Dermografizm
Diagnostyka i diagnoza

Dermografizm, czyli pokrzywka dermograficzna, jest jedną z najczęstszych form pokrzywki indukowanej fizycznie, występującą u 2-5% populacji. Diagnoza opiera się na klinicznym teście polegającym na lekkim potarciu lub zadrapaniu skóry (najczęściej na ramieniu lub plecach) tępym narzędziem, np. szpatułką językową, i obserwacji pojawienia się wypukłej linii lub bąbla pokrzywkowego w ciągu 5-7 minut. W diagnostyce stosuje się także specjalistyczne urządzenia, takie jak dermografometr czy FricTest, gdzie dodatnia odpowiedź definiowana jest jako bąbel o szerokości 3 mm po 10 minutach od prowokacji. Mechanizm dermografizmu to wyolbrzymiona potrójna odpowiedź Lewisa, obejmująca rozszerzenie naczyń włosowatych, odruchowe rozszerzenie tętniczek oraz powstanie linijnego obrzęku. W diagnostyce różnicowej należy uwzględnić przewlekłą pokrzywkę, mastocytozę układową, pokrzywkę barwnikową oraz alergię na lateks. Biopsja skóry jest rzadko konieczna, a histopatologia wykazuje niespecyficzny obrzęk skóry właściwej z niewielką infiltracją jednojądrzastą.

  1. Dermografizm – Diagnostyka
    1. Diagnostyka kliniczna
    2. Miejsca wykonywania testu
    3. Narzędzia diagnostyczne
    4. Reakcja trójfazowa Lewisa
    5. Rodzaje dermografizmu
  2. Rozpoznanie różnicowe
    1. Biopsja skóry
    2. Diagnostyka przed testami prowokacyjnymi
    3. Markery diagnostyczne i czynniki wpływające
  3. Diagnoza dermografizmu jamy ustnej
  4. Podsumowanie diagnostyki
    1. Kolejne rozdziały

Dermografizm – Diagnostyka

Dermografizm, znany również jako dermografia lub pokrzywka dermograficzna, jest jedną z najczęstszych form pokrzywki indukowanej fizycznie, dotykającą około 2-5% populacji ogólnej12. Nazwa pochodzi od greckiego terminu oznaczającego „pisanie na skórze”, co odnosi się do charakterystycznej reakcji, w której lekkie zadrapanie lub potarcie skóry powoduje powstanie wypukłych, zapalnych linii lub bąbli pokrzywkowych w kształcie zastosowanej siły zewnętrznej34.

Diagnostyka kliniczna

Diagnoza dermografizmu jest zazwyczaj prosta i opiera się głównie na obserwacji charakterystycznej reakcji skóry na bodźce mechaniczne5. Diagnoza stawiana jest na podstawie badania klinicznego i nie wymaga zwykle badań histopatologicznych ani biochemicznych6. Lekarz diagnozujący dermografizm wykonuje prosty test skórny, polegający na:

  • Lekkim potarciu lub zadrapaniu skóry tępym przedmiotem, najczęściej szpatułką/łopatką językową (lub innym narzędziem) na skórze ramienia lub pleców78
  • Obserwacji miejsca testu przez kilka minut w celu wykrycia reakcji9
  • Potwierdzeniu diagnozy, jeśli w ciągu kilku minut pojawia się wypukła linia lub bąbel pokrzywkowy w miejscu podrażnienia10

Dermografizm uznaje się za dodatni, gdy wystąpi charakterystyczna reakcja polegająca na pojawieniu się linijnych bąbli pokrzywkowych w miejscu zadrapania lub potarcia skóry w ciągu 5-7 minut od podrażnienia11. Zmiany te układają się zgodnie z kierunkiem i orientacją zadrapania i mogą przypominać pismo na skórze12.

Miejsca wykonywania testu

Wybór miejsca wykonania testu ma istotne znaczenie w diagnostyce dermografizmu. Obszary skóry chronione przed regularnym naciskiem i wpływami środowiskowymi (np. plecy) są zazwyczaj bardziej reaktywne niż miejsca bardziej eksponowane (np. pośladki i kończyny)1314. Z tego powodu dermografizm najłatwiej wywołać na tułowiu w porównaniu z kończynami15.

Narzędzia diagnostyczne

W praktyce klinicznej stosowane są różne narzędzia do diagnostyki dermografizmu:

  • Szpatułka językowa – najczęściej używane narzędzie w codziennej praktyce16
  • Dermografometr – specjalistyczne urządzenie z rysiakiem na sprężynie, które może być używane do stosowania stopniowanego, powtarzalnego nacisku (np. 3600 g/cm²) i rejestrowania reakcji skórnych; wykorzystywane głównie w placówkach badawczych17
  • FricTest – zwalidowany, łatwy w użyciu dermografometr do diagnozowania pacjentów z objawowym dermografizmem i do pomiaru ich progów wyzwalających i aktywności choroby18
  • Długopis kulkowy – proste narzędzie w diagnostyce dermografizmu i opóźnionej pokrzywki fizycznej19
  • Skin writometer – nowe urządzenie plastikowe z trzema ramionami o różnej długości, stosowane do diagnostyki i określania progu prowokacji u pacjentów z objawowym dermografizmem20

Dodatnia odpowiedź w teście FricTest jest definiowana jako bąbel pokrzywkowy o szerokości 3 mm (średnica końcówek FricTest) po 10 minutach od prowokacji21.

Reakcja trójfazowa Lewisa

Mechanizm dermografizmu opisuje się często jako wyolbrzymioną postać tzw. potrójnej odpowiedzi Lewisa. Mocne potarcie skóry wywołuje początkowo czerwoną linię (rozszerzenie naczyń włosowatych), po której następuje rozszerzenie rumienia na zasadzie odruchu aksonowego (rozszerzenie tętniczek) oraz powstanie linijnego bąbla pokrzywkowego (przesięk płynu/obrzęk)22. Dermografizm jest uważany za wyolbrzymienie tej potrójnej odpowiedzi23.

Rodzaje dermografizmu

W diagnostyce istotne jest rozróżnienie między różnymi rodzajami dermografizmu:

  • Prosty dermografizm – obserwowany u około 1,5-5% zdrowych osób, uważany za normalne zjawisko fizjologiczne2425
  • Objawowy dermografizm – charakteryzuje się obecnością świądu i ogólnie niższym progiem urticariogennym26
  • Biały dermografizm – przy potarciu skóry osób atopowych, potarta okolica staje się najpierw rumieniowa, ale rumień zastępowany jest w ciągu 10-15 sekund bladością, która może utrzymywać się przez 60 sekund lub dłużej27
  • Fałszywy dermografizm – może objawiać się podobnie klinicznie jak dermografizm, ale ma inny mechanizm podstawowy28

Biały dermografizm jest uważany za stygmat konstytucyjny atopowego zapalenia skóry i choć jest jednym z drobnych kryteriów diagnostycznych według Hanifina i Rajki, większość badań nie potwierdziła statystycznej zależności między jego występowaniem a atopowym zapaleniem skóry29.

Rozpoznanie różnicowe

W diagnostyce dermografizmu należy rozważyć różne schorzenia, które mogą dawać podobne objawy lub być z nim związane30:

  • Przewlekła pokrzywka – dermografizm występuje u około 22% pacjentów z przewlekłą idiopatyczną pokrzywką, choć niektórzy autorzy uważają, że nie jest on zwiększony w przewlekłej idiopatycznej pokrzywce31
  • Mastocytoza układowa – zwiększona liczba komórek tucznych w skórze3233
  • Pokrzywka barwnikowa (urticaria pigmentosa) – choroba charakteryzująca się obecnością objawu Dariera34
  • Alergia na lateks – może dawać podobne objawy skórne3536

Objawowy dermografizm należy odróżnić od objawu Dariera obserwowanego w pokrzywce barwnikowej i mastocytozie układowej, w których rzeczywista liczba komórek tucznych w skórze jest zwiększona z powodu hiperplazji komórek tucznych37. Objaw Dariera różni się od dermografizmu, ponieważ ten drugi dotyczy również skóry niezmienionej38.

Biopsja skóry

Biopsja skóry jest rzadko wymagana w diagnostyce dermografizmu, z wyjątkiem przypadków, gdy konieczne jest odróżnienie tego schorzenia od mastocytozy39. Histologia dermografizmu jest niespecyficzna, z obrzękiem skóry właściwej i kilkoma okołonaczyniowymi komórkami jednojądrzastymi4041. Histopatologia dermografizmu wykazuje obrzęk skóry właściwej z kilkoma okołonaczyniowymi komórkami jednojądrzastymi, podobnie do histologii ostrej pokrzywki42.

Diagnostyka przed testami prowokacyjnymi

Dermografizm powinien być rutynowo badany przed przeprowadzeniem testów prowokacyjnych, takich jak testy na alergie pokarmowe lub lekowe, nawet bez sugestywnej historii objawowego dermografizmu. W przypadku obecności objawowego dermografizmu, testy prowokacyjne powinny być przeprowadzane z eliminacją bodźców fizycznych43.

Warto zaznaczyć, że dermografizm może utrudniać interpretację testów skórnych na alergeny. Pacjenci z dermografizmem mogą nie kwalifikować się do standardowych testów skórnych z powodu ryzyka fałszywie dodatnich wyników44. W takich przypadkach alternatywnym podejściem jest pomiar swoistego IgE w surowicy45.

Markery diagnostyczne i czynniki wpływające

Kilka czynników może wpływać na diagnostykę dermografizmu:

  • Leki przeciwhistaminowe przyjmowane w poprzednich dniach mogą powodować wynik fałszywie ujemny46
  • U niektórych pacjentów z dermografizmem aktywność choroby może być zależna od czynników takich jak jedzenie i ćwiczenia47
    • U 2/3 pacjentów z objawowym dermografizmem nastąpił wzrost aktywności choroby po jedzeniu
    • Ćwiczenia często poprawiały aktywność objawowego dermografizmu u 8 na 10 pacjentów
    • Ćwiczenia chroniły pacjentów przed pogorszeniem po jedzeniu w połowie przypadków

Z tego powodu zaleca się, aby lekarze badający pacjentów pod kątem aktywności choroby poprzez testy prowokacyjne doradzali swoim pacjentom, aby nie jedli ani nie ćwiczyli przed testem, tak aby można było ocenić rzeczywistą aktywność choroby i progi48.

Diagnoza dermografizmu jamy ustnej

Choć rzadko opisywana w literaturze, dermografizm może również obejmować tkanki jamy ustnej49. W takich przypadkach pacjenci mogą wykazywać zwiększoną wrażliwość tkanek jamy ustnej na niewielki nacisk, co może niekorzystnie wpływać na procedury higieny jamy ustnej50.

Diagnoza dermografizmu jamy ustnej jest głównie kliniczna i opiera się na charakterystycznym wyglądzie linijnych bąbli po mechanicznej stymulacji błony śluzowej jamy ustnej51. Uznanie tego łagodnego zaburzenia i zapewnienie pacjenta o jego nieszkodliwości są ważne w leczeniu tego schorzenia52.

Podsumowanie diagnostyki

Diagnostyka dermografizmu jest zwykle prosta i opiera się na obserwacji charakterystycznej reakcji skóry na bodźce mechaniczne53. Kluczową cechą dermografizmu jest to, że bąbel pokrzywkowy (wzniesione, swędzące miejsce na skórze, które czasami jest jawnym objawem alergii) znika po pewnym czasie i nie pozostawia trwałego śladu na skórze54.

Diagnostykę dermografizmu przeprowadza się poprzez:

  1. Lekkie potarcie lub zadrapanie skóry tępym przedmiotem
  2. Obserwację miejsca testu przez kilka minut
  3. Potwierdzenie diagnozy, jeśli pojawi się wypukła linia lub bąbel pokrzywkowy

Dermografizm jest łagodnym schorzeniem, które zazwyczaj nie wymaga leczenia, chyba że objawy są nasilone lub przedłużone55. Naturalny przebieg dermografizmu jest nieprzewidywalny i może trwać od miesięcy do lat lub występować okresowo. U wielu osób dermografizm poprawia się z czasem i ustępuje samoistnie lub po leczeniu56.

Chociaż dermografizm jest często wywoływany przez stres i może być krępujący, zwłaszcza jeśli powoduje świąd, jest on powszechny i bardzo normalny, i zazwyczaj nie wpływa na jakość życia57. Przy odpowiedniej rutynie pielęgnacji skóry, kontroli stresu i leczeniu można zmniejszyć jego wpływ na codzienne funkcjonowanie.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Dermatographism – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK531496/
    Dermatographism, also known as dermographism urticaria or urticaria factitia, is a urticarial eruption upon pressure or trauma to the skin. The literal meaning is „to write on the skin.” Downward pressure on the skin produces a linear wheal in the shape of the applied external force. Dermatographism is the most common type of inducible/physical urticaria, occurring in approximately 2% to 5% of the population. A small subset of those with dermatographism becomes symptomatic with pruritus along with the erythematous wheals. This activity reviews the evaluation and management of dermatographism and the role of interprofessional team members in collaborating to provide well-coordinated care and enhance patient outcomes. […] Dermatographism, also known as Dermographism urticaria or urticaria factitia, is a urticarial eruption upon pressure or trauma to the skin. Urticarial skin reactions present as erythematous wheals in the dermis and can have innumerable causes. Dermatographism is the most common type of inducible/physical urticaria, occurring in approximately 2% to 5% of the population. Downward pressure on the skin produces linear erythematous wheals in the dermis in the shape of the external force applied, earning the name dermatographism, which means „writing on the skin.” A small subset of people with dermatographism becomes symptomatic with pruritus, stinging, prickling sensations that can bother the patient.
  • #2 Dermatographia (Dermatographism): What It Is, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17793-dermatographism-dermatographia
    Dermatographia is a skin condition that causes raised marks. Scratching, rubbing and pressure cause the reaction. It usually goes away within 30 minutes without treatment. Other names for dermatographia include dermatographism and skin writing. […] Dermatographia is a common, benign (not harmful) skin condition. It causes you to develop raised marks (wheals) or a reaction similar to hives when you scratch your skin. Pressure or rubbing (friction) may also cause a reaction. […] Dermatographism, dermatographic urticaria and skin writing are other names for dermatographia. […] Dermatographia can affect anyone. However, you may be more likely to have dermatographia if: […] Dermatographia is common. It affects about 2% to 5% of the general population. […] Your healthcare provider can diagnose dermatographia by agitating your skin. Theyll use a tongue depressor to scratch or press on the skin of your arm or back.
  • #3 Dermatographia (Dermatographism) – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dermatographia/symptoms-causes/syc-20371411
    Dermatographia is a condition in which lightly scratching your skin causes raised, inflamed lines where you’ve scratched. Though not serious, it can be uncomfortable. […] Dermatographia is a condition in which lightly scratching your skin causes raised, inflamed lines or welts. These marks tend to go away in less than 30 minutes. The condition is also known as dermatographism and skin writing. […] Dermatographia is harmless. Most people who have this condition don’t need treatment. If your symptoms bother you, talk with your health care provider, who might prescribe an allergy medicine. […] The exact cause of dermatographia isn’t clear. It may be an allergic reaction, though no specific allergen has been found. […] Dermatographia can occur at any age. It tends to be more common in teens and young adults. If you have other skin conditions, you may be at greater risk. One such condition is atopic dermatitis (eczema). […] See your health care provider if your symptoms bother you.
  • #4 Dermatographism – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK531496/
    Dermatographism, also known as dermographism urticaria or urticaria factitia, is a urticarial eruption upon pressure or trauma to the skin. The literal meaning is „to write on the skin.” Downward pressure on the skin produces a linear wheal in the shape of the applied external force. Dermatographism is the most common type of inducible/physical urticaria, occurring in approximately 2% to 5% of the population. A small subset of those with dermatographism becomes symptomatic with pruritus along with the erythematous wheals. This activity reviews the evaluation and management of dermatographism and the role of interprofessional team members in collaborating to provide well-coordinated care and enhance patient outcomes. […] Dermatographism, also known as Dermographism urticaria or urticaria factitia, is a urticarial eruption upon pressure or trauma to the skin. Urticarial skin reactions present as erythematous wheals in the dermis and can have innumerable causes. Dermatographism is the most common type of inducible/physical urticaria, occurring in approximately 2% to 5% of the population. Downward pressure on the skin produces linear erythematous wheals in the dermis in the shape of the external force applied, earning the name dermatographism, which means „writing on the skin.” A small subset of people with dermatographism becomes symptomatic with pruritus, stinging, prickling sensations that can bother the patient.
  • #5 Dermographism
    https://dermnetnz.org/topics/dermographism
    Dermographism is an exaggerated weal and flare response that occurs within minutes of the skin being stroked or scratched. Dermographism is the most common form of physical or chronic inducible urticaria. It is also called dermatographia and dermographic urticaria. […] Dermographism is a clinical diagnosis elicited using a sufficiently firm stroke of the skin usually across the back and waiting several minutes for the reaction to develop. A dermographometer is a device that applies a range of pressures, for example the Fric test, uses a plastic device with pegs of varying lengths which apply varying pressures. Antihistamines taken in the preceding days can cause a negative result. […] A skin biopsy is rarely required except occasionally to distinguish dermographism from mastocytosis. Histology of dermographism is nonspecific with oedema of the dermis with perivascular mononuclear cells.
  • #6
    https://journals.lww.com/jpat/fulltext/2006/10010/oral_manifestations_of_dermographism.11.aspx
    Dermographism is a type of physical urticaria, which literally means writing on skin. Dermographism may be defined as 'the appearance of a linear wheal at the site of brisk stroke with a firm object or by any configuration appropriate to the eliciting event’. In approximately 5 % of the population, exaggerated response of this constitutional whealing to trivial pressure and shearing forces is seen and termed dermographism. […] Although bronchial and genital mucosal involvement has been reported in the literature, there are no such instances where oral tissues were reported to be sensitive. This article reports one such unusual case, where a patient with dermographism also showed highly sensitive oral tissues. […] Diagnosis is based on clinical examination alone and does not require histopathologic or biochemical assistance. The clinical observation includes checking the response after using moderate pressure to stroke or gently scratch the skin.
  • #7 Dermatographia (Dermatographism) – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dermatographia/diagnosis-treatment/drc-20371415
    To test if you have dermatographia, your health care provider may draw a tongue depressor across the skin of your arm or back. If a raised line or a welt appears within a few minutes, you likely have the condition. […] Treatment for dermatographia often isn’t needed, as symptoms tend to clear up on their own. […] You’re likely to start by seeing your primary care provider. Or you may be referred to a doctor who specializes in skin conditions. This type of doctor is called a dermatologist. […] Your health care provider is likely to ask you a few questions, including: When did you begin experiencing symptoms?
  • #8 Dermatographia (Dermatographism) | Health Library | Memorial Health System
    https://www.mhsystem.org/health-library/con-20371396/
    Dermatographia is a condition in which lightly scratching your skin causes raised, inflamed lines or welts. These marks tend to go away in less than 30 minutes. The condition is also known as dermatographism and skin writing. […] The exact cause of dermatographia isn’t clear. It may be an allergic reaction, though no specific allergen has been found. […] To test if you have dermatographia, your health care provider may draw a tongue depressor across the skin of your arm or back. If a raised line or a welt appears within a few minutes, you likely have the condition. […] Treatment for dermatographia often isn’t needed, as symptoms tend to clear up on their own. But if your symptoms are bad or bother you, your health care provider may suggest a mild antihistamine medicine taken by mouth.
  • #9 Dermatographia (Dermatographism): What It Is, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17793-dermatographism-dermatographia
    Dermatographia appears within five to seven minutes of agitation. The marks appear in the same direction and orientation as the agitation. It may look like someone wrote on your skin with a pen. […] Symptoms of dermatographia are generally mild. They usually go away within 30 minutes. […] If your dermatographia is more severe and lasts longer than 30 minutes, treatment options include: […] Severe dermatographia that doesnt respond to the above therapies may be treated with a prescription biologic therapy, which is injected. […] Generally, dermatographia leaves no lasting marks, causing only minor, short-lived irritation and symptoms. The condition may last anywhere from months to years, or you may have it throughout your life. […] There isnt a cure, but for many, dermatographia goes away on its own in a year or two. Or it may grow milder over time so you dont experience major symptoms.
  • #10 Dermatographia (Dermatographism) | Beacon Health System
    https://www.beaconhealthsystem.org/library/diseases-and-conditions/dermatographia-dermatographism?content_id=CON-20371396
    Dermatographia is a condition in which lightly scratching your skin causes raised, inflamed lines where you’ve scratched. Though not serious, it can be uncomfortable. […] Dermatographia is a condition in which lightly scratching your skin causes raised, inflamed lines or welts. These marks tend to go away in less than 30 minutes. The condition is also known as dermatographism and skin writing. […] To test if you have dermatographia, your health care provider may draw a tongue depressor across the skin of your arm or back. If a raised line or a welt appears within a few minutes, you likely have the condition.
  • #11 Dermatographia (Dermatographism): What It Is, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17793-dermatographism-dermatographia
    Dermatographia appears within five to seven minutes of agitation. The marks appear in the same direction and orientation as the agitation. It may look like someone wrote on your skin with a pen. […] Symptoms of dermatographia are generally mild. They usually go away within 30 minutes. […] If your dermatographia is more severe and lasts longer than 30 minutes, treatment options include: […] Severe dermatographia that doesnt respond to the above therapies may be treated with a prescription biologic therapy, which is injected. […] Generally, dermatographia leaves no lasting marks, causing only minor, short-lived irritation and symptoms. The condition may last anywhere from months to years, or you may have it throughout your life. […] There isnt a cure, but for many, dermatographia goes away on its own in a year or two. Or it may grow milder over time so you dont experience major symptoms.
  • #12 Dermatographism Treatment | Frontier Allergy Austin
    https://www.frontierallergist.com/conditions/dermatographism/
    Your healthcare provider can diagnose dermatographia by writing on your skin. They’ll use a tongue depressor to write or press on the skin of your arm or back. Dermatographia will carry the physical marks left behind in the same direction and orientation as the writing. It may look as if someone wrote a word on your arm with a pen!
  • #13 Dermographism Urticaria Workup: Approach Considerations
    https://emedicine.medscape.com/article/1050294-workup
    The diagnosis of dermographism is usually made by observing the clinical response after using moderate pressure to stroke or gently scratch the skin. The site is important because areas protected from regular pressure and environmental influences (eg, the back) typically are more reactive than more exposed areas (eg, the buttocks and limbs). […] A dermographometer (spring-loaded stylus) can be used to apply graded, reproducible pressure (eg, 3600 g/cm2) and record skin responses. The use of this instrument is mostly limited to research settings. […] Biopsy specimens show dermal edema with a few perivascular mononuclear cells.
  • #14 +Bioline International Official Site (site up-dated regularly)
    http://www.bioline.org.br/request?dv08075
    Dermatographism also called as skin writing, dermographism or dermatographic urticaria is an enigma for dermatologists and immunologists alike. Although simpler to elicit, its clinical relevance or significance is yet to be fully known. When normal skin is stroked with a dull object, it becomes raised and inflamed to assume the shape of the stroke. The response consists of local erythema followed by edema and a surrounding flare reaction. Exaggeration of this response is known as dermatographism. Dermatographism can appear in persons of any age but is more common in young adults. Peak incidence is in the second and third decades of life. […] The diagnosis is usually made by observing the clinical response after using moderate pressure to stroke or gently scratch the skin. The site of elicitation of dermatographism is important as areas protected from regular pressure and environmental influences are more reactive than others. For this reason, dermatographism is elicited more markedly over the trunk as compared to the limbs.
  • #15 +Bioline International Official Site (site up-dated regularly)
    http://www.bioline.org.br/request?dv08075
    Dermatographism also called as skin writing, dermographism or dermatographic urticaria is an enigma for dermatologists and immunologists alike. Although simpler to elicit, its clinical relevance or significance is yet to be fully known. When normal skin is stroked with a dull object, it becomes raised and inflamed to assume the shape of the stroke. The response consists of local erythema followed by edema and a surrounding flare reaction. Exaggeration of this response is known as dermatographism. Dermatographism can appear in persons of any age but is more common in young adults. Peak incidence is in the second and third decades of life. […] The diagnosis is usually made by observing the clinical response after using moderate pressure to stroke or gently scratch the skin. The site of elicitation of dermatographism is important as areas protected from regular pressure and environmental influences are more reactive than others. For this reason, dermatographism is elicited more markedly over the trunk as compared to the limbs.
  • #16 Dermatograpia: What to Know About Skin Writing
    https://www.webmd.com/skin-problems-and-treatments/what-is-dermatographia
    Dermatographia, also called skin writing, is a condition that causes an allergic reaction when skin is scratched. This reaction looks like hives or welts. It may even happen when the skin is rubbed when pressure is applied. […] Experts estimate that 2% to 5% of people have dermatographism. Its quite common and isnt dangerous. […] Your doctor can diagnose dermatographia with a simple test. They use a tongue depressor or other tool to gently stroke your skin, drawing lines. They watch for welts to show up within a couple of minutes. […] Theres no cure for dermatographia. And because the symptoms usually go away very quickly, you probably dont need treatment. But some people may find their hives are very itchy or bothersome. […] Your doctor may prescribe an antihistamine to help ease the symptoms of dermatographia. Antihistamines help manage symptoms of allergies. Many are also available over the counter. […] A medication called cromolyn has the same effect as antihistamines. It helps stabilize the cell membrane that releases histamine and eases symptoms. Cromolyn requires a doctors prescription.
  • #17 Dermographism Urticaria Workup: Approach Considerations
    https://emedicine.medscape.com/article/1050294-workup
    The diagnosis of dermographism is usually made by observing the clinical response after using moderate pressure to stroke or gently scratch the skin. The site is important because areas protected from regular pressure and environmental influences (eg, the back) typically are more reactive than more exposed areas (eg, the buttocks and limbs). […] A dermographometer (spring-loaded stylus) can be used to apply graded, reproducible pressure (eg, 3600 g/cm2) and record skin responses. The use of this instrument is mostly limited to research settings. […] Biopsy specimens show dermal edema with a few perivascular mononuclear cells.
  • #18 Frictest® Tool- easy, simple and economy| contact and dermographic urticaria assessment
    https://medelink.ca/allergy/sub-page-frictest/?srsltid=AfmBOoqQapoCHwXrBgUYyYoe7ImoAxDv3noP-eQjH7LM7juxhN-leF97
    FricTest is a validated, easy to use dermographometer for diagnosing patients with symptomatic dermographism (urticaria factitia or dermographic urticaria) and for measuring their trigger thresholds and disease activity. […] A positive response is defined by a palpable weal of 3 mm in width (the diameter of FricTest tips) at 10 min after provocation. Positive test responses to provocation with the longest FricTest tip (provocation level IV) confirm the presence of symptomatic dermographism. […] Purpose: Confirm diagnosis of symptomatic dermographism and determine trigger thresholds (disease activity). […] Test result: Positive if wheal of 3 mm in width.
  • #19 USE OF A BALLPOINT PEN IN THE DIAGNOSIS OF PHYSICAL URTICARIA
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3088922/
    We propose use of a ballpoint pen as a simple instrument in the diagnosis of dermographism and delayed physical urticaria. […] With same ballpoint pen, diagnosis of delayed pressure urticaria can be done. […] Use of ballpoint pen is simple, easy to use procedure, and dermatologist can use this procedure to detect dermographism and delayed pressure urticaria.
  • #20 Skin writometer: A novel instrument for assessing provocation threshold in patients with symptomatic dermographism – IJCED
    https://www.ijced.org/html-article/13898
    Symptomatic dermographism, a type of physical urticaria is a common condition affecting patients quality of life. […] For its diagnosis, clinicians in India currently use tip of the ball point pen for estimating the provocation threshold. […] Hence, there is a need of a better method to diagnose symptomatic dermographism and determine the provocation threshold. Skin writometer, a plastic instrument with three arms of varying length can be novel in this regards. […] This instrument is simple, user friendly, easy to use and inexpensive. It can be used for diagnosis as well as assessment of treatment response in patients with symptomatic dermographism. […] We propose a novel instrument, known as the skin writometer for eliciting dermographism. This can be used for diagnosis as well as evaluation of treatment response to dermographism/symptomatic urticaria. […] Skin writometer, may be used as a simple, user friendly and inexpensive instrument for accurate diagnosis of symptomatic dermographism.
  • #21 Frictest® Tool- easy, simple and economy| contact and dermographic urticaria assessment
    https://medelink.ca/allergy/sub-page-frictest/?srsltid=AfmBOoqQapoCHwXrBgUYyYoe7ImoAxDv3noP-eQjH7LM7juxhN-leF97
    FricTest is a validated, easy to use dermographometer for diagnosing patients with symptomatic dermographism (urticaria factitia or dermographic urticaria) and for measuring their trigger thresholds and disease activity. […] A positive response is defined by a palpable weal of 3 mm in width (the diameter of FricTest tips) at 10 min after provocation. Positive test responses to provocation with the longest FricTest tip (provocation level IV) confirm the presence of symptomatic dermographism. […] Purpose: Confirm diagnosis of symptomatic dermographism and determine trigger thresholds (disease activity). […] Test result: Positive if wheal of 3 mm in width.
  • #22 +Bioline International Official Site (site up-dated regularly)
    http://www.bioline.org.br/request?dv08075
    Firm stroking of the skin produces an initial red line (capillary dilatation) followed by an axon-reflex flare with broadening erythema (arteriolar dilatation) and the formation of a linear wheal (transudation of fluid/edema). This is termed as the triple response of Lewis. An exaggerated form of this response is known as dermatographism. […] The exact mechanism of dermatographism remains uncertain but according to many, it is likely to be caused by mechanico-immunological stimulation of mast cells that release histamine. […] Dermatographism is seen in 4-5% of the normal population. Its prevalence in chronic idiopathic urticaria is reported to be 22% but a few authors believe that dermatographism is not increased in chronic idiopathic urticaria. […] Dermatographism is also called as mechanical urticaria. In that sense, it is a type of physical urticaria. However, it has been reported in association with chronic idiopathic urticaria (22%), cholinergic urticaria, hypereosinophilic syndrome, drug-induced urticaria, reactive polyarthritis with Helicobacter pylori and endocrinopathies like hyperthyroidism, hypothyroidism, diabetes mellitus, etc.
  • #23
    https://journals.lww.com/ijpd/fulltext/2018/19020/white_dermographism.28.aspx
    The weal and flare reaction described by Lewis in response to stroking the skin, consists of development of an initial red line (capillary dilatation) followed by an axon reflex flare with broadening erythema (arteriolar dilatation) and formation of linear weal (transudation of edema fluid). Dermographism is also called skin writing, factitious urticaria or dermograhic urticaria. Dermographism is essentially an exaggeration of this triple response […] Dermographism or 'simple’ dermographism, is noted in about 1.5%-5% of healthy individuals and is regarded as a normal physiological phenomenon. It has been postulated that it usually develops within five minutes of stroking the skin and persists for 15-30 min in contrast to the normal triple response of Lewis that subsides in less than 5-10 min. Symptomatic dermographism can be differentiated from simple dermographism by the presence of itching and a generally lower urticariogenic threshold.
  • #24
    https://journals.lww.com/ijpd/fulltext/2018/19020/white_dermographism.28.aspx
    The weal and flare reaction described by Lewis in response to stroking the skin, consists of development of an initial red line (capillary dilatation) followed by an axon reflex flare with broadening erythema (arteriolar dilatation) and formation of linear weal (transudation of edema fluid). Dermographism is also called skin writing, factitious urticaria or dermograhic urticaria. Dermographism is essentially an exaggeration of this triple response […] Dermographism or 'simple’ dermographism, is noted in about 1.5%-5% of healthy individuals and is regarded as a normal physiological phenomenon. It has been postulated that it usually develops within five minutes of stroking the skin and persists for 15-30 min in contrast to the normal triple response of Lewis that subsides in less than 5-10 min. Symptomatic dermographism can be differentiated from simple dermographism by the presence of itching and a generally lower urticariogenic threshold.
  • #25 USE OF A BALLPOINT PEN IN THE DIAGNOSIS OF PHYSICAL URTICARIA
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3088922/
    Physical urticaria encompasses a variety of conditions in which patients suffer from a chronic predisposition to develop localized or generalized urticaria or angioedema on contact with physical stimuli like mechanical, thermal or electromagnetic forces. The diagnosis of physical urticaria presents no major difficulties since patients are generally aware of the eliciting stimulus or give a suggestive history, and since the lesions can almost invariably be reproduced on appropriate testing. […] Dermographism or simple dermographism, which has been noted in about 1.5%-5% of healthy individuals, is regarded as a normal physiological phenomenon. However, in symptomatic dermographism (SD), even light pressure or rubbing from clothes may provoke widespread weal-and-flare reactions with itching and burning.
  • #26
    https://journals.lww.com/ijpd/fulltext/2018/19020/white_dermographism.28.aspx
    The weal and flare reaction described by Lewis in response to stroking the skin, consists of development of an initial red line (capillary dilatation) followed by an axon reflex flare with broadening erythema (arteriolar dilatation) and formation of linear weal (transudation of edema fluid). Dermographism is also called skin writing, factitious urticaria or dermograhic urticaria. Dermographism is essentially an exaggeration of this triple response […] Dermographism or 'simple’ dermographism, is noted in about 1.5%-5% of healthy individuals and is regarded as a normal physiological phenomenon. It has been postulated that it usually develops within five minutes of stroking the skin and persists for 15-30 min in contrast to the normal triple response of Lewis that subsides in less than 5-10 min. Symptomatic dermographism can be differentiated from simple dermographism by the presence of itching and a generally lower urticariogenic threshold.
  • #27
    https://journals.lww.com/ijpd/fulltext/2018/19020/white_dermographism.28.aspx
    On stroking the skin of atopic individuals, the rubbed area becomes erythematous, but the erythema is replaced in 10-15 seconds by pallor, which may persist for 60 seconds or more. This phenomenon is called 'white dermographism’ and is considered an abnormal vascular response in patients with atopic dermatitis. […] The precise reason for white dermographism remains to be established. The small blood vessels in atopic eczema show a tendency to vasoconstriction. This is substantiated clinically by the presence of white dermatographism, lower finger temperature, and pronounced vasoconstriction in response to cold. The same has been demonstrated through in vivo studies as a delayed blanch response to Acetyl choline, white reaction to nicotinic acid esters and abnormal reactions to histamine in affected skin.
  • #28 Dermatographism | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/20387
    Dermatographism lesions appear following mechanical trauma to the skin, most consistently stroking of the skin. […] Prevention and avoidance of precipitating factors such as physical stimuli and decreasing stressors are important factors in controlling dermatographism. […] If dermatographism is the leading differential, false dermatographism must be ruled out, a condition that presents clinically similar to dermatographism but has a different underlying mechanism. […] Dermatographism is a benign condition. […] Dermatographism has no direct complications. […] Dermatographism can be unsettling in its laborious course without resolve. However, the condition is benign, and patients must know this.
  • #29
    https://journals.lww.com/ijpd/fulltext/2018/19020/white_dermographism.28.aspx
    White dermographism is considered as constitutional stigmata of atopic dermatitis. Although it is one of the minor diagnostic criteria according to Hanifin and Rajka, most of the studies have failed to find any statistical significance between its prevalence and atopic dermatitis. This finding is in corroboration with the study conducted in Indian population by Dhar S, et al. […] It is often the first sign to appear in the initial stages of atopic dermatitis, and it is the last to disappear when the skin is returning to normal. Although it is known to appear more commonly in atopic dermatitis, it is not specific and is also seen to occur in infiltrative chronic inflammatory conditions, such as, disseminated neurodermatitis, psoriatic erythroderma, mycosis fungoides of the infiltrative type, and lymphoma associated erythroderma.
  • #30 Dermographism: Diagnosing a Peculiar Disorder – Dermatology Advisor
    https://www.dermatologyadvisor.com/home/topics/general-dermatology/dermographism-diagnosing-a-peculiar-disorder/
    Dermatographism, also known as dermographic urticaria, is a type of urticaria that usually occurs in teenagers and younger adults and can last a few weeks to a lifetime. […] The cause of this illness is unknown, but appears to be related to a mast cell abnormality and is probably autoimmune in nature. […] Clinicians can diagnose dermographism easily by using a tongue depressor. Run it over the surface of the patients skin. In a few minutes, a wheal should appear where the skin has been touched. […] Dermographism is usually treated with antihistamines to stop the reaction. […] The differential diagnosis includes chronic urticaria, systemic mastocytosis and urticaria pigmentosa as well as latex allergy. […] Clinicians should reassure their patients that this is not life threatening and can be properly managed. Referrals to a dermatologist or allergist are recommended.
  • #31 +Bioline International Official Site (site up-dated regularly)
    http://www.bioline.org.br/request?dv08075
    Firm stroking of the skin produces an initial red line (capillary dilatation) followed by an axon-reflex flare with broadening erythema (arteriolar dilatation) and the formation of a linear wheal (transudation of fluid/edema). This is termed as the triple response of Lewis. An exaggerated form of this response is known as dermatographism. […] The exact mechanism of dermatographism remains uncertain but according to many, it is likely to be caused by mechanico-immunological stimulation of mast cells that release histamine. […] Dermatographism is seen in 4-5% of the normal population. Its prevalence in chronic idiopathic urticaria is reported to be 22% but a few authors believe that dermatographism is not increased in chronic idiopathic urticaria. […] Dermatographism is also called as mechanical urticaria. In that sense, it is a type of physical urticaria. However, it has been reported in association with chronic idiopathic urticaria (22%), cholinergic urticaria, hypereosinophilic syndrome, drug-induced urticaria, reactive polyarthritis with Helicobacter pylori and endocrinopathies like hyperthyroidism, hypothyroidism, diabetes mellitus, etc.
  • #32 Dermographism: Diagnosing a Peculiar Disorder – Dermatology Advisor
    https://www.dermatologyadvisor.com/home/topics/general-dermatology/dermographism-diagnosing-a-peculiar-disorder/
    Dermatographism, also known as dermographic urticaria, is a type of urticaria that usually occurs in teenagers and younger adults and can last a few weeks to a lifetime. […] The cause of this illness is unknown, but appears to be related to a mast cell abnormality and is probably autoimmune in nature. […] Clinicians can diagnose dermographism easily by using a tongue depressor. Run it over the surface of the patients skin. In a few minutes, a wheal should appear where the skin has been touched. […] Dermographism is usually treated with antihistamines to stop the reaction. […] The differential diagnosis includes chronic urticaria, systemic mastocytosis and urticaria pigmentosa as well as latex allergy. […] Clinicians should reassure their patients that this is not life threatening and can be properly managed. Referrals to a dermatologist or allergist are recommended.
  • #33 Dermatographism – MD Searchlight
    https://mdsearchlight.com/skin-problems-and-treatments/dermatographism/
    Dermatographism is a skin condition where the skin reacts to physical pressure or rubbing, leading to raised welts or hives. These welts usually appear about 5 to 10 minutes after the skin is rubbed, and they can last from 15 to 30 minutes. […] Dermatographism is usually managed by avoiding triggers such as physical stimuli and stress. Treatment is typically only necessary for patients who experience symptoms. The go-to treatment is H1 antihistamines like cetirizine or loratadine. […] Omalizumab is being researched as a treatment and has shown effectiveness in clinical trials. […] The doctor needs to rule out the following conditions when diagnosing Dermatographism: – False dermatographism (white, black, and yellow types) – Latex allergy – Mastocytosis […] Dermatographism is a harmless condition. In some cases, it can come with itchiness. […] The prognosis for dermatographism is generally good. It is a harmless condition and tends to clear up faster compared to other long-term hives conditions. After 5 years, 36% of cases clear up, and after 10 years, 51% of cases clear up.
  • #34 Dermographism: Diagnosing a Peculiar Disorder – Dermatology Advisor
    https://www.dermatologyadvisor.com/home/topics/general-dermatology/dermographism-diagnosing-a-peculiar-disorder/
    Dermatographism, also known as dermographic urticaria, is a type of urticaria that usually occurs in teenagers and younger adults and can last a few weeks to a lifetime. […] The cause of this illness is unknown, but appears to be related to a mast cell abnormality and is probably autoimmune in nature. […] Clinicians can diagnose dermographism easily by using a tongue depressor. Run it over the surface of the patients skin. In a few minutes, a wheal should appear where the skin has been touched. […] Dermographism is usually treated with antihistamines to stop the reaction. […] The differential diagnosis includes chronic urticaria, systemic mastocytosis and urticaria pigmentosa as well as latex allergy. […] Clinicians should reassure their patients that this is not life threatening and can be properly managed. Referrals to a dermatologist or allergist are recommended.
  • #35 Dermographism: Diagnosing a Peculiar Disorder – Dermatology Advisor
    https://www.dermatologyadvisor.com/home/topics/general-dermatology/dermographism-diagnosing-a-peculiar-disorder/
    Dermatographism, also known as dermographic urticaria, is a type of urticaria that usually occurs in teenagers and younger adults and can last a few weeks to a lifetime. […] The cause of this illness is unknown, but appears to be related to a mast cell abnormality and is probably autoimmune in nature. […] Clinicians can diagnose dermographism easily by using a tongue depressor. Run it over the surface of the patients skin. In a few minutes, a wheal should appear where the skin has been touched. […] Dermographism is usually treated with antihistamines to stop the reaction. […] The differential diagnosis includes chronic urticaria, systemic mastocytosis and urticaria pigmentosa as well as latex allergy. […] Clinicians should reassure their patients that this is not life threatening and can be properly managed. Referrals to a dermatologist or allergist are recommended.
  • #36 Dermatographism – MD Searchlight
    https://mdsearchlight.com/skin-problems-and-treatments/dermatographism/
    Dermatographism is a skin condition where the skin reacts to physical pressure or rubbing, leading to raised welts or hives. These welts usually appear about 5 to 10 minutes after the skin is rubbed, and they can last from 15 to 30 minutes. […] Dermatographism is usually managed by avoiding triggers such as physical stimuli and stress. Treatment is typically only necessary for patients who experience symptoms. The go-to treatment is H1 antihistamines like cetirizine or loratadine. […] Omalizumab is being researched as a treatment and has shown effectiveness in clinical trials. […] The doctor needs to rule out the following conditions when diagnosing Dermatographism: – False dermatographism (white, black, and yellow types) – Latex allergy – Mastocytosis […] Dermatographism is a harmless condition. In some cases, it can come with itchiness. […] The prognosis for dermatographism is generally good. It is a harmless condition and tends to clear up faster compared to other long-term hives conditions. After 5 years, 36% of cases clear up, and after 10 years, 51% of cases clear up.
  • #37 +Bioline International Official Site (site up-dated regularly)
    http://www.bioline.org.br/request?dv08075
    Symptomatic dermatographism has to be differentiated from Dariers sign seen in urticaria pigmentosa and systemic mastocytosis in which the actual number of skin mast cells is increased due to mast cell hyperplasia. However, symptomatic dermatographism is also observed in mastocytosis after stroking uninvolved skin. […] Avoidance of precipitating physical stimuli, reduction of stress and anxiety are important factors. H1-antihistamines are the drugs of choice. However, combining H1 and H2 antihistamines has sometimes resulted in better control of the wheals. Other treatment options like NB-UVB therapy and psovalent + UVA (PUVA) therapy have been used with limited success.
  • #38 Dermographism – Knowledge and References – Taylor & Francis
    https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Dermatology/Dermographism/
    Dermographism is a condition where the skin reacts excessively to mild trauma, such as rubbing, resulting in the formation of wheals and erythema. The term literally means „drawing on the skin.” It is typically an idiopathic condition and is not associated with systemic disease. Symptomatic dermographism refers to the development of itchy weals when the skin is scratched or rubbed. […] Dermatographia (also called dermographism or “skin writing”) appears warm in infrared images. If the scratched or otherwise traumatized skin becomes red and elevated, it is called red dermographism, which is a diagnostic finding of physical urticaria. If the site becomes white, it is called white dermographism; this is usually seen in patients with atopic dermatitis. […] The diagnosis of CM relies mainly on recognition of (typical) skin lesions. A positive Darier’s sign serves as a major criterium. This involves a local wheal and flare reaction when lesions are stroked at moderate pressure. Darier’s sign differs from dermographism, since the latter also applies to nonlesional skin.
  • #39 Dermographism
    https://dermnetnz.org/topics/dermographism
    Dermographism is an exaggerated weal and flare response that occurs within minutes of the skin being stroked or scratched. Dermographism is the most common form of physical or chronic inducible urticaria. It is also called dermatographia and dermographic urticaria. […] Dermographism is a clinical diagnosis elicited using a sufficiently firm stroke of the skin usually across the back and waiting several minutes for the reaction to develop. A dermographometer is a device that applies a range of pressures, for example the Fric test, uses a plastic device with pegs of varying lengths which apply varying pressures. Antihistamines taken in the preceding days can cause a negative result. […] A skin biopsy is rarely required except occasionally to distinguish dermographism from mastocytosis. Histology of dermographism is nonspecific with oedema of the dermis with perivascular mononuclear cells.
  • #40 Dermographism
    https://dermnetnz.org/topics/dermographism
    Dermographism is an exaggerated weal and flare response that occurs within minutes of the skin being stroked or scratched. Dermographism is the most common form of physical or chronic inducible urticaria. It is also called dermatographia and dermographic urticaria. […] Dermographism is a clinical diagnosis elicited using a sufficiently firm stroke of the skin usually across the back and waiting several minutes for the reaction to develop. A dermographometer is a device that applies a range of pressures, for example the Fric test, uses a plastic device with pegs of varying lengths which apply varying pressures. Antihistamines taken in the preceding days can cause a negative result. […] A skin biopsy is rarely required except occasionally to distinguish dermographism from mastocytosis. Histology of dermographism is nonspecific with oedema of the dermis with perivascular mononuclear cells.
  • #41 Dermographism Urticaria Workup: Approach Considerations
    https://emedicine.medscape.com/article/1050294-workup
    The diagnosis of dermographism is usually made by observing the clinical response after using moderate pressure to stroke or gently scratch the skin. The site is important because areas protected from regular pressure and environmental influences (eg, the back) typically are more reactive than more exposed areas (eg, the buttocks and limbs). […] A dermographometer (spring-loaded stylus) can be used to apply graded, reproducible pressure (eg, 3600 g/cm2) and record skin responses. The use of this instrument is mostly limited to research settings. […] Biopsy specimens show dermal edema with a few perivascular mononuclear cells.
  • #42 Dermatographism | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/20387
    Dermatographism, also known as Dermographism urticaria or urticaria factitia, is a urticarial eruption upon pressure or trauma to the skin. Dermatographism is the most common type of inducible/physical urticaria, occurring in approximately 2% to 5% of the population. […] The exact cause of dermatographism is unknown. However, the release of histamine from mast cells is thought to play a role. Dermatographism has been seen in people with diabetes, hyperthyroidism, hypothyroidism, menopause, pregnancy, or medication-related conditions. […] Dermatographism is the most common type of urticaria, frequently presenting in young adults, with the peak incidence in the second and third decades. […] No concluding mechanism explains why dermatographism occurs. […] The histopathology of dermatographism demonstrates dermal edema with few perivascular mononuclear cells, similar to acute urticaria histology.
  • #43 Based on a patient: Dermographism should be routinely investigated before every provocation test | Allergologia et Immunopathologia
    https://www.elsevier.es/en-revista-allergologia-et-immunopathologia-105-articulo-based-on-patient-dermographism-should-S0301054611003661
    Based on a patient: Dermographism should be routinely investigated before every provocation test […] Based on this patient we suggest that symptomatic dermographism should be routinely investigated as first step before all provocation tests such as food or drug even without suggestive history of symptomatic dermographism and in the presence of symptomatic dermographism it should be performed by eliminating physical stimuli.
  • #44 Reddit – The heart of the internet
    https://www.reddit.com/r/Allergies/comments/8kb7az/when_allergy_testing_was_a_bust_due_to/
    I have been suffering from an array of allergy symptoms for the past three years and I finally got referred out to an allergist. […] I was supposed to be allergy tested today via skin pricking, however when I mentioned that I had this new symptom of Dermatographia and also flushing of my skin the nurse said we couldnt do allergy testing today as it would cause a false positive. […] She scratched my arm with her pen gently, and I broke out immediately in hives (Dermatographia). […] The nurse kept saying this looked more like an auto immune disorder…so what would he test me for? […] Does anyone know what the protocol is when allergy testing is a bust like this?
  • #45
    https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2022/immunotherapy
    Dermatographism is a limiting factor when it comes to allergy skin testing. […] Generally speaking, a negative control wheal of less than or equal to 3mm can allow for interpretation of allergy skin tests. […] It should be noted that just because a skin test is positive, that does not mean it is clinically relevant. […] An alternative approach in such circumstances, and also when the negative control exceeds 3mm, is the measurement of serum specific IgE. […] In this situation, one must use the patient’s symptom history, physical examination and exposure history to guide medical-decision making about whether an allergen is clinically relevant and should be included in the therapy.
  • #46 Dermographism
    https://dermnetnz.org/topics/dermographism
    Dermographism is an exaggerated weal and flare response that occurs within minutes of the skin being stroked or scratched. Dermographism is the most common form of physical or chronic inducible urticaria. It is also called dermatographia and dermographic urticaria. […] Dermographism is a clinical diagnosis elicited using a sufficiently firm stroke of the skin usually across the back and waiting several minutes for the reaction to develop. A dermographometer is a device that applies a range of pressures, for example the Fric test, uses a plastic device with pegs of varying lengths which apply varying pressures. Antihistamines taken in the preceding days can cause a negative result. […] A skin biopsy is rarely required except occasionally to distinguish dermographism from mastocytosis. Histology of dermographism is nonspecific with oedema of the dermis with perivascular mononuclear cells.
  • #47 In symptomatic dermographism, disease activity is affected by eating and exercise
    https://www.aaaai.org/tools-for-the-public/latest-research-summaries/the-journal-of-allergy-and-clinical-immunology-in/2022/symptomatic
    Symptomatic dermographism (SD) is characterized by the appearance of wheals on the skin accompanied by itch and/or a burning sensation after scratching, rubbing, and/or friction. […] The diagnosis of SD is made by provocation testing, i.e. scratching of the skin with a blunt object (a tongue blade, for example, or a dermographometer such as FricTest). […] Provocation testing with a dermographometer has the added benefit of allowing for the assessment of disease activity, by measuring the threshold of trigger strength in individual patients. […] In the current study published in The Journal of Allergy and Clinical Immunology: In Practice, Erta and coworkers tested 75 patients with SD for the impact of eating, exercising, or both on trigger thresholds and disease activity. […] Two thirds of SD patients had increased disease activity after eating, and one in ten had active SD only after eating.
  • #48 In symptomatic dermographism, disease activity is affected by eating and exercise
    https://www.aaaai.org/tools-for-the-public/latest-research-summaries/the-journal-of-allergy-and-clinical-immunology-in/2022/symptomatic
    Exercise, on the other hand, often improved SD disease activity, in eight of ten patients. […] Also, exercising protected patients from worsening after eating in half of cases. […] These results are the first to show that eating and exercise affect SD disease activity. […] That eating can worsen SD and that exercising can improve it has many implications, for SD patients and for physicians who treat them. […] Physicians who test patients for their disease activity by provocation testing should advise their patients to not eat or exercise before the test, so that true disease activity and thresholds are assessed.
  • #49
    https://journals.lww.com/jpat/fulltext/2006/10010/oral_manifestations_of_dermographism.11.aspx
    Dermographism is a type of physical urticaria, which literally means writing on skin. Dermographism may be defined as 'the appearance of a linear wheal at the site of brisk stroke with a firm object or by any configuration appropriate to the eliciting event’. In approximately 5 % of the population, exaggerated response of this constitutional whealing to trivial pressure and shearing forces is seen and termed dermographism. […] Although bronchial and genital mucosal involvement has been reported in the literature, there are no such instances where oral tissues were reported to be sensitive. This article reports one such unusual case, where a patient with dermographism also showed highly sensitive oral tissues. […] Diagnosis is based on clinical examination alone and does not require histopathologic or biochemical assistance. The clinical observation includes checking the response after using moderate pressure to stroke or gently scratch the skin.
  • #50
    https://journals.lww.com/jpat/fulltext/2006/10010/oral_manifestations_of_dermographism.11.aspx
    This article reports a patient with dermographism who was seen having exaggerated and peculiarly increased sensitivity of oral tissues to minor pressure. […] Oral examination revealed highly sensitive oral tissues. This had adversely affected his oral hygiene procedures. […] The condition was provisionally diagnosed as increased sensitivity of oral tissues associated with dermographism and/or pressure urticaria. […] Recognition of this benign disorder and reassurance is important in handling the condition. Treat dermographism symptomatically until the problem is adequately controlled or resolved. Careful attention has to be paid while managing these patients due to increased prevalence of allergic responses that are seen and due to increased sensitivity of oral and dermal tissues. […] The natural history of symptomatic dermographism and the peculiarly increased sensitivity of oral tissues remain unclear.
  • #51 Dermatographia in oral cavity unveiled: A case study – JOOO
    https://www.joooo.org/html-article/23094
    Dermatographia is a form of physical urticaria, quite uncommon in oral cavity characterized by elevated skin following localized erythema, oedema, and a flare-up reaction around it. […] Dermatographia (or Dermatographism) is an urticaria or a skin related disease which is caused or induced by writing on skin. […] Dermatographism can be symptomatic and experienced in a small subset of population, and it may or may not deteriorate their quality of life. […] The diagnosis of oral dermatographia is primarily clinical and supported by the characteristic appearance of linear wheals following mechanical stimulation of the oral mucosa. […] Management of oral dermatographia focuses on symptomatic relief and prevention of exacerbating factors. […] Oral dermatographia is an uncommon form of physical urticaria that can resemble other mucosal conditions.
  • #52
    https://journals.lww.com/jpat/fulltext/2006/10010/oral_manifestations_of_dermographism.11.aspx
    This article reports a patient with dermographism who was seen having exaggerated and peculiarly increased sensitivity of oral tissues to minor pressure. […] Oral examination revealed highly sensitive oral tissues. This had adversely affected his oral hygiene procedures. […] The condition was provisionally diagnosed as increased sensitivity of oral tissues associated with dermographism and/or pressure urticaria. […] Recognition of this benign disorder and reassurance is important in handling the condition. Treat dermographism symptomatically until the problem is adequately controlled or resolved. Careful attention has to be paid while managing these patients due to increased prevalence of allergic responses that are seen and due to increased sensitivity of oral and dermal tissues. […] The natural history of symptomatic dermographism and the peculiarly increased sensitivity of oral tissues remain unclear.
  • #53 Dermatographia (Dermatographism) | Health Library | Memorial Health System
    https://www.mhsystem.org/health-library/con-20371396/
    Dermatographia is a condition in which lightly scratching your skin causes raised, inflamed lines or welts. These marks tend to go away in less than 30 minutes. The condition is also known as dermatographism and skin writing. […] The exact cause of dermatographia isn’t clear. It may be an allergic reaction, though no specific allergen has been found. […] To test if you have dermatographia, your health care provider may draw a tongue depressor across the skin of your arm or back. If a raised line or a welt appears within a few minutes, you likely have the condition. […] Treatment for dermatographia often isn’t needed, as symptoms tend to clear up on their own. But if your symptoms are bad or bother you, your health care provider may suggest a mild antihistamine medicine taken by mouth.
  • #54 Dermographism: Causes, Symptoms, and Natural Remedies
    https://www.nirvahealth.com/blog/treatment-guide-to-dermographism
    Dermographism is very common, with at least 2%-5% of the population experiencing the condition. […] Dermographism is when the skin reacts to mechanical stress, wildly stroking. […] Studies explain that dermographism shows up when skin becomes highly sensitive. Researchers are yet to decipher the exact cause of these skin writings, and they say no specific allergen causes them. […] The key symptom of dermatographia is that the wheal (A raised, itchy area of skin that is sometimes an overt sign of allergy) that occurs disappears in some time; this does not leave a permanent mark on the skin. […] Primary symptoms of dermatographia include redness, swelling, welts or hives, and red lines. […] A ”scratch test” can identify if it is skin writing or some other skin disease. […] The main line of conventional treatment for dermatographia is anti-allergic treatment.
  • #55 Dermatographism – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK531496/
    Dermatographism is the most common type of urticaria, frequently presenting in young adults, with the peak incidence in the second and third decades. […] Dermatographism is a benign condition. In a minority of cases, pruritus can accompany the condition. Compared to the other chronic urticarias, symptomatic dermatographism displays the most expedited clearance of the condition after 5 years (36%) and 10 years (51%). […] Dermatographism has no direct complications. However, if the patient uses sedating antihistamines for treatment, they may need to exercise caution before engaging in certain activities such as driving or operating machinery. […] Dermatographism can be unsettling in its laborious course without resolve. However, the condition is benign, and patients must know this. The treatment involved, antihistamines, can result in drowsiness; therefore, it is best to advise the patient not to take the medication before operating a vehicle. […] Dermatographism is a benign yet startling lesion to most patients and their parents. Thus, it is imperative to educate the patient and their parents properly on the risk factors associated with the onset of dermatographism to avoid such stressors.
  • #56 How Do You Get Rid of Dermatographia?
    https://www.medicinenet.com/how_do_you_get_rid_of_dermatographia/article.htm
    Asymptomatic dermatographia requires no therapy, but symptomatic dermatographia may require treatment because it can be distressing and significantly impact the quality of life. […] Most people with dermatographia are asymptomatic and otherwise healthy. The natural course of dermatographia is unpredictable and may last for months or years, or occur intermittently. In many people, dermatographia improves over the years and clears on its own or with treatment.
  • #57 Dermatographia (Dermatographism): What It Is, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17793-dermatographism-dermatographia
    If you have dermatographia, it can generally be well-managed with good skin care and treatment. It usually goes away within 30 minutes, and it isnt dangerous. Most people dont see their healthcare provider for treatment. […] See your healthcare provider if your dermatographia doesnt go away within an hour, it appears with other symptoms or is painful. […] Dermatographia is annoying, especially if its itchy, and it may even be embarrassing. However, its common and very normal, and it usually doesnt affect your quality of life. With a proper skin care routine, stress management and treatment, you can reduce its impact.

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