Adrenergic urticaria: a rare underdiagnosed subtype

Abstract

Adrenergic was first described in 1985 by Shelley and Shelly1 with only 12 cases reported in the medical literature.2 It is characterized by erythematous wheals surrounded by hypopigmented skin.3 It is associated with stress-induced release of epinephrine and norepinephrine, as well as with caffeine and chocolate consumption.1, 5 The characteristic rash of adrenergic urticaria can be reproduced, and thus diagnosed, by injecting intradermal epinephrine and norepinephrine.1 Adrenergic urticaria is still underdiagnosed,1 and more cases must be reported to familiarize physicians with its presentation and to avoid untreated cases. Here we report a case of adrenergic urticaria in a previously healthy 39-year-old female successfully treated with propranolol.