Skin | Dermatology | Symptomatic dermographism (Disease)
Dermographism is the most common form of physical urticaria and can occur with other forms of urticaria. Incidence was reported in pregnancy, especially in the second quarter, the onset of menopause, children and patients with atopic disease Bechcet. Simple dermographism is the most common and patients with this form are asymptomatic. Still other forms are associated with pruritus significantly affect patient quality of life. Most patients with dermographism are healthy.
Dermographism may occur in people of any age but is most common in young adults. The peak incidence is in the second and third decade of life. Swelling usually develops 5-10 minutes to reach the skin and persists for 15-30 minutes. Edema may develop giant if dermographism is profound. Intermediate and late forms of dermographism are also described. They develop slowly and may take several hours to days. In patients with symptomatic dermographism is associated with itching skin rash that is most severe at night.
Causes and Risk factors
Urticaria is caused by physical factors in almost 12 percent of cases. These factors include pressure. Dermographism is the appearance of whealing and erythema within minutes where skin has been exposed to pressure or mechanical irritation. Symptomatic dermographism is present when normal pressures, such as those encountered in the activities of daily living, cause urticaria. Individuals with symptomatic dermographism can be shown to have a lower pressure threshold for the production of dermographism than normal individuals.
Symptoms can be aggravated by heat, warm baths, minor pressure (rubbing, scratching or wiping with a towel, exercise, stress and emotions. Itching and swelling can affect all body surfaces, but the scalp and genitals are rarely involved. Vulvodiia and dyspareunia in patients with symptomatic dermographism may appear.
Diagnosis and Treatment
Patients with simple dermographism are asymptomatic and require no therapy.
Recognizing the problem, avoidance of precipitating physical factors are important methods in medical therapy. In symptomatic individuals H1 antihistamines are used as preferred agents. We have successfully used with UV-B phototherapy with psoralen. The natural history of symptomatic dermographism is unpredictable. It can take months or years, or may be present intermittently. Many patients get better without condition and they heal after a few years. Symptomatic dermographism seems to be the best evolution of all healing chronic hives 5 years 10 years 36% and 51%. ...