AQUAGENIC URTICARIA

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.

Clinical

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].

Differential

See also aquagenic pruritus.

Treatment

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.

References

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.

RegionalDerm

Homepage | FAQs | Contact Dr. White


It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.