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Dermographism Urticaria

Background

The term dermographism (or dermatographism) literally means writing on the skin. Firm stroking of the skin produces an initial red line (capillary dilatation), followed by an axon-reflex flare with broadening erythema (arteriolar dilatation) and the formation of a linear wheal (transudation of fluid/edema); these events are collectively termed the triple response of Lewis.

An exaggerated response to this constitutional whealing tendency is seen in approximately 2-5% of the population and is referred to as dermographism. In a minority of people, it is accompanied by itching (symptomatic dermographism).

See the image below.

Dermographism urticaria. Courtesy of Professor Rai

Dermographism urticaria. Courtesy of Professor Raimo Suhonen and DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/reactions/s/dermographism2.jpg).

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Dermographism should be distinguished from other types of urticaria. See the following articles:

Acute urticaria

Cholinergic urticaria

Chronic urticaria

Contact syndrome urticaria

Pressure urticaria

Solar urticaria

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