Role of sweat in the pathogenesis of cholinergic urticaria
- VernacularTitle:汗液在胆碱能性荨麻疹中的作用
- Author:
Yaxuan ZHENG
1
;
Huichun SU
1
Author Information
- Publication Type:Journal Article
- Keywords: Urticaria; Acetylcholine; Pruritus; Cholinergic urticaria; Sweat allergy; Hypohidrosis/anhidrosis
- From: Chinese Journal of Dermatology 2025;58(6):573-577
- CountryChina
- Language:Chinese
- Abstract: Cholinergic urticaria (CholU) is a special type of chronic inducible urticaria characterized by transient, needle-sized wheals and erythema with stinging pain and/or itching, precipitated by increased core body temperature as a result of exercise or passive heating. Some cases were accompanied by angioedema, which seriously affects their quality of life. The pathogenesis of CholU involves sweat allergy and atopic diathesis, increased histamine release in sweat and the influence of Malassezia, decreased cholinergic receptors in hypohidrotic areas, decreased expression of cholinesterase, serum factors and autoantibodies, etc. Standard-dose and updosed second generation H1-antihistamines are the first-line therapy for CholU. For refractory CholU patients with normal sweating, biological agents, sweat desensitization and other therapies could be further chosen, while patients with severe hypohidrosis could be further treated with glucocorticoid pulse therapy and so on. This review summarizes the pathogenesis, classification, clinical manifestations, diagnosis and treatment of CholU from the perspective of the role of sweat in the pathogenesis of CholU.
