Cholinergic urticaria

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Cholinergic urticaria
CU on the volar aspect of the forearm

Cholinergic urticaria (CU) presents with tiny very itchy wheals or small bumps on skin on a reddish background.[1]

It is a type of physical urticaria that appears when a person is sweating or their core body temperature increases.[2][3]


Symptoms and signs

Cholinergic urticaria typically presents with a number of small, short-lasting hives but may also involve cutaneous inflammation (wheals) and pain which develops usually in response to exercise, bathing, staying in a heated environment, or emotional stress.[4][5] Although the symptoms subside rapidly, commonly within 1 hour, Cholinergic urticaria may significantly impair quality of life, especially in relation to sporting activities.[6]



Though overall research is limited, various studies indicate that CU is relatively common across populations with prevalence rates reportedly ranging from 5% to 20% (depending on locale, race, and age).[7][8][9] The condition is more common in young adults, and prevalence appears to peak in adults aged 26–28 (up to 20%).[7] The vast majority of cases are reported to be mild, and proportionally few individuals seek medical attention regarding the condition.


Cholinergic urticaria was first described by Duke[10] in 1924 as "urticaria calorica". The term cholinergic is derived from the finding that hives similar to those of CU can be evoked using cholinergic agonists (e.g. methacholine).

See also


  1. 1.0 1.1 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "7. Erythema and urticaria". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Elsevier. pp. 151–152. ISBN 978-0-323-54753-6. Archived from the original on 2023-04-29. Retrieved 2023-04-29.
  2. Schwartz, Robert. "Cholinergic Urticaria". Medscape. Archived from the original on 25 August 2018. Retrieved 20 March 2018.
  3. Nakamizo, S.; Egawa, G.; Miyachi, Y.; Kabashima, K. (2012). "Cholinergic urticaria: Pathogenesis-based categorization and its treatment options". Journal of the European Academy of Dermatology and Venereology. 26 (1): 114–116. doi:10.1111/j.1468-3083.2011.04017.x. PMID 21371134. Archived from the original on 2020-09-30. Retrieved 2020-12-10.
  4. Moore-Robinson, M.; Warin, R. P. (1968). "Some clinical aspects of cholinergic urticaria". The British Journal of Dermatology. 80 (12): 794–799. doi:10.1111/j.1365-2133.1968.tb11948.x. PMID 5706797.
  5. Hirschmann, J. V.; Lawlor, F.; English, J. S.; Louback, J. B.; Winkelmann, R. K.; Greaves, M. W. (1987). "Cholinergic urticaria. A clinical and histologic study". Archives of Dermatology. 123 (4): 462–467. doi:10.1001/archderm.1987.01660280064024. PMID 3827277.
  6. Poon, E.; Seed, P. T.; Greaves, M. W.; Kobza-Black, A. (1999). "The extent and nature of disability in different urticarial conditions". The British Journal of Dermatology. 140 (4): 667–671. doi:10.1046/j.1365-2133.1999.02767.x. PMID 10233318.
  7. 7.0 7.1 Zuberbier, T.; Althaus, C.; Chantraine-Hess, S.; Czarnetzki, B. M. (1994). "Prevalence of cholinergic urticaria in young adults". Journal of the American Academy of Dermatology. 31 (6): 978–981. doi:10.1016/S0190-9622(94)70267-5. PMID 7962780.
  8. Silpa-Archa, N.; Kulthanan, K.; Pinkaew, S. (2011). "Physical urticaria: Prevalence, type and natural course in a tropical country". Journal of the European Academy of Dermatology and Venereology. 25 (10): 1194–1199. doi:10.1111/j.1468-3083.2010.03951.x. PMID 21175877.
  9. Godse, K.; Farooqui, S.; Nadkarni, N.; Patil, S. (2013). "Prevalence of cholinergic urticaria in Indian adults". Indian Dermatology Online Journal. 4 (1): 62–63. doi:10.4103/2229-5178.105493. PMC 3573461. PMID 23437429.
  10. DDuke, W. W. (1924). "URTICARIA CAUSED SPECIFICALLY BY THE ACTION OF PHYSICAL AGENTS: (LIGHT, COLD, HEAT, FREEZING, BURNS, MECHANICAL IRRITATION, AND PHYSICAL AND MENTAL EXERTION)". JAMA: The Journal of the American Medical Association. 83: 3–9. doi:10.1001/jama.1924.02660010007002.

External links

External resources