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Chapter 054. Skin Manifestations of Internal Disease (Part 17)

Table 54-14 Causes of Urticaria and Angioedema I. Primary cutaneous disorders A. Acute and chronic urticariaa B. Physical urticaria 1. Dermatographism 2. Solar urticariab 3. Cold urticariab 4. Cholinergic urticariab C. Angioedema (hereditary and acquired)b II. Systemic diseases A. Urticarial vasculitis B. Hepatitis B or C infection C. Serum sickness D. Angioedema (hereditary and acquired) a A small minority develop anaphylaxis. b Also systemic. The common physical urticarias include dermographism, solar urticaria, cold urticaria, and cholinergic urticaria. Patients with dermographism exhibit linear wheals following minor pressure or scratching of the skin. It is a common disorder, affecting ~5% of the population. Solar urticaria characteristically occurs within minutes of sun exposure and is a skin sign of one. | Chapter 054. Skin Manifestations of Internal Disease Part 17 Table 54-14 Causes of Urticaria and Angioedema I. Primary cutaneous disorders A. Acute and chronic urticaria B. Physical urticaria 1. Dermatographism 2. Solar urticaria0 3. Cold urticaria0 4. Cholinergic urticaria0 C. Angioedema hereditary and acquired 0 II. Systemic diseases A. Urticarial vasculitis B. Hepatitis B or C infection C. Serum sickness D. Angioedema hereditary and acquired aA small minority develop anaphylaxis. Also systemic. The common physical urticarias include dermographism solar urticaria cold urticaria and cholinergic urticaria. Patients with dermographism exhibit linear wheals following minor pressure or scratching of the skin. It is a common disorder affecting 5 of the population. Solar urticaria characteristically occurs within minutes of sun exposure and is a skin sign of one systemic disease erythropoietic protoporphyria. In addition to the urticaria these patients have subtle pitted scarring of the nose and hands. Cold urticaria is precipitated by exposure to the cold and therefore exposed areas are usually affected. In some patients the disease is associated with abnormal circulating proteins more commonly cryoglobulins and less commonly cryofibrinogens or cold agglutinins. Additional systemic symptoms include wheezing and syncope thus explaining the need for these patients to avoid swimming in cold water. Cholinergic urticaria is precipitated by heat exercise or emotion and is characterized by small wheals with relatively large flares. It is occasionally associated with .