In the human body, along with other neurotransmitters that transmit impulses through the synaptic gap between neurons, there is acetylcholine. It is responsible for neuromuscular neuronal communication and is also the main one in the parasympathetic nervous system. If for some reason this substance begins to be produced in excess, a person may develop a disease - cholinergic urticaria.
In the article we will talk about the causes of its appearance and methods of treatment.
Introduction to Cholinergic Urticaria
The mentioned ailment is quite rare. It accounts for no more than 8% of cases of the total number of patients with urticaria. Interestingly, young people most often suffer from it, although there are no age or gender restrictions for this disease.
On the skin, cholinergic urticaria resembles a burn from nettle leaves - the same blistersor red, itchy patches that cause severe discomfort. But in some cases, the rash is invisible, however, the itching in this case, patients are no less worried. In medicine, this disease has another name - itchy dermatosis.
Cholinergic urticaria: pathogenesis
Reliable causes of the described pathology are still not known. None of the studies have been able to conclusively prove the direct effect of one or another component on the appearance of her symptoms.
The generally accepted theory of the development of cholinergic urticaria still associates allergies with the rupture of the so-called mast cells in our skin. They are immune highly specialized units involved in adaptive immunity. And their rupture at a time when a person sweats from exposure to external heat, an increase in internal temperature, or at the time of a stressful situation, is provoked by the release of acetylcholine.
Whether cholinergic urticaria has causes other than those named is unknown, but in medicine there are 3 main factors that can cause it:
- Pathological reaction to heat exposure.
- Physical activity.
- Existing diseases (pathologies of the endocrine system, gastrointestinal tract, as well as vegetative-vascular or neurocirculatory dystonia).
Moreover, the development of cholinergic urticaria begins only if a person has both a predisposition to allergic reactions and hypersensitivity to acetylcholineat the same time.
Symptoms
Signs of the disease appear immediately after exposure to an irritating factor, and they are quite difficult to confuse with any other symptoms.
- Small bubbles appear first, the skin around which, as a rule, becomes edematous and hyperemic.
- Most often the rash appears on the neck, décolleté, forearms and chest. The lower torso is rarely involved.
- The blisters are very itchy and burning.
- Cholinergic urticaria, the symptoms of which we discuss in this article, is often accompanied by fever.
- Due to the fact that acetylcholine is a neurotransmitter, excessive sensitivity to it can cause manifestations of its excessive activity - diarrhea, nausea, vomiting, excessive salivation.
Diagnosis
Cholinergic urticaria is diagnosed simply. To determine it, standard laboratory tests and anamnesis are sufficient. And due to the fact that the first manifestations of the pathology are visible immediately after the provoking effect of any of the factors listed above, the patient can always quite clearly determine what exactly caused the disease.
To clarify the diagnosis, a subcutaneous injection of an analogue of acetylcholine is performed or a provocative test is done in the form of a thermal effect on the skin (for this, the patient's hand is placed in hot water). If 20 minutes later, rashes appear, which subsequently disappear without a trace, the diagnosis is considered proven.
Cholinergic urticaria: treatment with folk remedies
If other forms of the disease can be treated with antihistamines, then cholinergic urticaria is quite resistant to them.
In this case, these drugs can only slightly and for a short time reduce the symptoms of allergies. Researchers attribute this to the hypersensitivity of the human body to the stimulus that it produces.
The 2nd and 3rd generations of histamine receptor blockers - Loratadine, Cetirizine, Ebastine, etc. may be somewhat more effective. Only an experienced dermatologist should prescribe them, choosing an individual dosage and taking into account possible side effects.
In some cases, folk remedies may also be useful:
- An infusion of licorice root to drink half a glass twice a day. Powder from this root is taken in ½ tsp. and drink water.
- Infusion of dry nettle. Grass for this is poured with boiling water and allowed to brew. Drink as tea 3 times a day.
- Peppermint and chamomile teas, which have a mild calming effect, are equally useful. They are drunk instead of black tea.
- They also take horseradish juice (root), which is mixed with honey in a ratio of 1:1. Take a teaspoon three times a day.
To relieve itching andto remove puffiness, you can make lotions from a solution of soda, chamomile, string, lemon juice diluted with water. Any of these agents is impregnated with a sterile bandage and applied to areas with a rash for half an hour. This procedure, if repeated 4 times a day, can alleviate the patient's condition.
Prevention of an allergic reaction
If a patient has already been diagnosed with cholinergic urticaria once, then in order to avoid a recurrence of the disease, he will need to adhere to certain rules and restrictions:
- Avoid hot baths. Cool showers are now more beneficial for washing.
- Spicy foods will have to be excluded from the diet. Hot food can also be harmful.
- Alcohol is not allowed.
- Profuse sweating will have to be avoided both during physical exertion and in all other cases. If perspiration appears, you should rest in the shade or take a shower.
- Stressful situations should be carefully avoided. When this is not possible, the patient should be sedated.
