Adrenergic urticaria: review of the literature and proposed mechanism Journal Article

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Authors: Hogan, S. R.; Mandrell, J.; Eilers, D
Article Title: Adrenergic urticaria: review of the literature and proposed mechanism
Abstract: Adrenergic urticaria is a rare type of stress-induced physical urticaria characterized by transient outbreaks of red papules surrounded by halos of hypopigmented, vasoconstricted skin. First described in 1985, there are 10 reported cases of adrenergic urticaria in the English-language medical literature. Episodes are caused by various triggers, including emotional upset, coffee, and chocolate, during which serum catecholamines and IgE are elevated, whereas histamine and serotonin levels remain within normal limits. The precise mechanisms leading to the pathogenesis of adrenergic urticaria have yet to be elucidated. Diagnosis can be made by intradermal injection of epinephrine or norepinephrine, which reproduces the characteristic rash, or by clinical observation. Trigger avoidance and oral propranolol are currently the best known treatments for adrenergic urticaria. Nonspecific therapies, including tranquilizers and antihistamines, may also ease symptoms. This article explores the pathophysiology of adrenergic urticaria and proposes a mechanism by which propranolol treats the condition.
Journal Title: Journal of the American Academy of Dermatology
Volume: 70
Issue: 4
ISSN: 1097-6787; 0190-9622
Publisher: Unknown  
Journal Place: United States
Date Published: 2014
Start Page: 763
End Page: 766
Language: eng
DOI/URL:

10.1016/j.jaad.2013.10.062
Notes: CI: Copyright (c) 2013; JID: 7907132; 0 (Receptors, Adrenergic); 9Y8NXQ24VQ (Propranolol); YKH834O4BH (Epinephrine); OTO: NOTNLM; 2013/06/26 [received]; 2013/10/29 [revised]; 2013/10/31 [accepted]; 2013/12/25 [aheadofprint]; ppublish