By Gary M. White, MD
Aquagenic urticaria is one of the physical urticarias in which urticaria develops after exposure to water. Rain, sweat, saliva, tears, bath water, or any other source of water--irrespective of temperature--may cause this. The lesions develop within 10-13 minutes of exposure.
Vaseline application before exposure can prevent the development of wheals.
Patients with both aquagenic urticaria and cholinergic urticaria have been described.
Small, urticarial wheals similar to those of cholinergic urticaria develop within 10-13 minutes of exposure to water (e.g., washing one's hands, rain, taking a bath) irrespective of temperature. Lesions persist for minutes to an hour. Usually the upper body is affected.
There is a salt-dependent variant that requires salt water to precipitate. It usually affects the inferior facial contours and neck [CED 2013;38;754-7].
See also aquagenic pruritus.
Daily antihistamine use may be the best approach. Pre-application of a barrier cream/ointment (e.g., petrolatum) can prevent development of the lesions. Also used are stanazol, narrowband UVB, and PUVA.
An 18-year-old man with recurrent episodes of an itchy rash after hand washing, showering/bathing, drinking water, and getting rain-soaked. Ann Dermatol. 2017 Jun; 29(3): 341–345.
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