Dermographism is the most common form of physical urticaria and manifests as an exaggerated wheal and flare reaction of the skin induced by pressure. In dermographism, inadvertent stroking or rubbing of the skin will result in corresponding linear wheals. The wheals usually persist for about 15-30 minutes. The condition is usually asymptomatic, but some forms are associated with pruritus. The exact cause of dermographism is unknown, but clinically it appears similar to urticaria. Agents that are known to cause or exacerbate urticaria also may cause dermographism (eg, angiotensin converting enzyme [ACE] inhibitors).
An increased incidence has been reported during pregnancy and in individuals with Behçet syndrome, thyroid disorders, infections, and atopic dermatitis. Dermographism affects approximately 2%-5% of the population and is more common in young adults.
Dermographism in Adult
Alerts and Notices
Synopsis
Codes
ICD10CM:
L50.3 – Dermatographic urticaria
SNOMEDCT:
7632005 – Dermographism
L50.3 – Dermatographic urticaria
SNOMEDCT:
7632005 – Dermographism
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Early contact dermatitis may present with linear urticarial lesions.
- Delayed pressure urticaria may develop up to hours after the inciting pressure and is usually painful, while dermographism develops over minutes and is usually asymptomatic or pruritic.
- Acute or chronic urticaria
- Other physical urticarias
- Angioedema
- Urticaria pigmentosa
- Systemic mastocytosis
- Lesions from strongyloidiasis (cutaneous larva currens) may resemble rapidly moving urticarial wheals.
- The early stages of bullous pemphigoid may manifest with urticarial plaques.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:05/24/2022
Last Updated:05/25/2022
Last Updated:05/25/2022
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Dermographism in Adult