History:

This patient came with c/o extremely pruritic evanescent lesions on trunk and shoulders for the last 2 years. They used to appear during exercise and after taking a hot bath. O/E They were 3-5 mm edematous red urticarial papules. A few of them coalesced to form big plaques. They used to subside after taking a rest. This photograph was taken after giving the patient a brief exercise regime. He was prescribed Tab.Hydroxyzine 25 mg at bed time and advised to avoid vigorous exercise and hot baths.

Cholinergic urtcaria is a chronic disease seen between the age group of 10 to 30 years. It is allergy to the sweat as it comes out  from the eccrine glands on the surface of the skin . Exercise, hot bath, tight clothing, fever, spicy food and emotional stress can precipitate the attacks. Sometimes it may lead to syncope.

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