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Dermographism in Adult
Other Resources UpToDate PubMed

Dermographism in Adult

Contributors: Jeffrey M. Cohen MD, Noah Craft MD, PhD, Lindy P. Fox MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

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.

Codes

ICD10CM:
L50.3 – Dermatographic urticaria

SNOMEDCT:
7632005 – Dermographism

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

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
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Patient Information for Dermographism in Adult
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Contributors: Medical staff writer

Overview

Dermographism, which means "skin writing," is a condition in which your skin responds to light scrapes or scratches by quickly forming raised red flare-ups, known as wheals, in the same shape as the scratches. The flare-ups usually go away on their own within 30 minutes to 2 hours, but they can be itchy and visually bothersome. This type of skin rash is a unique form of hives.

The main cause of dermographism is not entirely known, but may be related to local histamine that is released under the skin, causing the affected skin area to swell. The condition only affects the skin and is not dangerous; however, it can be a major annoyance for the patient.

Who’s At Risk

Dermographism mainly occurs in young adults, and on average lasts for up to 6.5 years. Between 2% and 5% of the general population has this condition.

Signs & Symptoms

If a light scrape or scratch to the skin quickly results in a raised red rash in the same pattern as the scratch, dermographism should be suspected. The reaction may be itchy, but it should resolve on its own within 2 hours.

If the flare-up lasts several hours to days, the patient may have a form of the condition known as delayed dermographism, in which the reaction lasts longer and may also be painful, sometimes described as a "burning sensation."

Symptoms of dermographism may also be seen in response to infection or after taking certain prescription drugs, such as penicillin.

Self-Care Guidelines

Luckily, the skin rashes of dermographism go away on their own, so the best thing to do during a flare-up is to avoid scratching and wait for the swelling and redness to calm down. Over-the-counter antihistamines may be taken to help relieve symptoms faster. Avoiding scraping and scratching of any kind can help prevent flare-ups.

When to Seek Medical Care

Seek medical help if you have unbearable itching, burning, or pain during flare-ups.

Treatments

Antihistamines may be prescribed for dermographism to help get rid of itching; however, if antihistamines do not help, even after an increased dosage, other medicines may be considered by your physician. Currently, there is no cure for dermographism.
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Dermographism in Adult
A medical illustration showing key findings of Dermographism : Linear configuration, Wheal
Clinical image of Dermographism - imageId=1308870. Click to open in gallery.  caption: 'Linear pink, edematous plaques with surrounding pink erythema on the back, with similar papules (hives) in the vicinity.'
Linear pink, edematous plaques with surrounding pink erythema on the back, with similar papules (hives) in the vicinity.
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