Dermographism: the inflammatory writing of the skin

Dermographism is the most common form of physical urticaria and consists of the appearance of hives or marks on the skin after scratching or superficially scratching the area. In addition, to speak of dermographism it is necessary that the lesions be palpable. Dermographism is classified as:

• Simple dermographism: phenomenon extraordinarily affecting 2-5% of the population. The lesions are asymptomatic and appear quickly when scratching the skin and remit within 30 minutes.
• Symptomatic dermographism: less frequent condition in which itchy lesions appear within 5 minutes of scratching and usually persist for more than 30 minutes (usually less than 2 hours).

It can appear in isolation or accompanying other forms of, such as triggered by cold, pressure or exercise.

Why is it produced?

The pathophysiological mechanisms of symptomatic demographics are unknown. Although the vasoactive mediators from the cutaneous mast cells with raising the levels of histamine after the episodes.

Although it is more common in atopic patients, no implicated allergens could be identified in this process. DG can be triggered by simple actions such as scratches, friction with clothing or solid objects. The disease can be exacerbated by cold, hot water, emotional stress, exercise, and exposure to cold in some series of patients. Typically, the disease lasts between 2-6 years and generally affects young adults.

How is dermographism on the skin diagnosed?

The diagnosis is simple, it can and consists of:

• Scratch with a firm, non-sharp object, such as a paper clip, pen, or dermographometer, the anterior surface of the patient's forearm, which is the area where injuries are best reproduced. In 5-10 minutes It is possible to check if the dermographism is positive and in what intensity it is expressed.
• The patient must refrain from taking antihistamines orally for several days before the test.

Which is the treatment?

When it does not cause symptoms, it does not require any treatment, except to avoid those known triggers that exacerbate it.

• If the skin is dry, it is useful to use emollients applied daily.
• In those cases in which the patient is present and this interferes in the activities of daily living, the H1 antihistamines They have been shown to be effective in treating symptoms and reducing the number of hives, and are the drugs of first choice.
• First and second generation H1 antihistamines such as hydroxyzine and cetirizine.
• Treatment usually lasts for Several months in most patients with symptoms.
• Baths or showers with very hot water, vigorous drying and the use of very thick and tight clothing should be avoided.

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