Aspects of pathogenesis, differential and modifying approaches in cholinergic urticaria



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Abstract

Cholinergic urticaria is a subtype of chronic inducible urticaria mediated by hyper sweating and clinically manifested by urticarial elements, pruritus and angioedemas. This form of urticaria is of scientific interest considering its high prevalence in particular age groups, prolonged duration, distinct reduction in the quality of life of patients and high risk of developing life-threatening systemic reactions. There are types of anaphylaxis, also occurring due to increased sweating during physical activity. However, although clinical and laboratory characteristics have been described for each of these types, distinct differential diagnostic algorithms between these pathologies and systemic reactions in cholinergic urticaria have not yet been developed. Also, clear recommendations for modification of life style and limitation/elimination of the causal trigger for patients are currently open. These interventions are at the centre of therapy for all inducible forms of chronic urticaria. This article presents a review of the current literature and practical development of recommendations for specialists and patients.

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About the authors

Natalia P. Maltseva

State Research Center of Dermatovenerology and Cosmetology

Author for correspondence.
Email: maltseva.natalia.p@gmail.com
ORCID iD: 0000-0002-4022-3570
SPIN-code: 2588-5718
Россия, Moscow

Kseniya A. Ryabova

The First Sechenov Moscow State Medical University (Sechenov University)

Email: acksinja@gmail.com
ORCID iD: 0000-0003-0520-0936
SPIN-code: 9000-6894
Россия, Moscow

Yury V. Zhernov

The First Sechenov Moscow State Medical University (Sechenov University); Research Institute of Human Ecology and Environmental Hygiene named after A.N. Sysina, Centre for Strategic Planning and Management of Biomedical Health Risks

Email: zhernov_yu_v@staff.sechenov.ru
ORCID iD: 0000-0001-8734-5527
SPIN-code: 4538-9397

MD, Dr. Sci. (Medicine), Professor

Россия, Moscow; Moscow

Oksana V. Sebekina

Russian Medical Academy of Continuous Professional Education; City Clinical Hospital No. 24

Email: sebekin1@mail.ru
ORCID iD: 0000-0002-3508-9602
SPIN-code: 2922-9398

MD. Cand. Sci. (Medicine), Assistant Professor

Россия, Moscow; Moscow

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2. Fig. 1. Differential diagnostic algorithm for cholinergic urticaria and exercise-induced anaphylaxis scenarios (Compiled on the basis of a literature review [31–46]).

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