Garafalo J, Kaplan A P
J Allergy Clin Immunol. 1981 Aug;68(2):103-5. doi: 10.1016/0091-6749(81)90166-4.
A case of unusually severe dermatographism is reported in which baseline plasma histamine levels were repeatedly elevated and histamine release into the circulation was demonstrable upon challenge by scratching the skin. Passive transfer was positive when the patient was challenged after a 48-hr interval, and the responsible factor was heat labile consistent with an IgE-dependent mechanism. Five additional patients with severe dermatographism had elevated baseline plasma histamine levels, but an augmented response upon stroking the skin was not evident. The response of this latter group to antihistamine therapy was excellent; however, the unusual patient described here was only partially responsive. These data suggest that histamine is an important mediator of dermatographism but may not be the sole mediator, particularly when the presentation is of unusual severity. In contrast to patients with cold urticaria and cholinergic urticaria, demonstration of histamine release upon stroking dermatographic patients may be difficult, perhaps because of less total mediator release than that in patients with other physically induced urticarias.
报告了一例异常严重的人工荨麻疹病例，其中基线血浆组胺水平反复升高，且通过搔抓皮肤激发后可证明组胺释放进入循环系统。在间隔48小时后对患者进行激发时，被动转移试验呈阳性，且相关因素对热不稳定，这与IgE依赖机制一致。另外五例严重人工荨麻疹患者的基线血浆组胺水平升高，但轻抚皮肤后反应增强不明显。后一组对抗组胺治疗的反应良好；然而，此处描述的异常患者仅部分有反应。这些数据表明，组胺是人工荨麻疹的重要介质，但可能不是唯一的介质，特别是当表现异常严重时。与寒冷性荨麻疹和胆碱能性荨麻疹患者不同，轻抚人工荨麻疹患者后证明组胺释放可能很困难，这可能是因为总的介质释放量比其他物理性诱导性荨麻疹患者少。
