Adrenergic urticaria: a first report from Thailand

Area of Science:

• Dermatology
• Allergology
• Immunology

Background:

• Chronic urticaria presents a diagnostic challenge, often with varied triggers and presentations.
• Urticarial conditions can manifest with unique physical characteristics and physiological responses.

Observation:

• A 22-year-old female patient presented with a decade-long history of chronic urticaria.
• Distinctive pruritic papules surrounded by a blanched, vasoconstricted halo were observed during stress and exercise.
• The characteristic halo hives were successfully reproduced via intradermal adrenaline injection.

Findings:

• The patient's symptoms are consistent with adrenergic urticaria, a rare form of physical urticaria.
• The vasoconstricted halo is a key diagnostic feature, linked to the body's response to adrenaline.
• This case represents the inaugural documented instance of adrenergic urticaria in Thailand.

Implications:

• This report expands the geographical understanding of adrenergic urticaria.
• It highlights the importance of considering physical urticaria subtypes in patients with chronic hives.
• Further research into the pathophysiology and management of adrenergic urticaria is warranted.