In the human body, along with other neurotransmitters that transmit impulses through the synaptic cleft between neurons, there is acetylcholine. He is responsible for the neuromuscular neuronal connection 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 - urticaria cholinergic.
In the article we will talk about the causes of its appearance and methods of treatment.
General information about cholinergic urticaria
The aforementioned ailment is quite rare. It accounts for no more than 8% of cases of the total number of cases of urticaria. It is interesting that most often young people suffer from it, although there are no age or gender restrictions for this disease.
Cholinergic urticaria on the skin resembles a burn from nettle leaves - the same blisters or red itchy spots that cause severe discomfort. But in some cases, the rash is invisible, however, 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 could convincingly prove the direct effect of a component on the appearance of its symptoms.
The generally accepted theory of the development of cholinergic urticaria so far associates allergies with the rupture of the so-called mast cells in our skin. They are highly specialized immune units involved in adaptive immunity. And their rupture at a time when a person is sweating 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.
It is not known whether cholinergic urticaria has reasons other than those mentioned, but in medicine there are 3 main factors that can cause it:
- Pathological reaction to thermal effects.
- Exercise stress.
- 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 a predisposition to allergic reactions and hypersensitivity to acetylcholine at the same time.
Symptoms
Signs of the disease appear immediately after exposure to an irritating factor, and it is quite difficult to confuse them with any other symptoms.
- The first are small vesicles, the skin around which, as a rule, becomes edematous and hyperemic.
- Most often, the rash appears on the neck, around the décolleté, forearms and chest. The lower body is rarely involved.
- Bubbles itch a lot and cause a burning sensation.
- Cholinergic urticaria, the symptoms of which we consider in this article, are often accompanied by fever.
- Due to the fact that acetylcholine is a mediator of the nervous system, excessive sensitivity to it can cause manifestations of its excessive activity - diarrhea, nausea, vomiting, and excessive salivation.
Diagnostics
Diagnosed with urticaria is cholinergic simply. To determine it, standard laboratory tests and history taking 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 above factors, the patient can always quite clearly determine what exactly caused the disease.
To clarify the diagnosis, subcutaneous administration of an acetylcholine analogue is carried out or a provocative test is made in the form of thermal exposure to the skin (for this, the patient’s hand is placed in hot water). If rashes appear 20 minutes after that, 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 briefly reduce the symptoms of allergies. Researchers attribute this to the hypersensitivity of the human body to an irritant that it itself produces.
2 and 3 generations of histamine receptor blockers — Loratadin, Cetirizine, Ebastin, 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 be useful:
- Infusion of licorice root, which you need to drink half a glass twice a day. Powder from this root is taken ½ tsp. and washed down with water.
- Infusion of dry nettles. For this, pour grass with boiling water and let it brew. They drink like tea 3 times a day.
- No less useful are mint and chamomile teas, which have a mild soothing effect. 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 eliminate itching and remove puffiness, you can make lotions from a solution of soda, chamomile, string, lemon juice diluted with water. A sterile bandage is impregnated with any of these means and is applied to areas with a rash for half an hour. This procedure, if repeated 4 times a day, can alleviate the condition of the patient.
Prevention of an allergic reaction
If the patient has already been diagnosed with “urticaria cholinergic”, then in order to avoid relapse, he will need to adhere to certain rules and restrictions:
- Avoid using a hot bath. For washing, it is now more beneficial to take a cool shower.
- Spicy foods will have to be excluded from the diet. Hot foods can also be harmful.
- Alcohol is not allowed.
- You will have to avoid excessive sweating both during physical exertion, and in all other cases. When perspiration appears, you need to relax in the shade or take a shower.
- Stressful situations should be carefully avoided. When this is not possible, the patient must take a sedative.