Do i have Cholinergic urticaria?? Please help - Photos attached

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Hi Everyone,

I have recently been getting what i think is Cholinergic urticaria. I have been to a dermatologist and all he could say was that it could be a rare form of urticaria. Fleofedine - the antihistamine hasnt worked for me, it made no difference.

Basically i get it when theres a change in body temp and has been happening for about a year. This includes when i walk to work and about 20mins in i get what feels like prickly heat all over and can feel my body get warm. It also happens at the start of when i play sport (2-3 times a week), but once i sweat it out im fine.

Its very uncomfortable when it happens and the only thing that helps is getting some cold like a cold drink or an air conditioned room. Its frustrating as i walk to work and exercise regularly to keep healthy and its almost like its god way of saying STOP being healthly.

The following photos are from after a 1hr game of squash. Can anyone confirm that its Cholinergic urticaria? Any help would be great.

http://i19.photobucket.com/albums/b157/burr_ger/CIMG4340.jpg
http://i19.photobucket.com/albums/b157/burr_ger/Image039.jpg


Thanks

Simon

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the photo of my arm is very bright, if you turn down your brightness you can see in detail the little lumps and redness on my arm. Thanks

[dice]

Whilst having these marks/rashes doesn't guarantee that you have Cholinergic Urticaria (your dermatologist should aid in confirming this), your symptoms certainly suggest this.

I developed Cholinergic Urticaria when I was around 4-5 year old and had pretty severe rashes along with constant itching. This stopped until I was 13 having taken a number of dosages of a specific type of steroid (from the ER - it isn't recommended, I don't recommend that you go down this road either).

Whilst not a permanent solution (depending on how you see this method), I find that daily cardio exercise provides an itch free day for, especially in the winter where it's pretty cold (in the UK). I believe that is a lack of sweat that is causing this as I only feel relief once I'm sweating efficiently. In the right conditions/exercise routine I could be sweating within 3 minutes. I suggest you read some of my posts (e.g. here) if you want more info.

I know it's not a permanent solution but it's the first time in about 6 years that I've more or less had an itch free winter (so far). And it's a motivator to keep fit. Good luck.

[HivesGuy]

Hello Simon and welcome to the forum!

I second what dice says and you should get a definite diagnosis from a licensed doctor to confirm, but it could definitely be cholinergic urticaria. Sometimes my skin gets red and kinda blotchy during an attack (which is how yours kinda looks in the pics), and I don't actually get the hive bumps. In fact, my chest looked like that just 2 nights ago.

Plus the fact that this only happens when you get hot or exercise, and it is relieved by cooling down (or once you start to sweat), sounds exactly like cholinergic urticaria.

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Thanks for the replies. When i went to the dermatologist he said that it was possibley a RARE form of urticaria and gave me the fenofexadine to try. He said there was no point booking another appointment as there is nothing more they can do. I guess from reading the forum that its true that there is no cure and that its more trial and error to see what helps.

The strange thing for me is that it happens more in the summer, looks like for most its happens in the winter. The fact that its cold now is a relief, in the summer when the sun is shinning my body temp rises and i get this prickly heat sensation -  which is the start of it happening and becomes very uncomfortable.

One thing i noticed for myself is it i stop doing exercise and put on a bit of wieght i actaully get it worse. Im guessing with the extra fat the body heats up a lot more quickly and its a lot worse. Also like with a lot of people once you sweat it out you feel better.

Is it ture that it may have something to do with the hardness of the water? Im thinking of putting a watrer filter in to soften it.

[HivesGuy]

About the water softening:

I have found that softer water, combined with a good moisturizing soap (like dove), helps a lot to keep the skin in better condition. This, in turn, seems to make the skin more bearable, and may slightly decrease the intensity or frequency of attacks.  But just let me stress that it by no means is a cure-all, and I still have Cholinergic Urticaria. But it may be worth it just to have better skin that is less dry/itchy.

As far as the season thing, I really get Cholinergic Urticaria in BOTH summer and winter, but in different ways. For example, in the summer, I get a reaction on days when I go outside and the sun is scortching. But after that, I usually sweat (sometimes for days), and I don't have as bad reactions. So when going from my air conditioned house to the heat outside, it spurs a reaction.

In the winter, however, I usually enjoy a nice relief while inside my house (I rarely turn on the heater), and of course outside it is nice and cold as well. But the problem here is going into a crisp, hot building. That extreme temperature change from cool/cold to warm/hot sends my body practically into shock.

Yesterday would be a great example of that. I went into walmart, and they had the heat blasting. I instantly started getting prickly/itchy, and I just handed my wife the credit card and told her she is going to have to shop without me. I then went to the car, and scrached with the A/C on full blast until I cooled off.

Like you said, once we sweat we are usually fine. However, during the winter it gets very dry and cold, and sweating becomes a serious challenge. So I can hive multiple times per day, as opposed to the summer where I may just get hives once and then sweat.

[burr_ger]

Feeling 90% better... See my new post on how:

http://www.cholinergicurticaria.net/forum/index.php?topic=415.0