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Severe refractory cholinergic urticaria treated with danazol
Mark S La Shell1, Ronald W England
1Department of Primary Care, Yokota AFB, Japan. mark.lashell@yokota.af.mil
Background:
Cholinergic urticaria is a form of physical urticaria triggered by a rise in core body temperature. Antihistamines are the mainstay of treatment; however, adequate symptom control can sometimes be difficult to maintain. Limited data suggest danazol may be an effective alternative in severe, refractory cases.
Methods And Results:
We present a case of a 22-year-old male with severe, refractory cholinergic urticaria. Despite treatment with high doses of antihistamines, he continued to have symptoms that impaired his ability to function. Treatment with danazol resulted in a significant improvement in the control of his urticaria.
Discussion:
Cholinergic urticaria can sometimes be severe. In cases that fail to respond to traditional forms of treatment, danazol is a viable alternative for the treatment of cholinergic urticaria. Given the potential adverse effects associated with its use, danazol should be reserved for more severe and refractory cases.
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