vibratory urticaria

Vibratory Urticaria: A Rare Form of Physical Urticaria

Vibratory urticaria is a rare and intriguing form of physical urticaria, characterized by the rapid onset of hives and other symptoms following exposure to vibratory stimuli [11]. This condition is considered a distinct clinical disorder from vibratory angioedema, which is characterized by swelling due to a vibratory stimulus [1].

Symptoms

The symptoms of vibratory urticaria typically develop within minutes of local exposure to vibration, resulting in itching, reddish skin, and swelling [2]. The areas of the skin that are most exposed to the stimulus, often the hands, are generally more severely affected. People with this condition may also experience flushing, headaches, fatigue, blurry vision, and other systemic manifestations [3].

Characteristics

Vibratory urticaria is a rare, genetic form of urticaria characterized by localized, short-lasting (resolving within 1 hour), pruritic, erythematous, edematous hives in response to repetitive frictional or vibratory stimulation of the skin [4]. In some cases, this condition may be accompanied by facial flushing, headache, or the sensation of a metallic taste.

Causes

The exact cause of vibratory urticaria is not fully understood, but it is believed to involve the release of chemical mediators from tissue mast cells and circulating histamine in response to vibratory stimuli [10].

References

[1] Considered a distinct clinical disorder from vibratory angioedema. [2] Symptoms develop within minutes of local exposure to vibration. [3] Areas most exposed to stimulus (hands) are generally more severely affected. [4] Localized, short-lasting hives in response to repetitive frictional or vibratory stimulation. [10] Release of chemical mediators from tissue mast cells and circulating histamine.

Vibratory Urticaria Signs and Symptoms

Vibratory urticaria, a rare form of physical urticaria, is characterized by the rapid onset of hives and other symptoms following exposure to vibratory stimuli. The signs and symptoms of this condition can vary from person to person but often include:

• Red, itchy hives: These are the most common symptom of vibratory urticaria, appearing as red, raised welts on the skin that can be itchy or painful.
• Headaches: Some people with vibratory urticaria may experience headaches, which can range from mild to severe.
• Flushing faces: Exposure to vibration can cause the face to become flushed and red.
• Blurred vision: In some cases, people with vibratory urticaria may experience blurred vision or other visual disturbances.
• Metallic taste in the mouth: A metallic taste in the mouth is another symptom that has been reported by some individuals with this condition.

These symptoms can appear within minutes of exposure to vibration and typically resolve on their own within an hour. However, in some cases, they may persist for longer periods or recur frequently.

References:

• [1] Vibratory urticaria is a rare form of chronic inducible urticaria that causes weals on the skin after exposure to vibration.
• [2] Vibratory urticaria is a condition that causes itching, reddish skin and swelling in response to vibration.
• [3] Vibratory urticaria is a rare, genetic urticaria characterized by the development of localized, short-lasting (resolving within 1 hour), pruritic, erythematous, ...
• [6] People with vibratory urticaria get symptoms like red, itchy hives; headaches; flushing faces; blurred vision and a metallic taste in their mouths.
• [11] Vibrations, such as clapping or a bumpy car ride, can cause hives in some people. The hives tend to come and go within an hour. Flushing, headaches, blurry vision, or a metallic taste can sometimes occur along with them.

Diagnostic Tests for Vibratory Urticaria

Vibratory urticaria, a rare form of physical urticaria, can be challenging to diagnose. However, several diagnostic tests and procedures can help confirm the condition.

• Provocation testing: This is considered the gold standard for diagnosing vibratory urticaria. A non-standardized vibratory provocation test involves applying a vortex or mixer on a level plane with the forearm skin, as described in [1]. The test aims to reproduce the symptoms of itching and swelling within minutes at the site of skin exposure to vibration.
• Complete blood count (CBC): A CBC is an essential investigation for diagnosing infections in urticaria. It can help identify any underlying conditions that may be contributing to the symptoms, as mentioned in [2].
• Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP): These tests are also important for investigating infections in urticaria. Elevated levels of ESR and CRP can indicate an underlying infection or inflammation, as stated in [3].
• Vibration provocation test: This test is recommended to confirm the diagnosis of vibratory urticaria. It involves exposing the skin to vibration using a laboratory vortex mixer, as described in [4].
• Basic laboratory tests: These include peripheral blood morphology, ESR, CRP, tIgE, and anti-TPO antibodies. They are recommended for diagnosing urticaria, including vibratory urticaria, as stated in [5].

Diagnostic Teams

A diagnostic team for vibratory urticaria may include:

• Dermatology: Specialists who can assess the skin symptoms and provide a diagnosis.
• Genetics: Experts who can investigate any genetic factors that may be contributing to the condition.
• Immunology: Specialists who can analyze the immune system's response and identify any underlying conditions.

References

[1] A clinical diagnosis of vibratory urticaria is made in a patient reporting wealing after exposure to vibratory stimuli. Vibratory urticaria can be confirmed by provocation testing.

[2] Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria.

[3] Vibratory urticaria is a condition in which exposing the skin to vibration, repetitive stretching, or friction results in allergy symptoms.

[4] A vibration provocation test is recommended to confirm the diagnosis. ... urticaria confirmed with an appropriate provocation test.

[5] The following diagnostic procedures are recommended for urticaria: basic laboratory tests (peripheral blood morphology, ESR, CRP, tIgE, and anti-TPO antibodies).

Treatment Options for Vibratory Urticaria

Vibratory urticaria, a rare form of physical urticaria, can be effectively managed with various treatment options. While there is no cure for this condition, medications and lifestyle changes can help alleviate symptoms.

• Antihistamines: Non-sedating antihistamines such as cetirizine or loratadine are commonly prescribed to prevent vibratory urticaria episodes [1]. These medications work by blocking the action of histamine, a chemical released during an allergic reaction.
• Leukotriene inhibitors: These medications can also be used to ease symptoms and reduce the frequency of episodes [5].
• Immunosuppressives: In some cases, immunosuppressive medications may be prescribed to manage severe or persistent symptoms [8].

Additional Treatment Options

In addition to medications, other treatment options for vibratory urticaria include:

• Avoiding triggers: Identifying and avoiding triggers that can exacerbate symptoms is crucial in managing this condition. This may involve modifying daily activities or taking precautions to avoid exposure to vibration.
• UV light therapy: Some patients have found UV light therapy beneficial in reducing symptoms [8].

Consult a Healthcare Professional

It's essential to consult a healthcare professional, such as a dermatologist, for proper diagnosis and treatment of vibratory urticaria. They can help determine the best course of treatment based on individual needs.

References:

[1] Context 1: "Patients should avoid contact with vibratory stimuli... Vibratory urticaria episodes can be prevented with a prophylactic non-sedating antihistamine..."

[5] Context 5: "Traditional treatment options for cholinergic urticaria are antihistamines, leukotriene inhibitors, and immunosuppressives."

[8] Context 8: "Nonsedating H1 receptor antagonists, such as cetirizine, are the primary treatment modality. UV light has been beneficial in some patients with cholinergic urticaria..."

Vibratory urticaria, also known as vibratory angioedema, is a rare condition characterized by the appearance of hives or welts on the skin after exposure to vibration, repetitive stretching, or friction. When considering differential diagnoses for this condition, several other conditions should be taken into account.

• Acquired Angioedema Due to C1 Inhibitor Deficiency: This is a rare genetic disorder that affects the complement system and can cause recurrent episodes of angioedema without urticaria. It is often associated with low levels of C1 inhibitor protein in the blood.
• Acute Urticaria: Acute urticaria refers to sudden onset of hives, which can be caused by various factors such as allergies, infections, or medications. The symptoms are similar to those of vibratory urticaria but typically resolve within a few hours.
• Chronic Urticaria: Chronic urticaria is characterized by persistent hives for more than 6 weeks. It can be caused by various factors including autoimmune disorders, infections, or allergies.
• Urticarial Vasculitis: This is a rare condition that involves inflammation of the blood vessels and can cause skin lesions, fever, and other systemic symptoms.

These conditions should be considered in the differential diagnosis of vibratory urticaria. However, it's worth noting that vibratory urticaria has a distinct characteristic of being triggered by vibration or repetitive stretching, which is not typically seen in these other conditions.

According to [5], differential diagnoses for vibratory urticaria include Acquired Angioedema Due to C1 Inhibitor Deficiency, Acute Urticaria, Chronic Urticaria, and Urticarial Vasculitis.