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Dermography, also known as dermatographia or “skin writing,” causes red lines or weals to appear on the skin when scratched or rubbed. It is caused by mast cells becoming overly sensitive to minor trauma and releasing histamines, and there is no known cure. Outbreaks can be controlled through lifestyle changes and taking oral antihistamines. Prevention includes avoiding triggers and keeping the skin hydrated. Treatment involves antihistamines, but there is no known cure.
Dermography is a dermatological condition that causes red lines, sometimes known as weals or bruises, to develop when a sufferer’s skin is scratched or rubbed. It is also known as dermatographia, dermatographic urticaria, or “skin writing.” Wheals are a type of hive and aren’t dangerous, but they can be itchy and uncomfortable. The signs usually last only a few minutes, although in severe cases they can persist for hours or days. There is no cure for the condition, although outbreaks can often be controlled through a combination of lifestyle changes and taking oral antihistamines.
Symptoms
In patients with dermographia, even superficial scratching causes small blood vessels in the skin to dilate or widen and form a wheal. Often, the swelling follows the line of the scratch, appearing as a raised red line on the skin. These hives or wheals may be itchy or, in rare cases, have a burning sensation.
Lines and weals appear after five minutes of scratching or stroking the skin, in most cases, and disappear within 30 minutes. A form called delayed dermatographism shows no symptoms for several hours after the initial trigger, and the hives can last for a day or more. This condition can come and go, but people often experience it
Causes and frequency
Mast cells are a type of immune cell found in the skin, mucous membranes, and other tissues. When an allergen enters the body, these cells are stimulated, releasing chemicals called histamines that cause a runny nose, swollen eyes, rashes or hives, and other symptoms of an allergic reaction. In a person with dermographia, mast cells become overly sensitive to minor trauma and cause hives to appear on the skin when it is rubbed or scratched.
Experts aren’t sure what causes mast cell hyperreactivity. Some believe it is associated with allergies, as mast cells play an important role in allergic reactions, but others dispute this. Many sufferers have no other allergy symptoms and no specific allergen appears to trigger the condition.
Some people still choose to have allergy tests done, just in case the hives are triggered by – or made worse by – an identifiable cause. For example, some medications, including penicillin, can cause a rash or hives. The most appropriate type of allergy test is a blood test, as traditional “scratch tests” or patch tests require rubbing suspected allergens into a patient’s skin. This can cause a reaction in someone with dermographies unrelated to the actual allergen.
About 4% – 5% of people have dermography and it is considered one of the most common forms of hives, or hives-producing disorders. It tends to be more common in people in their 20s and 30s and is equally common in men and women.
Prevention
While dermographies can’t be prevented entirely, there are things a person can do to minimize the frequency and severity of outbreaks. Those with the condition can identify possible triggers and avoid them. Possible triggers include using irritating fabrics, such as wool, or using harsh soaps or personal care products. Some people find that eliminating fabric softener can also help prevent reactions from clothing. While this condition isn’t known to be caused by a specific allergy, it’s possible that an allergic reaction could make the problem worse, so anything known to cause a reaction should be avoided.
Keeping your skin hydrated can also help. People with the condition should drink lots of water and use a moisturizing lotion to reduce the chances of developing dry skin, which can encourage more scratching. Both heat and cold can trigger an outbreak, so things like bathing in very hot water can cause bruising, so sufferers should adjust their hygiene routine to see if it offers relief.
Hives can develop as a result of stress, so someone who already has dermographies may find that the condition worsens during particularly stressful times. Finding ways to relax and reduce anxiety can make wheals less common.
Treatment and prognosis
An outbreak of skin wheals caused by dermography usually goes away on its own relatively quickly, so there is often no need to treat the condition. People who are extremely prone to outbreaks or who find the condition very uncomfortable can be treated with over-the-counter or prescription oral antihistamines. Sometimes, a combination of medications is needed to provide relief.
While antihistamines can reduce symptoms, there is no known cure for this condition. In many cases, an outbreak can last for several months or years and then disappear. However, the wheals may eventually come back for some sufferers.
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