Cholinergic urticaria: More than a simple inducible urticaria

Background: Cholinergic urticaria (ChU) is characterized by small wheals induced by an elevated core temperature. Its pathomechanism and various aspects of its clinical manifestations are still poorly understood. This study aimed to evaluate the spectrum of symptoms and signs of ChU in Korean patients. Methods: We retrospectively reviewed the medical records of patients diagnosed with ChU. Results: Among 203 patients (188 male and 15 female), 29 (14%) complained only of an itching or burning sensation without visible skin eruption. The prevalence of ChU was highest in patients in their twenties (56%), while most patients first developed their symptoms during their teens (65%). Patients with a visible skin eruption showed better responses to antihistamines than those without skin lesions. Conclusions: Physicians should consider the varying manifestations of ChU, including cholinergic pruritus and erythema as minor variants, to provide better management of ChU.