This patient complained to me that she gets rashes when she comes walking to the clinic in the morning. Today she showed me the lesions, numerous small (1-4 mm in diameter) pruritic wheals with surrounding flares. Lesions used to subside in 30 minutes. A diagnosis of cholinergic urticaria was made.
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Severe cholinergic urticaria successfully treated with scopolamine butylbromide in addition to antihistamines.
H. Ujiie, T. Shimizu, K. Natsuga, K. Arita, K. Tomizawa, H. Shimizu
Clin Exp. Dermatol