Sweat hypersensitivity Type CU

Specialty| Dermatology

Sweat hypersensitivity is a type of Cholinergic urticaria which refers to those who are hypersensitive to their own sweat.[1]

## Contents

* 1 Signs and symptoms
* 2 Pathophysiology
* 3 Diagnosis
* 4 Treatment
* 5 References

## Signs and symptoms[edit | edit source]

The hives are observed to coincide with perspiration points of sweating.[2]

## Pathophysiology[edit | edit source]

Tanaka et al. found that the sweat hyper-sensitivities of CU and atopic dermatitis seem to be virtually the same, and therefore, the sweat-induced histamine release from basophils may also be mediated by a specific IgE for sweat in atopic dermatitis as well as CU.[2]

## Diagnosis[edit | edit source]

Diagnosis is made by injecting autologous (the person's own) sweat into the skin.[3]

## Treatment[edit | edit source]

* Proposed first-line treatment: Rapid desensitization protocol using autologous sweat.[3]
* Non-pharmacological treatment: Forced perspiration by excessive body warming (hot bath or exercise) used daily may reduce the symptoms through exhaustion of inflammatory mediators.[4] This non-pharmacological treatment is contraindicated in those with CU as a result of hypohidrosis (see below).
* Antihistamines are a commonly prescribed first-line treatment for conventional urticaria, but its effectiveness in the treatment of CU is rather limited in most cases. Some research suggests that first-generation antihistamines with anticholinergic properties such as diphenhydramine are most successful at treating CU.[citation needed]
* Treatment(s) with mixed success: omalizumab (anti-IgE therapy),[5][6] danazol (synthetic androgen),[7] propranolol (beta blocker),[8][9] zileuton (antileukotriene).

## References[edit | edit source]

1. ↑ "Cholinergic Urticaria: Background, Pathophysiology, Etiology". 2021-02-12. Archived from the original on 2018-08-25. Retrieved 27 June 2021.
2. ↑ 2.0 2.1 Bito, T.; Sawada, Y.; Tokura, Y. (2012). "Pathogenesis of cholinergic urticaria in relation to sweating". Allergology International. 61 (4): 539–544. doi:10.2332/allergolint.12-RAI-0485. PMID 23093795.
3. ↑ 3.0 3.1 Kozaru, T.; Fukunaga, A.; Taguchi, K.; Ogura, K.; Nagano, T.; Oka, M.; Horikawa, T.; Nishigori, C. (2011). "Rapid Desensitization with Autologous Sweat in Cholinergic Urticaria". Allergology International. 60 (3): 277–281. doi:10.2332/allergolint.10-OA-0269. PMID 21364312.
4. ↑ Kobayashi, H.; Aiba, S.; Yamagishi, T.; Tanita, M.; Hara, M.; Saito, H.; Tagami, H. (2002). "Cholinergic urticaria, a new pathogenic concept: Hypohidrosis due to interference with the delivery of sweat to the skin surface". Dermatology. 204 (3): 173–178. doi:10.1159/000057877. PMID 12037443.
5. ↑ Metz, M.; Bergmann, P.; Zuberbier, T.; Maurer, M. (2008). "Successful treatment of cholinergic urticaria with anti-immunoglobulin E therapy". Allergy. 63 (2): 247–249. doi:10.1111/j.1398-9995.2007.01591.x. PMID 18186820.
6. ↑ Sabroe, R. A. (2010). "Failure of omalizumab in cholinergic urticaria". Clinical and Experimental Dermatology. 35 (4): e127–e129. doi:10.1111/j.1365-2230.2009.03748.x. PMID 19925484.
7. ↑ La Shell, M. S.; England, R. W. (2006). "Severe refractory cholinergic urticaria treated with danazol". Journal of Drugs in Dermatology. 5 (7): 664–667. PMID 16865874.
8. ↑ Pachor, M. L.; Lunardi, C.; Nicolis, F.; Cortina, P.; Accordini, C.; Marchi, G.; Corrocher, R.; De Sandre, G. (1987). "Usefulness of propranolol in the treatment of cholinergic urticaria". La Clinica Terapeutica. 120 (3): 205–210. PMID 2973859.
9. ↑ Ammann, P.; Surber, E.; Bertel, O. (1999). "Beta blocker therapy in cholinergic urticaria". The American Journal of Medicine. 107 (2): 191. doi:10.1016/S0002-9343(99)00038-8. PMID 10460061.

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Urticaria and erythema

Urticaria
(acute/chronic)|

| Allergic urticaria|

* Urticarial allergic eruption

|

Physical urticaria|

* Cold urticaria
* Familial
* Primary cold contact urticaria
* Secondary cold contact urticaria
* Reflex cold urticaria

* Heat urticaria
* Localized heat contact urticaria
* Solar urticaria

* Dermatographic urticaria
* Vibratory angioedema
* Pressure urticaria
* Cholinergic urticaria
* Aquagenic urticaria

Other urticaria|

* Acquired C1 esterase inhibitor deficiency
* Adrenergic urticaria
* Exercise urticaria
* Galvanic urticaria
* Schnitzler syndrome
* Urticaria-like follicular mucinosis

Angioedema|

* Episodic angioedema with eosinophilia
* Hereditary angioedema

Erythema|

| Erythema multiforme/
drug eruption|

* Erythema multiforme minor
* Erythema multiforme major
* Stevens–Johnson syndrome, Toxic epidermal necrolysis
* panniculitis (Erythema nodosum)
* Acute generalized exanthematous pustulosis

|

Figurate erythema|

* Erythema annulare centrifugum
* Erythema marginatum
* Erythema migrans
* Erythema gyratum repens

Other erythema|

* Necrolytic migratory erythema
* Erythema toxicum
* Erythroderma
* Palmar erythema
* Generalized erythema

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