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      Adrenergic Urticaria: An Updated Review

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          Abstract

          It can be difficult to delineate the cause of urticarial eruptions, and in chronic cases, it can be a challenging condition to effectively treat. Several forms of urticarial eruptions are well documented and established. Our review focuses on a form of urticaria that is less commonly reported: adrenergic urticaria. In this review, we aim to consolidate the literature in the hopes that this urticarial subtype is considered in urticarial differentials, as well as highlight potential gaps in the research and future directions in treatment options.

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          Locus Coeruleus Activity Mediates Hyperresponsiveness in Posttraumatic Stress Disorder

          Christoph Naegeli, Thomas Zeffiro, Marco Piccirelli … (2018)
          Article 0 comments Cited 47 times – based on 0 reviews     Review now
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            Adrenergic urticaria: a new form of stress-induced hives.

            W Shelley, E Shelley (1985)
            A distinctive new type of autonomic-system-dependent urticaria was seen in two patients. This "adrenergic" urticaria is to be contrasted with cholinergic urticaria. Widespread pruritic, urticarial papules developed at times of stress, each papule being surrounded by a striking white halo. Associated with these lesions was an increase in plasma noradrenaline and adrenaline concentrations. In severe attacks large plaques of urticaria appeared as well. The halo hives could be replicated with an intradermal injection of noradrenaline, but not with acetylcholine. Treatment with a beta-adrenoreceptor-blocker, propranolol, prevented attacks.
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              Dermatological Manifestations of Postural Tachycardia Syndrome Are Common and Diverse

              Wen-Hao Huang, Anindita Deb, Collin Culbertson … (2015)
              Background and Purpose Postural tachycardia syndrome (POTS) is a syndrome of orthostatic intolerance in the setting of excessive tachycardia with orthostatic challenge, and these symptoms are relieved when recumbent. Apart from symptoms of orthostatic intolerance, there are many other comorbid conditions such as chronic headache, fibromyalgia, gastrointestinal disorders, and sleep disturbances. Dermatological manifestations of POTS are also common and range widely from livedo reticularis to Raynaud's phenomenon. Methods Questionnaires were distributed to 26 patients with POTS who presented to the neurology clinic. They were asked to report on various characteristics of dermatological symptoms, with their answers recorded on a Likert rating scale. Symptoms were considered positive if patients answered with "strongly agree" or "agree", and negative if they answered with "neutral", "strongly disagree", or "disagree". Results The most commonly reported symptom was rash (77%). Raynaud's phenomenon was reported by over half of the patients, and about a quarter of patients reported livedo reticularis. The rash was most commonly found on the arms, legs, and trunk. Some patients reported that the rash could spread, and was likely to be pruritic or painful. Very few reported worsening of symptoms on standing. Conclusions The results suggest that dermatological manifestations in POTS vary but are highly prevalent, and are therefore of important diagnostic and therapeutic significance for physicians and patients alike to gain a better understanding thereof. Further research exploring the underlying pathophysiology, incidence, and treatment strategies is necessary.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 11 June 2024
                Publication date (Electronic, collection): June 2024
                Volume: 16
                Issue: 6
                Electronic Location Identifier: e62171
                Affiliations
                [1 ] Dermatology, Lincoln Memorial University DeBusk College of Osteopathic Medicine, Harrogate, USA
                [2 ] Medicine, Michigan State University College of Human Medicine, East Lansing, USA
                [3 ] Dermatology, MI Skin Center Dermatology Clinic, Northville, USA
                Author notes
                Article
                DOI: 10.7759/cureus.62171
                PMC ID: 11238893
                PubMed ID: 38993474
                SO-VID: 92921692-f951-47ca-8158-7748531af95e
                Copyright © Copyright © 2024, Slater et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 11 June 2024
                Categories
                Subject: Psychiatry
                Subject: Internal Medicine
                Subject: Dermatology

                Keywords: autoimmune disorders and urticaria,differential diagnosis of chronic urticaria,psychology and urticaria,urticarial eruptions,vasoconstriction in urticaria,stress-induced urticaria,adrenergic urticaria review,urticaria,adrenergic,adrenergic urticaria
                Data availability:
                Keywords: autoimmune disorders and urticaria, differential diagnosis of chronic urticaria, psychology and urticaria, urticarial eruptions, vasoconstriction in urticaria, stress-induced urticaria, adrenergic urticaria review, urticaria, adrenergic, adrenergic urticaria

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