Dermographism is an abnormal reaction skin to mechanical irritation, in which the slightest impact leaves pronounced stripes on the body, often swelling and surrounded by an itchy rash. Depending on the color of these stripes, red or white dermographism of the skin is distinguished. The exact cause of the development of pathology is almost impossible to determine. In most cases, it is considered a type of urticaria caused by external or internal triggers.

The term “dermography” comes from the words derma - skin and grapho - write. Translated from Greek, it means “skin writing” or “skin writing.” In a person suffering from dermographism, the skin is indeed constantly “painted” with various symbols, similar to mysterious inscriptions. They are formed even from minor exposure to seams on clothing, folds of bed linen, or touching with a blunt object. It could be stripes different sizes and forms characterized slight swelling and redness or paleness of the skin.

Important! Similar manifestations found in every person. But if dermographism is normal, then with increased pressure on the skin, the affected area first turns pale and then acquires a natural color or a slightly reddish tint, which quickly disappears.

With dermographic urticaria, the pressure mark is distinguished not only by a more pronounced change in color, but also by swelling of the skin with itchy rashes on it. Such symptoms persist for several hours or days.

Species classification of dermographism

The division of this pathology into types is carried out according to the clinical picture of its manifestations at all stages of the disease. Depending on this, there are 4 types of dermographism:

In addition to the indicated types of dermographism, there are 2 forms of its occurrence - acute and chronic. In the first case, due to the hypersensitivity of the epidermis when pressed in inflammatory process not only the superficial, but also deeper layers are involved. This leads to long-term preservation of marks and the development of extensive inflammation, spreading to uninjured neighboring areas of the skin. Chronic dermographism, regardless of the “color” variety, is characterized by a less severe process, which manifests itself as irritation of the skin only at the site of pressure on it.

Reasons for the development of pathology

Despite the clearly defined characteristic manifestations that accompany dermographism, the causes of the pathology are quite difficult to determine. But a certain connection has been identified between a nonspecific skin reaction and some pathological conditions. Experts include the most common of them:

• constant stress;
• prolonged neuropsychic stress;
• alcohol intoxication;
• exposure to negative conditions external environment(critical temperatures, chemicals, etc.).

Each of these provoking factors can cause any type of dermographism.

In addition, the presence of an atypical skin reaction often becomes a symptom serious illnesses, in particular visceral nervous system. Therefore, if it manifests itself, it is necessary to immediately undergo a diagnostic examination.

If we talk about the mechanism of development of external manifestations, then cutaneous dermographism is caused by the reaction of the vessels of the epidermis to an irritant: red - by their expansion, white - sharp narrowing. Any physical impact becomes an irritating factor: friction, pressure, impact.

Diagnostic value of the disease

Direct determination of dermographism as a diagnosis is not difficult - this is easily done by pronounced characteristic manifestations on the skin during a visual examination and testing the skin for mechanical impact. However, this dermatological pathology is rarely an independent disease - most often it is one of the symptoms of the underlying disease. Therefore, it is impossible to say exactly which doctor treats dermographism. This could be an allergist, gastroenterologist, immunologist, neurologist, dermatologist or another specialist. To determine the cause and prescribe the correct treatment, it is extremely important to undergo a thorough diagnosis.

Important! Special attention requires dermographism in children, because in childhood the risk of disease progression, complications and side effects from treatment.

Diseases that cause dermographism pose a particular danger to a child. They can lead to the development of the following negative consequences:

• damage to various internal organs;
• decreased motor ability;
• changes in hormone levels;
• metabolic disorders at the cellular level;
• change in blood formula;
• disability, asphyxia, death.

Therefore, when the first signs of dermographism appear in children, you should immediately contact your pediatrician. Self-medication is strictly forbidden. Only qualified medical care can provide quality treatment and prevent the development of complications.


Before treating dermographism, a child or adult patient first undergoes a differential examination to identify or exclude the most likely diseases:

To identify the cause of dermographism, the following are prescribed:

Based on the results diagnostic studies The root cause of skin hypersensitivity is determined and a course of treatment is prescribed.

Treatment of dermographism

Unusual skin reaction to minor external influence largely depends on the functionality of nerve endings concentrated in the dermis. Therefore, if at diagnostic examination Since the underlying diseases that caused dermographism have not been established, it is correlated with a disorder of the nervous system.

Most often, an atypical skin reaction is caused by psycho-emotional stress and is eliminated without the use of strong medications. In the absence of serious concomitant diseases A few simple lifestyle changes may be enough to treat dermographism. It is necessary to streamline the daily routine, ensure good rest, exclude stressful situations and take a course of sedatives. All psychiatrists give such recommendations, linking the appearance of dermographism with dysfunction of those parts of the brain that are responsible for the tactile sensitivity of the skin. This is confirmed by statistics, according to which 20% of patients with mental disorders in the background organic damage brain have symptoms of dermographism.

For more severe stages of the disease, treatment is carried out in a hospital according to the following scheme:

1. The patient is isolated in a room where there is no sharp corners and solid objects.
2. Antihistamines are prescribed internally to eliminate skin reactions and sedatives to prevent or relieve stress.
3. Affected areas are treated antiseptic solutions.
4. Antibiotics are prescribed if necessary.

For most patients with dermographism, this treatment plan helps to quickly improve their well-being, reduce skin sensitivity, eliminate redness and prevent the development of extensive inflammation.

If the causes of the pathology, including those of a neuropathic nature, cannot be established, all that can be done is to eliminate its manifestations. For this purpose it is used drug therapy and home remedies.

Medicines

For the treatment of dermographism, drugs of 3 groups are used:

• antibiotics;
• vasoconstrictor or vasodilator - in accordance with the type of reaction.

Most often, taking medications internally has virtually no effect. Therefore, preference is given to means local action, which eliminate itching and inflammation. Claritin, Cetirizine, Zyrtec, Bricanil and other drugs aimed at relieving the effects of allergies, insect bites, inflammation and irritation are excellent for these purposes.

Folk remedies

Highly effective in the treatment of dermographism herbal infusions. They are prepared from celandine, string, chamomile, mint, coltsfoot, oak bark. These plants can be used alone or combined. For cooking healing infusion 2 tbsp. crushed plant material is steamed in 0.5 liters of boiling water and allowed to brew.

Treatment of the affected areas can be carried out with any in a convenient way– wipe, apply compresses or douses after a shower. Baths with the indicated infusions or with salt (preferably sea salt, but without chemical additives) will be useful. With daily use of such recipes positive results will become visible in 10–15 days.

Disease prevention

Since the underlying causes of dermographism are not clearly defined, it is necessary to determine the necessary preventive measures not easy either. Taking into account the fact that the skin is susceptible to damage, it would not be superfluous to observe the following precautions:

• choose loose clothing made from natural materials;
• do not rub your skin during water procedures, especially with a hard washcloth;
• purchase only hypoallergenic personal hygiene products and cosmetics;
• Avoid skin exposure to too low or high temperatures;
• give up bad habits;
• treat any diseases in a timely manner.

But the main thing is a healthy lifestyle, proper nutrition, good rest and lack of stress. Under such living conditions, it is possible to prevent the development of not only dermographism, but also many other serious diseases.

Causes, symptoms, diagnosis, consequences and treatment of dermographic urticaria: video

It is important to monitor your health in a timely manner, otherwise delay in such matters may cause disability. If red dermographism progresses, it is necessary to promptly find out the causes of the characteristic disease and begin conservative treatment to ensure normal indicators and eliminate discomfort. In fact, this is one of the varieties of the diagnosis “Urticarial dermographism”.

What is red dermographism

Diagnose characteristic disease on early stage development is difficult, and the pathological process only gets worse. Cutaneous dermographism is a persistent disease prone to chronic course. Externally, this is an allergy that begins with redness of the skin and continues with a burning sensation, itching and the formation of blisters. Dermographism is the reaction of the skin to thermal, mechanical and other effects on the upper layer of the epidermis. Before treatment, it is important to identify and treat the cause of dermographism.

Red dermographism – photo

Causes of red dermographism

Mechanical urticaria has a hereditary predisposition, or develops against a background of weakened immunity. These are not all pathogenic factors that a patient can learn about during a personal visit to a specialist. If dermographism is suspected, the red doctor recommends undergoing detailed diagnostics and tests, and collects medical history data. Below are the most common causes of dermographism, which only aggravate the clinical picture:

• emotional instability;
• persistent stress;
• mechanical effect on the skin;
• elevated temperatures environment;
• bad heredity;
• long-term use medicines;
• disorders of the thyroid gland;
• problems at work digestive system;
• mental illness;
• dysbacteriosis;
• food intoxication;
• the presence of helminthic infestations, lamblia;
• long-term alcoholism;
• intoxication of the body chemicals;
• environmental factor;
• allergic reaction due to weakened immunity.

Symptoms

The disease does not appear immediately, and the skin gradually acquires a new color and visible swelling appears. The person becomes nervous and irritable, any touch to the dermis causes discomfort, discomfort. The main symptoms of red dermographism are not only external factor, but also cause certain health problems. It is recommended to pay attention to the following signs of red dermographism:

• hemorrhagic rash, urticaria;
• formation of blisters on the body;
• reflex actions - scratch or rub the pathology;
• change in skin color (becomes pink, red, purple);
• physical exhaustion;
• the appearance of scars on the dermis;
• changes in the structure of the skin;
• increased swelling of the dermis.

Diagnostics

The characteristic pathology can be determined by a biochemical blood test, and donating biological material is indicated exclusively in laboratory conditions. Diagnosis of red dermographism additionally includes collecting medical history data and research to identify concomitant diagnoses. In addition, it is necessary differential diagnosis.

Treatment of red dermographism

The disease can remain in the life of an adult patient and a child for life, but the main goal and task of the patient is to maintain normal dermographism with conservative or alternative methods. Intensive care should start immediately after detailed diagnostics, provides integrated approach to the problem. Conservative treatment dermographism includes the following pharmacological groups:

• antihistamines: Loratadine, Zyrtec, Claritin, Tagamet, Cetirizine;
• decongestant ointments: Lekomax, Troxevasin, Arthralgin;
• antipruritics: Sinaflan, Diprosalik, Acyclovir, heparin ointment;
• lacto- and bifidobacteria: Bifidumbacterin Forte, Simbiter, Hilak Forte;
• choleretic drugs: Flamin, Odeston, Hofitol, choleretic collection.

Red dermographism is a disorder characterized by the fact that the skin, under the influence of changes ambient temperature, pressure, or even with nervous overstrain, the appearance of red spots is noted, which long time don't disappear.

Sometimes this skin condition indicates the presence of ailments of other organs or systems of the body. In most cases, indicates prolonged or intense physical influence any factor on the skin area.

The main symptom is the appearance of red spots on the skin, which are a consequence of mechanical pressure at her. However, in some cases, blisters, swelling, itching and other clinical manifestations may occur.

Establishing the correct diagnosis is based on an objective examination and laboratory examinations. Treatment in all cases is conservative.

Etiology

Red dermographism is nothing more than a reaction of the skin to thermal, mechanical and other external influences, against the background of which red marks appear on the skin that persist for quite a long period of time.

The reasons for the development of pathology remain not fully understood, however, among the predisposing factors are:

• prolonged exposure to low or high temperatures;
• friction of the skin against tight clothing;
• shocks and other impacts;
• susceptibility to nervous overstrain;
• genetic predisposition;
• the course of allergic processes.

• chronic;
• any nature;
• pathological influence, and other protozoa;
• disruption of the functioning of the thyroid gland, which often happens when it is partially removed;
• Gluten intolerance.

Symptoms

Based on the name of the disease, it can be understood that the main clinical sign is the appearance of red spots on the skin. Normally, when you press on the skin, you can always notice some changes on it, namely, the area of ​​​​the skin first turns pale, then turns red, and after a short period of time the color returns to normal.

However, some people report persistent redness or paleness of the skin. Such conditions are called red and white dermographism, respectively.

In the vast majority of cases, this pathology does not cause the appearance of other symptoms, but some patients note the presence of:

• strong skin itching in the area of ​​redness, and constant scratching of such an area leads to the appearance of wounds;
• minor;
• rashes unknown etiology;
• blisters.

However, the main symptoms are not considered external manifestations, but psychological discomfort. Enough large number people are embarrassed by the fact that they have such a pathology, which is why the prevalence of the disease among children, adolescents and adults is still not fully known.

Rashes and redness often persist from several hours to a couple of days, and then disappear on their own and without a trace, but provided that there is no influence of any factor.

It is worth noting that even with repeated manifestations, red dermographism does not lead to complications.

Diagnostics

To put correct diagnosis it is necessary to carry out a whole complex diagnostic measures, but before implementing them, the dermatologist needs:

• get acquainted with the medical history and collect the life history of not only the patient, but also his close relatives. In some cases, this will help to find out what reason lies behind the occurrence of the disease;
• carefully examine the patient and examine the condition of the skin. To do this, a specific test is performed, which involves applying a hard object to the skin, after which the clinician records the condition of the affected area after two, twelve and forty-eight hours. In addition, you can use other types of influence on the skin - cold, heat or water;
• interview the patient in detail regarding the presence and intensity of additional symptoms.

Laboratory diagnostics includes:

• general and biochemical analysis blood;
• clinical analysis urine;
• microscopic studies feces– to confirm or refute the presence of helminthic infestation;
• analysis of thyroid hormones;
• tests to assess the state of immunity.

In addition, consultations may be needed:

• gastroenterologist;
• endocrinologist;
• allergist;
• immunologist.

Such specialists will appoint additional examinations, the need for which is determined by the fact that the cause of red dermographism may be hidden behind pathologies of internal organs.

Treatment

Elimination of such a disease involves the use of conservative treatment methods, including:

• taking medications;
• diet therapy;
• use of traditional medicine recipes.

Drug treatment is aimed at using:

• antihistamines;
• vasoconstrictors;
• choleretic drugs;
• decongestant ointments, as well as creams that relieve severe itching;
• lacto- and bifidobacteria.

Nutritional therapy is individual in nature and is prescribed by the attending physician personally for each patient, but there are several general rules:

• complete rejection of fatty and spicy foods, smoked meats and spices, carbonated and alcoholic drinks;
• enriching the diet with fresh fruits, herbs and vegetables;
• daily use fermented milk products;
• preparing dishes by boiling, baking, stewing and steaming;
• abundant drinking regime.

Red dermographism can be treated folk remedies, the most effective of which are:

• nettle and raspberry roots;
• sage and string;
• St. John's wort and chamomile;
• valerian and celandine;
• olive oil;
• raw potatoes.

From the above components you need to prepare decoctions for oral administration or use as lotions, especially for the last two ingredients.

Prevention and prognosis

To avoid symptoms, you need to follow a few simple rules:

• avoid contact with allergens;
• avoid stress;
• reduce the effect of cold and hot temperatures on the skin;
• normalize the rest and wakefulness regime;
• stop wearing tight clothes;
• perform regularly hygiene procedures;
• take a full course several times a year clinical examination to identify gastrointestinal pathologies or endocrine system that can cause this disease.

The prognosis for red dermographism is favorable in most cases - complete recovery can be achieved.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

Diseases with similar symptoms:

Vitamin deficiency is a painful human condition that occurs as a result of an acute lack of vitamins in the human body. There are spring and winter vitamin deficiency. Restrictions regarding gender and age group, in this case no.

Dermatitis is a general definition that implies inflammation of the skin caused by exposure to certain factors (internal or external). Dermatitis, the symptoms of which can develop as a result of biological, chemical or physical exposure from various types of factors, respectively, can manifest itself in a specific form, determined from the characteristics of this exposure; in this article we will look at what dermatitis is in general.

Dermographism is strong increased sensitivity skin to external irritants. From the slightest touch or too much pressure on the skin, pronounced traces of impact remain on its surface, which can appear in the form of red or white stripes. The type of dermatological disease is determined by their color, and the patient is subsequently diagnosed with red or white dermographism. The exact cause of the disease is still not known. It is believed that this is one of the species, the appearance of which may be associated with external or internal irritants of the body.

General characteristics of the disease

Translated from Greek language Dermographism is referred to as “skin writing” or “skin writing.” People suffering from this pathology of epidermal tissues daily observe many different patterns on their bodies, which sometimes resemble inscriptions and drawings. The nature of their occurrence is that sensitive skin turns red and appears in stripes after contact with solid environmental objects. Tight clothing, pressed folds from a blanket, and normal stroking of the skin can lead to swelling, redness, or the appearance of multiple white edema of irregular shape.

Based on the type of skin reaction, acute and chronic dermographism are distinguished. The first type of disease is characterized by an increased degree of sensitivity of the epidermis. In case of mechanical impact on the skin, not only its upper layer becomes inflamed, but also deeper tissues. Swelling from touching a hard object may not go away for several days, and the inflammatory process begins to develop so extensively that it affects other areas of the skin that were not injured. Chronic dermographism of red or white etiology does not occur so aggressively, and is limited to local irritation of the epidermis directly at the site of contact of the skin and an object from the environment.

Species classification of dermographism

Given dermatological disease divided into types based on the observed clinical picture of its course at all stages of manifestation. Dermographism is classified as follows:

Diagnostic value of the disease

Dermographism may not always act as independent disease skin. Quite often - it's just additional symptom to the main pathology, which lies in the unhealthy state of one or another internal organ of a person. When a patient with signs of red or white dermographism seeks medical help, doctors refer him for examinations to exclude the presence of diseases such as:

• depletion or intoxication of the nervous system;
• meningitis;
• psoriasis;
• autonomic neurosis;
• thyrotoxicosis;
• sympathetic innervation;
• parasympathetic nervous system disorder.

How is dermographism treated?

You should not make hasty conclusions if red or white spots periodically appear on your skin. Their presence does not necessarily indicate that a person is developing skin dermographism. You need to seek help from a dermatologist or immunologist so that they can conduct an initial examination of the epidermal tissues and coordinate the procedure for further examination and all necessary tests.

In addition to visually examining the irritated areas of the skin, the doctor, using a special medical equipment Performs skin testing for mechanical stress.

If the test results are positive and the presence of red or white dermographism is suspected, the patient is recommended to undergo the following examination:

Based on the results of the examination, it will be more clear what the cause of skin hypersensitivity is and what course of treatment to choose in a particular case. Most often, this abnormal behavior of the skin is associated with nervous overstrain, and does not require global therapy with potent drugs.

It is enough for a patient to streamline his lifestyle, sleep at least 8 hours a day, avoid stress, use sedatives, and the painful skin condition disappears by itself. Practicing psychiatrists are inclined to the same opinion, reducing the manifestation of red and white dermographism to malfunctions in the functioning of some brain centers responsible for the sensory perception of tactile touches by the skin. A striking example This is because 20% of mentally ill people with signs of organic brain damage suffer from red and white dermographism.

Opposition severe forms disease consists of the following manipulations:

1. Isolation of the patient from the outside world into a room with a minimum number of objects with a sharp and hard surface.
2. Taking antihistamines to minimize skin irritation.
3. External treatment of inflamed areas of the skin with antiseptic solutions in the form of salicylic acid and camphor alcohol.

Therapy for red and white dermographism at home consists of rubbing the reddened areas of the skin with decoctions of chamomile, oak bark, and coltsfoot. You can also soak pieces of gauze in them and make compresses on the inflamed areas epidermis. As medicines local spectrum of action drugs such as:

• claritin;
• cetirizine;
• Benadryl;
• Zyrtec;
• Tagamet;
• Zantac;
• bricanil.

To eliminate stress factors, include in the diet soothing tincture peony or motherwort. It is taken 1 tbsp. twice a day - morning and evening. The majority of patients suffering from red and white dermographism noted an improvement in their general health, a decrease in the level of skin sensitivity, a decrease in the amount of redness, and there was no factor in the development of an extensive inflammatory process.

Dermographic urticaria, which has other names - autographism, urticarial dermographism, dermatographic urticaria, is considered as a special type of mechanical urticaria, which manifests itself with long-term or short-term exposure to a mechanical irritant on the skin. In this article we will look at photos, symptoms and treatment of demographic (dermographic) urticaria, the causes of its appearance and features of the disease.

Features of the disease

Factors that provoke autographism can be belt pressure, clothing friction, vibration, or the movement of a blunt object along the skin with pressure. In this case, the skin does not always itch, but reacts to provocation by forming swellings, redness, and blisters that repeat the shape of the irritant object or its trajectory. For example, if a patient scratches an itchy area, whitish-pink stripes will appear above the skin as they scratch.

The dermographic form also includes urticaria due to pressure, when skin reactions appear in the form of swelling and irritation after 2–6 hours. For example, under wristwatch After prolonged pressure, a bracelet-shaped blister will swell around the wrist. Tight ones can have the same effect. compression stockings, tight shoes.

The term dermography itself means “writing on the skin.” Painful “inscriptions” can appear in various areas, least often on the face.

Autographism is observed in 8–13% of all types of urticaria. More often (65 - 95%) the disease affects people predisposed to allergies, often occurring in parallel with other types of allergies -,. But with dermographic urticaria it appears less frequently.

Urticarial dermographism (photo)

Classifications of demographic urticaria

By shape

Classified:

• primary form which develops directly under the influence of a provoking factor;
• secondary when the disease is provoked by an existing internal pathology ( , neurological diseases, systemic lupus, serum sickness).

This video will tell you what autographism is:

By reaction speed

Based on the speed of reaction, there are three types of autographism:

• immediate type(more frequent), in which the skin reaction is visible 2 to 5 minutes after pressure, persisting for about half an hour;
• average when swelling and irritation develops in the interval from half an hour to 2 hours and lasts up to 3 to 9 hours;
• late(a rare type), which gives a skin reaction after 4–6 hours, which lasts up to 2–3 days.

With a medium and late reaction, itching, soreness, and hyperemia appear in places where prolonged and strong pressure was applied to the body:

• on the shoulders after the straps of a backpack or shoulder bag;
• on the ankles after squeezing them with a tight elastic band of socks;
• on the wrists after the belt of a bag or bracelet;
• in any places that are compressed tight underwear, belts;
• on the feet after prolonged walking;
• on the buttocks when sitting for a long time, on the skin from the inside of the thighs after horseback riding and cycling.

With all types, a clear sequence of skin changes is observed: the action of a physical irritant causes redness of the skin, then the reddened area swells, swelling forms, which increases, becoming wider.

By type of reaction

They differentiate according to the type of reaction:

1. Local dermographism, in which skin reactions are limited to the area of ​​irritation.
2. Reflex, when changes in the skin after pressing and running a hard, sharp object over the body appear after 5–20 seconds in the form of a bright red stripe up to 6–7 mm wide. This phenomenon is explained by the expansion of small arterioles and is a typical vasomotor reflex.

By manifestation

There are several types of dermographism:

• Red, in which red or bright pink streaks appear on the skin, caused by strong pressure from a blunt, hard object. Better expressed on the upper body.
• White dermographism. With slight short pressure, it is characterized by the appearance of white stripes, which is caused by a spasm of the capillaries. It is more pronounced on the legs and lasts longer than “red” dermographism. Unlike “red,” this vascular reaction is explained not by expansion, but by narrowing of the capillaries.
• Dermographism sublime, in which red stripes up to 60 mm wide are initially formed with uneven contours, which after 2–3 minutes are replaced by white, long-lasting blisters that swell above the skin. Similar skin changes due to high permeability vascular wall.

Causes

Medical analysis of the mechanism of occurrence and development of dermographic urticaria and its variations has not been completed. It has been established that painful changes in the skin with pressure, vibration, or pressing are caused by stimulation mast cells. In response to provocation, they actively release large portions of histamine, a regulator, into the blood allergic reactions, - which activates processes that increase the permeability of the microvascular wall, which further determines the nature and severity of symptoms.

Skin coloration under line pressure is associated with:

• expansion(red autographism) or
• narrowing(white uniform) small vessels providing blood supply to the skin.

But it is not clear why the skin of different patients reacts in one way or another.

A connection has been found between dermographic urticaria and sharp fluctuations ambient temperature, with a tendency of patients to allergies, with an abnormal state of the nervous system. Statistical research prove that every fifth patient with psychoneurological pathologies exhibits signs of dermography on the skin.

It has been established that urticarial dermographism affects people:

• with a hereditary predisposition to the disease;
• after a viral infection;
• with special emotional instability;
• after severe stress, prolonged nervous strain;
• after poisoning with ethanol, heavy metals, and other toxins.

Symptoms

The symptoms of autographism depend on the type of disease, but in any case, with mechanical irritation of the skin, the basic signs remain as follows:

• the appearance of red, pink, whitish stripes directed in the direction of the stimulus or repeating its shape;
• itching, swelling, burning and feeling of skin tension;
• swelling of the skin in the form.

A feature of dermographism, unlike many other allergic skin reactions, is the frequent absence of itching or its very weak intensity.

Types of dermographism and symptoms Table No. 1

Reaction	Type of dermographism	Basic symptoms	May appear	Onset of manifestation and duration
immediate	white (weak fast pressure); red (strong, longer pressure)	red or white streaks, blisters, erythema (redness)	Itching, burning, soreness, general weakness, chills, headache, nausea	appear in the range from 3 seconds to 10 minutes after pressure on the skin; Lasts 0.5 – 2 hours
mixed	red stripe surrounded by white border
slow	red, after prolonged exposure	red, itchy, painful blisters in the shape of a provoking object	appear in the range from 0.5 to 9 hours after physical irritation of the skin; lasts about 36 hours
mixed	exalted	Stage 1: red, uneven stripes; Stage 2: Linear whitish blisters rising above the skin (similar to burn blisters) surrounded by a pinkish-red area	duration of stage 1 – 2 – 3 minutes; Stage 2 lasts from half an hour to 36 hours.

Diagnostics

Immediate-type dermographic urticaria is fairly easy to identify. The allergist irritates the skin with a blunt spatula, running it over the patient’s body with average degree pressure. The appearance of red or white stripes or blisters in the area of ​​irritation within 3 to 20 minutes confirms the diagnosis.

The delayed type of dermographism is more difficult to identify, since all signs develop several hours after prolonged pressure on the body.

We will find out further whether urticarial dermographism can be treated.

Treatment

In a therapeutic way

Local remedies that relieve skin manifestations- itching, erythema, swelling: Radevit, Elidel, Psilo-balm, Protopic, Eplan, La-Cri, Skin Cap. Glucocorticoid external agents help in severe cases.

They are divided according to their effects:

1. Weak glucocorticoid ointments: Sinaflan, Flucinar, Laticort, .
2. Medium: Afloderm, Triamcinolone;
3. Strong: Advantan, Celestoderm B, Lokoid, Elokom, Cloveit, Dermovate

By medication

Dermographic urticaria is treated with the same groups of medications as other types of urticaria. First of all, antiallergic drugs of different generations are used, which are selected depending on the patient’s individual reaction to a particular drug.

• Some doctors recommend vasoconstrictors for the red form of dermographism and vasodilators for the white form.
• Others have a negative attitude towards this treatment option, since the effect of such drugs on the body is general, which means their influence extends to the vessels of all organs, including the brain and heart. Therefore, the use of vasodilators (vasodilators) or drugs with opposite effects can lead to problems in the blood supply to the cerebral and coronary vessels or their sudden expansion, which threatens.

The treatment regimen for urticarial dermographism is discussed below point by point.

Antihistamines II – III generation

Typically, therapy begins with the use of standard doses of antihistamines of the 2nd - 3rd generation. Daily dosage for adults:

• Claritin, Lomilan () – 10 mg;
• Telfast, Fexadine (fexofenadine) – 150 mg. Strictly prohibited for pregnant women, nursing mothers, and children under 6 years of age;
• Xyzal, Suprastinex, Zodak, Glencet, Cesera (levocetirizine) – 5 mg, contraindications are the same as for drugs with fexofenadine;
• Ebastine (piperedine) – 10 mg;
• Erius, Allergostop (desloratadine) – 5 mg;
• Zyrtec, Zodac (cetirizine) – 10 mg.

A new drug that helps well with dermographic urticaria, but does not cause sedation (drowsiness) - Trexil with active component terfenadine Used in tablets and suspensions. The recommended dose for adult patients, starting from 12 years of age, is 60 mg (or 10 ml of suspension) 2 times. Children's doses: 3 - 7 years old - 15 mg, 7 - 12 years old - 30 mg, morning and evening.

If antistaminic last generations do not help, the dosage, as a rule, is not increased, but a second medicine with a different active substance is added to the treatment regimen.

Or they use 1st generation products, which are often more effective for urticaria: Pipolfen. For severe skin manifestations with severe itching, Tavegil and Suprastin are administered intramuscularly.

For frequent exacerbations of long-term dermographism, use:

• Ketotifen. Adult dose 0.001 - 0.002 g twice a day. Children are given syrup: up to six months - in daily dose at the rate of 0.05 mg per kilogram of baby’s weight, from six months to 3 years – 0.5 mg twice a day, from 3 years – 1 mg.
• Cyproheptadine: 4 – 8 mg (3 or 4 times); The pediatric dose, based on the norm of 0.25 - 0.5 mg/kg, is also divided into 3 - 4 doses.

Histamine H2 receptor suppressors

If the patient does not respond to therapy with antiallergic medications, they try the introduction of drugs that suppress histamine H2 receptors:

• Cimetidine: 0.3 grams up to 4 times a day. Children's daily doses from one year of age are calculated: 25 – 30 mg per 1 kilogram of weight, for infants up to one year old - at the rate of 20 mg/kg of weight;
• Ranitidine for patients over 12 years of age: 0.150 - 0.300 g (2 or 1 time per day);
• Famotidine (from 12 years old) - twice 0.020 g.

Hormonal agents

In those in rare cases, when the severity of symptoms does not decrease, it is necessary to use short courses (2 - 4 days) hormonal agents, which quickly relieve swelling and itching.

Prednisolone is usually prescribed daily adult dose 0.04 - 0.06 grams, Dexamethasone - 0.004 - 0.020 g (or 1 injection per day) in the acute period.

Since skin manifestations of dermographic urticaria are associated with abnormally high permeability of the vascular wall, the following is used:

• ascorbic acid;
• flavonoids (Rutin, Ascorutin, Quercetin, Vitamin P) under the control of blood clotting to avoid increased viscosity;
• vitamers (semi-synthetic derivatives) – Venoruton, Phlebodia, Detrolex, Troxevasin in various forms(capsules, gel, solutions).

For severely tolerated symptoms - particularly severe itching, neurological disorders, it is advisable to prescribe tranquilizers from the group of benzodiazepines (Xanax, Diazepam) and antidepressants - Doxepin.

Disease prevention

In order for exacerbations of dermographism to occur less frequently, it is necessary:

Complications

With the development of urticarial dermographism, the consequences may be as follows:

1. Frequent exacerbations of urticaria deplete the nervous system of patients, leading to depression.
2. Prolonged pressure, often repeated in the same places, contributes to thinning and damage to the dermis. At the same time, pyogenic bacteria easily penetrate deep into the skin, leading to pustular skin infections and local suppuration with the development.
3. General symptoms ailments that often accompany skin reactions - fever, nausea, headaches - contribute to falling immune defense body.
4. Since any allergic diseases“reinforced” by other types of allergies, dermographic urticaria in rare cases becomes complicated, dangerous swelling larynx, .

Forecast

A timely diagnosis and treatment undertaken slow down and alleviate the disease. Strengthening the immune system, vascular wall, and nervous system contributes to the mild course of the pathology.

This video presents useful information about dermographic and other types of urticaria: