Publications

Abstract The physical urticarias are a heterogeneous sub- group of chronic urticarias in which wheals can be repro- ducibly induced by different specific physical stimuli such as cold, heat, pressure, vibration, or sunlight. Physical urti- carias comprise up to 25 % of chronic urticarias and occur more frequently in young adults. Symptoms, i.e. wheal and flare responses or angioedema, are usually limited to the skin areas exposed to the eliciting stimulus. However, gen- eralised urticaria with variable extracutaneous manifesta- tions can also occur. Some patients may also present with more than one physical urticaria. Skin lesions in physical urticaria result from mast cell activation and mediator re- lease. The mechanisms by which physical stimuli activate skin mast cells are not fully understood. Because of this, trigger avoidance and symptomatic treatment are key thera- peutic concepts for physical urticarias. Identification of the inducing physical trigger, including its individual thresh- olds, is necessary for an effective therapy. Here, we have summarized clinical features, diagnostic workup and thera- py options for physical urticarias.