Resolution of Refractory Cholinergic Urticaria in a Child Treated With Dupilumab

Cholinergic urticaria (CholU) is a chronic, inducible urticaria triggered by an increase in body temperature and is often refractory to antihistamine therapy. We report a 17-year-old male with a one-year history of persistent pruritus, stinging, and wheals following exercise and minor physical exertion. After no response to antihistamines, he was started on dupilumab and achieved complete resolution of these episodes within four months. To our knowledge, dupilumab has not previously been reported as an off-label treatment for pediatric CholU, highlighting the need for further studies.