0.5 to 1 hour. Occasional systemic symptoms caused by acetylcholine (such as salivation, headache, bradycardia, diminished pupils and spastic abdominal pain, diarrhea), etc., severe dizziness can cause syncope. A skin test or a scratch test with 1: 5000 acetylcholine can cause wind masses at the injection site and satellite-like small wind masses around.

Basic Information

English name
cholinergic urticaria
Visiting department
dermatology
Multiple groups
young people
Common causes
Exercise, heat, stress, alcohol, etc.
Common symptoms
Wind mass, itching, tingling or burning, may be accompanied by drooling, headache, etc.
Contagious
no

Causes of cholinergic urticaria

More common in youth. Mainly due to exercise, heat, stress, eating hot drinks or alcoholic beverages, etc., causing cholinergic nerves to impulse and release acetylcholine, which increases the levels of cyclic guanosine monophosphate (cGMP) in basophils and mast cells, resulting in release Histamine.

Clinical manifestations of cholinergic urticaria

It appears as a round papular wind mass with a diameter of 2 to 4 mm and a few degrees of red halo around the stimulation within a few minutes after stimulation. It is often distributed in the upper trunk and upper limbs and does not fuse with each other. Conscious itching, tingling, or burning sensation, sometimes only itching without skin lesions, can be resolved within 0.5 to 1 hour. Mild cholinergic urticaria can occur in normal puberty. Generally, symptoms can resolve after stopping exercise or calm, so it is not easy to attract attention. Occasional systemic symptoms caused by acetylcholine (such as salivation, headache, bradycardia, diminished pupils, and spastic abdominal pain, diarrhea), etc., severe dizziness can cause syncope. A skin test or a scratch test with 1: 5000 acetylcholine can cause wind masses at the injection site and satellite-like small wind masses around.

Cholinergic urticaria diagnosis

According to young people, it is often induced by exercise, heat, nervousness, eating hot drinks, etc., manifested as small wind masses, itching, and sometimes accompanied by systemic symptoms such as drooling, headache, abdominal pain, diarrhea, induced by exercise or hot bath, intradermal injection of nicotine Wind mass induced by picrate or acetocholine can be diagnosed.

Cholinergic urticaria treatment

1. General treatment < br Avoid inducements. Cholinergic urticaria should keep the body cool, avoid sweating, avoid heat, mental stress, eat hot drinks or alcoholic beverages, etc.
2. Oral medicine
In addition to taking antihistamines routinely, I often added atropine, probencin, and reserpine to obtain satisfactory results. Topical medicine: Itching solution, calamine lotion, etc. can be used in summer, and emulsion (such as diphenhydramine cream) can be used in winter.

Cholinergic urticaria prevention

Cholinergic urticaria should keep the body cool, avoid sweating, avoid heat, mental stress, eat hot drinks or alcoholic beverages, etc. Some traditional Chinese medicines, such as Shouwu, Chinese wolfberry, ginseng, astragalus, ganoderma, jujube, privet seed, dodder, schisandra, huangjing, huai yam, codonopsis, etc., have anti-free radicals, improve immune function, promote metabolism, regulate the nervous system And endocrine system and other functions, have obvious anti-allergic effects. People with allergies can choose soup for tea.

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