Imagine that you are running on the treadmill at the gym and, suddenly, small red patches appear on the trunk, arms and legs, associated with burning or tingling… You stop the physical activity; gradually the symptoms ease. From then on, every time you practise intense physical activity, those plaques appear… Is it allergy to physical exercise ?? Cholinergic urticaria is a type of induced urticaria triggered by increased body temperature with day-to-day activities: physical activity, sweating, hot baths, consumption of alcoholic beverages and hot or spicy foods. Emotional stress can also be a triggering factor. When the stimulus ceases, the symptoms disappear in less than an hour. It was first described in 1924 by Duke and affects up to 20% of young adults. Cholinergic urticaria constitutes 5% of chronic urticarias and 30% of physical urticarias. Although it is not a serious disease, most of the time it can compromise the patient’s quality of life. The diagnosis can be confirmed by a provocation test, performed under medical supervision, in addition to the clinical history. Treatment with antihistamines, known as antiallergics, can be used successfully, always under expert guidance.
References:
1) Fukunaga A, Washio K, Hatakeyama M, Oda Y, Ogura K, Horikawa T, Nishigori C. Cholinergic urticaria: epidemiology, physiopathology, new categorization, and management. Clin Auton Res. 2018 Feb;28(1):103-113. doi: 10.1007/s10286-017-0418- 6. Epub 2017 Apr 5. PMID: 28382552.
2) Maurer M, Fluhr JW, Khan DA. How to Approach Chronic Inducible Urticaria. J Allergy Clin Immunol Pract. 2018 Jul-Aug;6(4):1119-1130. doi: 10.1016/j.jaip.2018.03.007. PMID: 30033913.
3) Geller M. Anafilaxia e urticárias físicas. Braz J Allergy Immunol. 2013;1(4):195-201
