Symptomatic dermographism: an inadequately described disease

Abstract

Background: Symptomatic dermographism is the most common form of physical urticaria with a prevalence of 2-5%. However, its clinical picture has rarely been described.

Objective: To understand more of patients' views about the practical aspects of their condition, its cause and impact on quality of life.

Methods: Ninety-one of 150 patients with symptomatic dermographism from our specialist urticaria clinic completed a 38-question questionnaire sent them by mail.

Results: The mean duration of disease was 6¼ years. In most patients, the condition was continuous, but ~25% had prolonged symptom-free phases. Severity was evaluated as moderate in 45%, severe in 33% and very severe in 6% of respondents. Other responses included: symptoms worse in the evening in 81%; quality of life significantly impaired in 44%; normal life not possible 7%; stress induces acute episodes 44%; other urticarial forms coexist 21%; allergy coexist 48%. A family history was reported in 14%. Almost all patients were taking H1 -anti-histamines, 49% getting marked improvement and 23% becoming symptoms free.

Limitations: It is a survey only of patient opinions.

Conclusions: This questionnaire survey confirmed that symptomatic dermographism is a debilitating condition with profound effects on quality of life but its underlying cause and disease mechanisms remain obscure.