Loyola University Chicago Stritch School of Medicine, Maywood, Illinois.
Division of Dermatology, Loyola University Medical Center, Maywood, Illinois.
J Am Acad Dermatol. 2014 Apr;70(4):763-766. doi: 10.1016/j.jaad.2013.10.062. Epub 2013 Dec 25.
Adrenergic urticaria is a rare type of stress-induced physical urticaria characterized by transient outbreaks of red papules surrounded by halos of hypopigmented, vasoconstricted skin. First described in 1985, there are 10 reported cases of adrenergic urticaria in the English-language medical literature. Episodes are caused by various triggers, including emotional upset, coffee, and chocolate, during which serum catecholamines and IgE are elevated, whereas histamine and serotonin levels remain within normal limits. The precise mechanisms leading to the pathogenesis of adrenergic urticaria have yet to be elucidated. Diagnosis can be made by intradermal injection of epinephrine or norepinephrine, which reproduces the characteristic rash, or by clinical observation. Trigger avoidance and oral propranolol are currently the best known treatments for adrenergic urticaria. Nonspecific therapies, including tranquilizers and antihistamines, may also ease symptoms. This article explores the pathophysiology of adrenergic urticaria and proposes a mechanism by which propranolol treats the condition.
肾上腺素性荨麻疹是一种罕见的应激诱导性物理性荨麻疹，其特征为短暂性红色丘疹发作，周围环绕着色素减退、血管收缩的皮肤晕圈。该病于 1985 年首次描述，在英语医学文献中有 10 例报告病例。发作由各种诱因引起，包括情绪激动、咖啡和巧克力等，在此期间血清儿茶酚胺和 IgE 升高，而组胺和 5-羟色胺水平仍在正常范围内。导致肾上腺素性荨麻疹发病的确切机制尚未阐明。通过皮内注射肾上腺素或去甲肾上腺素可以做出诊断，可复制出特征性皮疹，或通过临床观察做出诊断。目前，肾上腺素性荨麻疹的最佳治疗方法是避免触发因素和口服普萘洛尔。非特异性治疗方法，包括镇静剂和抗组胺药，也可能缓解症状。本文探讨了肾上腺素性荨麻疹的病理生理学，并提出了普萘洛尔治疗该病的机制。
