Dermatographism in Urticaria

Dermatographism is a severe form of urticaria expression where one is able to write on the skin. It is nothing but a heightened sensitivity of skin whereby, when pressed with an object or fingernail, the skin shows raised eruptions of urticaria, which may remain on the skin for some time. Writing lines and words on skin expressing urticaria is called dermatographism.

Dermatographism is observed in about 5% of urticaria patients. The writer of this article suspects based on experience that it is likely to be more, as many patients may not experiment with pressing their skin with such objects.

Appearance of dermatographism on back skin

The typical appearance of dermatographism is shown in a picture of one of the patients treated at Life Force. The eruptions, in this case, are linear, raised inflamed, and swollen in look, which may be with or without itching.

Some of the patients may not have experienced such writing on the skin but may present with pressure urticaria.

Causes: What goes on the skin writing?

Well, dermatographism is shown on the skin as the result of a complex play of immune cells from behind the skin. Usually, in response to the allergy (and allergens), blood cells release histamine, which leads to urticaria. However, in the case of dermatographism, it is believed that the mast cells release histamine without any allergens. This happens due to the weak membrane of mast cells, which is responsible for histamine release due to pressure. (Mast cells  are normal cells residing in the skin tissues and used for the healing of wounds.)

The exact cause of dermatographism is not fully understood. The factors which may trigger are more or less the same as those of urticaria, as explained on this website.

Symptoms:

Symptoms are lines and words (whatever one writes!) on the skin, with raised hives, associated with itching and swelling. It may last for a few minutes to hours or rarely days. In some cases, there may be the simultaneous appearance of hives elsewhere on the skin as well.

The tendency to have dermatographism may last for months or years.

Photo of patient affected with dermatographism on back

Treatment for dermatographism:

a. Conventional treatment for Dermatographism:

The treatment for dermatographism is practically the same as that for urticaria, which includes antihistamines, H1 or H2antagonists, and cortisone. With the symptomatic approach, dermatographism has been found to be very difficult to treat as far as its recurring tendency is concerned.

b. Homeopathic treatment for Dermatographism

Homeopathic treatment aims at treating the fundamental tendency of having dermatographism, where this tendency is understood to be an expression of the deeper level of immunological disturbance. The treatment is different than treating simple cases of urticaria. Another level of medicines is called for.

The results in the cases are Dermatographism using homeopathy are positive.

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