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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/06/03 15:07:00」(JST)

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Dermatographic urticaria (also known as dermographism, dermatographism or "skin writing") is a skin disorder seen in 4–5% of the population and is one of the most common types of urticaria,^[1] in which the skin becomes raised and inflamed when stroked, scratched, rubbed, and sometimes even slapped.^[2] It is most common in young adults, ages 20-30 during times of high stress or depression.

Presentation

The symptoms are thought to be caused by mast cells in the surface of the skin releasing histamines without the presence of antigens, due to the presence of a weak membrane surrounding the mast cells. The histamines released cause the skin to swell in the affected areas.

Self-referential illustration of dermatographic urticaria

This weak membrane easily and rapidly breaks down under physical pressure causing an allergic-like reaction, in general a red wheal (welt) to appear on the skin. It can often be confused with an allergic reaction to the object causing a scratch, when in fact it is the act of being scratched that causes a wheal to appear. These wheals are a subset of urticaria (hives) that appear within minutes, in some cases accompanied with itching. The first outbreak of urticaria can lead to others on body parts not directly stimulated, scraped, or scratched. In a normal case, the swelling will reduce itself with no treatment within 15–30 minutes, but, in extreme cases, itchy red weals may last anywhere from a few hours to days.

Causes

The underlying cause of dermographism is not known, and can last for many years without relief. Ninety-five percent of chronic cases are never solved. Increased incidence has been observed following prolonged exposure to microwaves.^[3]^[4] Sometimes the condition goes away, sometimes it stays forever. It is not a life-threatening disease and is not contagious.

Symptoms can be induced by periods of stress, tight or abrasive clothing, watches, glasses, heat, cold,^[5] or anything that causes stress to the skin or the patient. In many cases, it is a great annoyance, effecting shame and embarrassment upon sufferers, and in some rare cases symptoms are severe enough to impact a patient's life.

Treatment

Dermographism can be treated by antihistamines, which prevent histamine from causing the reaction. These may need to be given as a combination of H₁ antagonists, or possibly with an H₂-receptor antagonist such as cimetidine.^[6]^[7]

Not taking hot baths or showers may help if it is generalized (all over) and possibly for localized (in a specific area). If not taking showers helps, it may be a condition called shower eczema. If it affects mainly the head, it may be psoriasis. In rare cases, allergy tests may uncover substances the patient is allergic to. Using biodegradable or hypo-allergenic soaps and laundry supplies may help.

While cromoglycate, which prevents histamine from being released from mast cells, is used topically in rhinitis and asthma, it is not effective orally for treating chronic urticaria.^[8]^[9]

Frequent anecdotal evidence suggests taking in small amounts of alcohol may help with the itching, or temporary cause the inflammation/welts to subside.

Acupuncture and Chinese herbs have long been used to treat urticaria in the Asian world. Results of clinical trials of both acupuncture and Chinese herbs are inconclusive and are possibly a result of the placebo effect, as the trials did not involve a control group.^[10]^[11]^[12]

References

^ Jedele KB, Michels VV (1991). "Familial dermographism". Am. J. Med. Genet. 39 (2): 201–3. DOI:10.1002/ajmg.1320390216. PMID 2063925. http://www3.interscience.wiley.com/cgi-bin/fulltext/110516063/PDFSTART.
^ Kontou-Fili K, Borici-Mazi R, Kapp A, Matjevic LJ, Mitchel FB (1997). "Physical urticaria: classification and diagnostic guidelines. An EAACI position paper". Allergy 52 (5): 504–13. DOI:10.1111/j.1398-9995.1997.tb02593.x. PMID 9201361.
^ "Sadcikova Clinical manifestations of reactions to microwave irradiation in various occupational groups 1973". http://www.scribd.com/doc/35452882/Sadcikova-Clinical-manifestations-of-reactions-to-microwave-irradiation-in-various-occupational-groups-1973. Retrieved 6 May 2012.
^ B. Hocking (February 2001). "Microwave sickness: a reappraisal". Occupational medicine (Oxford, England) 51 (1): 66–69. PMID 11235831.
^ Kaplan AP (1984). "Unusual cold-induced disorders: cold-dependent dermatographism and systemic cold urticaria". J Allergy Clin Immunol 73 (4): 453–6. DOI:10.1016/0091-6749(84)90354-3. PMID 6200525.
^ Wozel G, Sahre EM, Barth J (1990). "[Effectiveness of combination treatment with H1-(Tavegyl) and H2-antagonists (Altramet) in chronic/chronically-recurrent urticaria]" (in German). Dermatologische Monatschrift 176 (11): 653–9. PMID 2083605.
^ Negro-Alvarez JM, Miralles-López JC (2001). "Chronic idiopathic urticaria treatment" (^{[dead link]} – ^{Scholar search}). Allergologia et immunopathologia 29 (4): 129–32. PMID 11674926. http://db.doyma.es/cgi-bin/wdbcgi.exe/doyma/mrevista.pubmed_full?inctrl=05ZI0102&rev=105&vol=29&num=4&pag=129.
^ Thormann J, Laurberg G, Zachariae H (March 1980). "Oral sodium cromoglycate in chronic urticaria". Allergy 35 (2): 139–41. DOI:10.1111/j.1398-9995.1980.tb01728.x. PMID 6770707.
^ Soter NA (December 1990). "Urticaria: current therapy". The Journal of allergy and clinical immunology 86 (6 Pt 2): 1009–14. DOI:10.1016/S0091-6749(05)80245-3. PMID 1979795.
^ Jianli Che (2006). "The Effect of Acupuncture on Serum IgE Level in Patients with Chronic Urticaria". Journal of Traditional Chinese Medicine 26 (3): 189–190. PMID 17078446. http://d.wanfangdata.com.cn/Periodical_zyzz-e200603012.aspx.
^ Chung-Jen Chen MD, Hsin-Su Yu MD PhD (1998). "Acupuncture Treatment of Urticaria". Archives of Dermatolology 134 (11): 1397–1399. DOI:10.1001/archderm.134.11.1397. PMID 9828874. http://archderm.ama-assn.org/cgi/content/abstract/134/11/1397.
^ Benjamin Kligler, Roberta A. Lee (April 2004). Integrative medicine: principles for practice. 134. McGraw-Hill Professional. pp. 371–377. ISBN 978-0-07-140239-2. http://books.google.com/?id=-JUcjUGBV6kC.

UpToDate Contents

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1. 物理性蕁麻疹 physical urticarias
2. 好酸球増加症候群の臨床症状、病態生理、および診断 clinical manifestations pathophysiology and diagnosis of the hypereosinophilic syndromes
3. そう痒症：疫学および患者評価 pruritus etiology and patient evaluation
4. 寒冷蕁麻疹 cold urticaria
5. 肥満細胞活性化障害 mast cell activation disorders

English Journal

Physical urticarias and cholinergic urticaria.

Abajian M, Schoepke N, Altrichter S, Zuberbier HC, Maurer M.Author information Department of Dermatology and Allergy, Allergie - Centrum Charité/ECARF, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany.AbstractPhysical urticarias are a unique subgroup of chronic urticaria in which urticarial responses can be reproducibly induced by different specific physical stimuli acting on the skin. These conditions include urticaria factitia/symptomatic dermographism, delayed pressure urticaria, cold contact urticaria, heat contact urticaria, solar urticaria, and vibratory urticaria/angioedema. Physical urticarias and cholinergic urticarias are diagnosed based on the patients' history and provocation tests including trigger threshold testing where possible. Treatment is mainly symptomatic. Many patients benefit from avoiding eliciting triggers, and desensitization to these triggers can be helpful in some physical urticarias and in cholinergic urticaria.
Immunology and allergy clinics of North America.Immunol Allergy Clin North Am.2014 Feb;34(1):73-88. doi: 10.1016/j.iac.2013.09.010. Epub 2013 Oct 28.
Physical urticarias are a unique subgroup of chronic urticaria in which urticarial responses can be reproducibly induced by different specific physical stimuli acting on the skin. These conditions include urticaria factitia/symptomatic dermographism, delayed pressure urticaria, cold contact urticari
PMID 24262690

Retreatment With Omalizumab Results in Rapid Remission in Chronic Spontaneous and Inducible Urticaria.

Metz M, Ohanyan T, Church MK, Maurer M.Author information Department of Dermatology, Venerology, and Allergology, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany.AbstractIMPORTANCE Omalizumab has emerged as a novel and effective treatment option for patients with antihistamine-resistant chronic urticaria. It is unclear whether patients with recurrent urticaria symptoms after discontinuation of omalizumab treatment can benefit from retreatment. OBJECTIVE To assess the response of patients with chronic urticaria who receive omalizumab retreatment. DESIGN, SETTING, AND PARTICIPANTS Retrospective analyses were conducted of outpatients treated at an urticaria specialist center of a university hospital. Participants included 25 consecutive patients (aged 18-74 years; 18 women) with chronic spontaneous urticaria, chronic inducible urticaria, or both who showed complete response to omalizumab treatment, experienced relapse after discontinuation of treatment, and received retreatment with omalizumab. INTERVENTIONS Subcutaneous treatment with omalizumab (150-600 mg/mo). MAIN OUTCOMES AND MEASURES Response after retreatment was assessed by the urticaria activity score in patients with chronic spontaneous urticaria and by trigger threshold testing (in patients with cold urticaria or symptomatic dermographism) and/or a carefully determined history (in patients with cholinergic urticaria, solar urticaria, or pressure urticaria). Adverse events were documented. RESULTS All patients experienced complete response after retreatment. None of the patients reported relevant adverse events during omalizumab treatment and retreatment. CONCLUSIONS AND RELEVANCE Omalizumab retreatment is effective and safe in patients with chronic urticaria who have benefited from initial omalizumab treatment.
JAMA dermatology.JAMA Dermatol.2014 Jan 29. doi: 10.1001/jamadermatol.2013.8705. [Epub ahead of print]
IMPORTANCE Omalizumab has emerged as a novel and effective treatment option for patients with antihistamine-resistant chronic urticaria. It is unclear whether patients with recurrent urticaria symptoms after discontinuation of omalizumab treatment can benefit from retreatment. OBJECTIVE To assess th
PMID 24477320

Evidence for a role of neural pathways in dermographism.

Ralph JW.
The British journal of dermatology.Br J Dermatol.2013 Dec;169(6):1362-3. doi: 10.1111/bjd.12506.
PMID 23855485

Japanese Journal

Six Cases of Antihistamine-Resistant Dermographic Urticaria Treated with Oral Ciclosporin

Toda Sayuri,Takahagi Shunsuke,Mihara Shoji,Hide Michihiro
Allergology International 60(4), 547-550, 2011
Background: Dermographic urticaria (DU) is characterized by strong itch and wheals induced by mechanical scratching. H1-receptor antagonists may reduce symptoms of DU to some extent, but other treatme …
NAID 130004477118

Adult-onset Still's disease : a report of 28 cases and review of the literature

MEHRPOOR Golbarg,OWLIA Mohammad Bagher,SOLEIMANI Hossein,AYATOLLAHI Jamshid
Modern rheumatology 18(5), 480-485, 2008-10-01
NAID 10024374236

皮膚描記テストの評価システムの開発

熱海健志,山本紳一郎,米田隆志,小山浩幸,滝脇弘嗣
ライフサポート 16(Supplement), 153-154, 2004
NAID 130001056075

Related Pictures

Dermographism Urticaria: Background, Pathophysiology and Etiology, Epidemiology Dermographism - Pictures, Causes, Symptoms, Treatment Dermatographism | Dermatographic Urticaria | What Is Dermographism (Skin Writing Disease)? Dermagraphism = الكتوبية الجلدية او الجلد القرطاسي The Multi Mom: Dermographism (Chronic Urticaria) Dermographism images | DermNet NZ Dermographism - Pictures, Causes, Symptoms, Treatment

★リンクテーブル★

リンク元

「皮膚描記症」

Dermatographic urticaria
	Classification and external resources
	; Dermatographic urticaria is sometimes called "skin writing".
ICD-10	L50.3
ICD-9	708.3
OMIM	125635
DiseasesDB	12736
eMedicine	derm/446

　　[★]

英: dermographism, dermographia, dermography
ラ: dermographismus
同: デルモグラフィー
関: 紅色皮膚描記症, 白色皮膚描記症

[0] Jedele KB, Michels VV (1991). "Familial dermographism". Am. J. Med. Genet. 39 (2): 201–3. DOI:10.1002/ajmg.1320390216. PMID 2063925. http://www3.interscience.wiley.com/cgi-bin/fulltext/110516063/PDFSTART.

[1] Kontou-Fili K, Borici-Mazi R, Kapp A, Matjevic LJ, Mitchel FB (1997). "Physical urticaria: classification and diagnostic guidelines. An EAACI position paper". Allergy 52 (5): 504–13. DOI:10.1111/j.1398-9995.1997.tb02593.x. PMID 9201361.

[2] "Sadcikova Clinical manifestations of reactions to microwave irradiation in various occupational groups 1973". http://www.scribd.com/doc/35452882/Sadcikova-Clinical-manifestations-of-reactions-to-microwave-irradiation-in-various-occupational-groups-1973. Retrieved 6 May 2012.

[3] B. Hocking (February 2001). "Microwave sickness: a reappraisal". Occupational medicine (Oxford, England) 51 (1): 66–69. PMID 11235831.

[4] Kaplan AP (1984). "Unusual cold-induced disorders: cold-dependent dermatographism and systemic cold urticaria". J Allergy Clin Immunol 73 (4): 453–6. DOI:10.1016/0091-6749(84)90354-3. PMID 6200525.

[pmid2083605-5] Wozel G, Sahre EM, Barth J (1990). "[Effectiveness of combination treatment with H1-(Tavegyl) and H2-antagonists (Altramet) in chronic/chronically-recurrent urticaria]" (in German). Dermatologische Monatschrift 176 (11): 653–9. PMID 2083605.

[pmid11674926-6] Negro-Alvarez JM, Miralles-López JC (2001). "Chronic idiopathic urticaria treatment" (^{[dead link]} – ^{Scholar search}). Allergologia et immunopathologia 29 (4): 129–32. PMID 11674926. http://db.doyma.es/cgi-bin/wdbcgi.exe/doyma/mrevista.pubmed_full?inctrl=05ZI0102&rev=105&vol=29&num=4&pag=129.

[pmid6770707-7] Thormann J, Laurberg G, Zachariae H (March 1980). "Oral sodium cromoglycate in chronic urticaria". Allergy 35 (2): 139–41. DOI:10.1111/j.1398-9995.1980.tb01728.x. PMID 6770707.

[pmid1979795-8] Soter NA (December 1990). "Urticaria: current therapy". The Journal of allergy and clinical immunology 86 (6 Pt 2): 1009–14. DOI:10.1016/S0091-6749(05)80245-3. PMID 1979795.

[9] Jianli Che (2006). "The Effect of Acupuncture on Serum IgE Level in Patients with Chronic Urticaria". Journal of Traditional Chinese Medicine 26 (3): 189–190. PMID 17078446. http://d.wanfangdata.com.cn/Periodical_zyzz-e200603012.aspx.

[10] Chung-Jen Chen MD, Hsin-Su Yu MD PhD (1998). "Acupuncture Treatment of Urticaria". Archives of Dermatolology 134 (11): 1397–1399. DOI:10.1001/archderm.134.11.1397. PMID 9828874. http://archderm.ama-assn.org/cgi/content/abstract/134/11/1397.

[11] Benjamin Kligler, Roberta A. Lee (April 2004). Integrative medicine: principles for practice. 134. McGraw-Hill Professional. pp. 371–377. ISBN 978-0-07-140239-2. http://books.google.com/?id=-JUcjUGBV6kC.

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dermographism