Angioedema, vibratoryT78.3; D84.1

Rare edema formation occurring after repetitive (vibratory) shocks to the skin, limited to the site of action, usually painful or burning or itching.

Often autosomal dominant inheritance mechanism. Sporadic cases also known.

After vibratory trauma (working with percussion drills, motor mowers, jogging), first redness appears at the site of exposure, followed by an itchy or painful swelling. Maximum of symptoms a few hours after exposure, after 24 hours skin condition returns to normal.

Edema of the deep dermis and subcutis. Interstitial and periadnexual infiltrate of eosinophilic and neutrophilic leukocytes, T-lymphocytes and monocytes. Detection of proinflammatory cytokines such as TNF-alpha, IL-3, IL-6 as well as the expression of adhesion molecules (VCAM-1, ICAM-1) in the vessel walls.

Avoid triggering mechanisms as far as possible. The only effective therapy is the administration of systemic glucocorticoids such as prednisolone (e.g. Decortin H) initially 50-80 mg/day, with the lowest possible maintenance dose. Antihistamines are generally ineffective.