Urticaria adrenergic F54 und L50.-

Shelley and Shelley 1985

Controversial entity (type physical urticaria) where, after episodes of severe emotional stress, itching and urticarial efflorescences are said to occur.

The etiopathogenesis is unclear

Urticarial itchy exanthema of 0.2-0.3cm large wheals which are typically surrounded by a pale halo.

In serum, catecholamines and IgE are elevated (Hogan SR et al. 2014).

Bulky intradermal perivascular infiltrate from lymphocytes and eosinophilic granulocytes (Lang C et al. 2016).

Clinic, intradermal test with adrenaline (10ng adrenaline in 0.02ml physiological saline solution) is said to lead to local itching and wheals (Haustein UF 1990)

cholinergic urticaria

One with beta-blockers is recommended (2x25mg propanolol) possibly combined with antihistamines (Hogan SR Versuch et al. 2014). In a single case, an anxiolytic benzodiazepine improved symptoms (Kawakami Y et al. 2015).

1. Haustein UF (1990) Adrenergic urticaria and adrenergic pruritus. Acta Derm Venereol.70:82-84.
2. Hogan SR et al (2014) Adrenergic urticaria: review of the literature and proposed mechanism. J Am Acad Dermatol 70:763-766.
3. Kawakami Y et al (2015) Refractory case of adrenergic urticaria successfully treated with clotiazepam. J Dermatol 42:635-637
4. Lang C et al (2016) A Case of Adrenergic Urticaria Associated with Vitiligo. Dermatopathology (Basel) 3:83-86.