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Physical urticaria: Clinical features, pathogenesis, diagnostic work-up, and management
Sheila M McSweeney1, Evangelos A A Christou1, Marcus Maurer2
1St. John's Institute of Dermatology, Guy's Hospital, London, England.
Journal of the American Academy of Dermatology
|March 31, 2023
Summary
Physical urticaria involves skin reactions like hives and swelling triggered by physical stimuli such as cold, heat, or pressure. Accurate diagnosis through clinical assessment and provocation testing is key for effective management of these conditions.
Area of Science:
- Dermatology
- Immunology
Background:
- Physical urticaria encompasses a group of conditions characterized by recurrent wheals and/or angioedema.
- These reactions are triggered by external physical stimuli, including mechanical, thermal, or solar factors.
Purpose of the Study:
- To provide an evidence-based summary of physical urticaria.
- To cover epidemiology, clinical features, pathogenesis, diagnostic approaches, and management strategies.
Main Methods:
- This review synthesizes current evidence on physical urticaria.
- It includes clinical assessment and provocation testing for diagnosis.
Main Results:
- Physical urticaria is classified by triggers: mechanical (friction, pressure, vibration), thermal (cold, heat), and solar radiation.
- Symptoms can include mucosal involvement and systemic effects like nausea, headache, or anaphylaxis.
Conclusions:
- Differentiating physical urticaria from other chronic urticarias requires careful clinical evaluation and specific testing.
- Appropriate management strategies are informed by accurate diagnosis.
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