What Is Dermographism?

Dermographism is a rare disorder that produces lines on the skin on contact. Let's see what exactly it is and how it can be treated.
What Is Dermographism?

Last update: 04 September, 2021

Dermatographism, also known as dermatographic urticaria, or factitia urticaria, is a disorder characterized by pressure rashes or skin lesions. According to the American Osteopathic College of Dermatology (AOCD), it affects 2-5% of the general population. Most people don’t bother to treat it and don’tt know the characteristics of the condition.

The manifestations occur with any type of pressure on the skin, regardless of whether it’s soft or strong. For example, and depending on the sensitivity of each patient, a hug or a caress of several seconds can cause the outbreaks. Today, we’ll tell you what it’s all about and how it can be treated.

Symptoms of dermographism

Dermographism has several clinical presentations
The symptoms of dermographism can be subtle in some patients. Therefore, constant self-assessment is important to detect the problem.

The first thing you have to know about this condition is that, in theory, it isn’t considered an allergy. Its signs can lead patients to believe that it is, especially since some of these people have a medical history of allergies (especially dermatitis). Dermographism is divided into two types: simple and symptomatic. In the first case, people develop the following:

  • Reddish lesions that appear in relief
  • Swelling in the contact area
  • Inflammation

Patients with this condition can suffer from drawn lines or figures on their skin, and these will be marked based on the above signs. According to the Genetic and Rare Diseases Information Center (GARD), they appear after 30 minutes and disappear on average after the same period of time.

You don’t have to voluntarily put pressure on the skin for the skin disorder to develop. Any kind of pressure can trigger it: drying off with a towel, brushing against each other during sports and washing your hands are some examples of actions that can cause it.

Those who develop symptomatic dermographism suffer from the same symptoms, except that this time they are accompanied by hives. These cases are less frequent than the first type, and they’re generally chronic. The evolution of the disorder is very uncertain. It can last weeks, months, years or develop intermittently throughout the life of those diagnosed.

Causes of dermographism

The exact cause of dermographism is not known. Some researchers theorize that histamine release may play a leading role, although so far the allergens responsible for this have not been found.

Other studies point to a multifactorial approach, in which drug intake, genetic predisposition, systemic diseases, and infectious agents are to blame for outbreaks. The problem is that the disorder occurs in a very heterogeneous group of patients, so it is not possible to establish common characteristics.

It is believed to be most common during the first two decades of life, as well as in patients who often have dehydrated skin. This explains, at least partially, why people with dermatitis can have the disorder. It doesn’t focus on specific areas of the body, although the lines are most visible on the arms, back, and chest.

The evidence further indicates that, although it may not be its main trigger, stress may be related to dermographism. The cases are benign, although they can cause discomfort, frustration and discomfort in patients. This is especially the case with the symptomatic variant.

Diagnosis of dermographism

Diagnosing the condition usually consists of ruling out allergic triggers. The specialist will assess the patient’s medical history, symptoms, and family predisposition before performing any of the allergen exposure tests. Since their manifestation isn’t related to them, the results of the examinations will be negative.

To check the severity of the symptoms, the doctor may use a dermographometer. This is a pen-shaped instrument used to apply different levels of pressure to the skin.

If the patient is in the middle of an episode, this should be enough to confirm the disorder. As another option, blood tests can also be done for allergy markers.

Treatment options

Dermographism can be controlled
As dermographism can worsen with constant rubbing, it’s advisable to wear loose and comfortable clothing during physical exercise.

Since its exact causes are unknown, there’s currently no standard treatment for dermographism. Some patients improve after taking antihistamines, so the specialist may choose them if the symptoms are very acute.

The benign nature of the condition should reassure patients that a negative prognosis isn’t possible. However, it’s recommended that they include a series of habits in their routine to reduce the prevalence of flare-ups. Among the most important we highlight the following:

  • Avoid bathing in hot water
  • Reduce your skin’s exposure to the sun (the episodes get worse if you do the opposite)
  • Avoid wearing clothing that is too tight or made from materials that generate friction
  • Keep your skin moisturized
  • Consider playing a sport with less physical contact
  • Try not to wear accessories that can generate friction during the episodes (necklaces, earrings, watches and others)
  • Don’t draw on the skin in the middle of an outbreak. You may have permanent scars
  • Don’t use irritating products like soaps, detergents, shampoos, and so on
  • Avoid daily stress
  • Try to maintain a healthy diet and sleep 8 hours a day

If you follow all this advice, the condition should manifest itself less frequently, and, if it does, it will do so with mild symptoms. The episodes aren’t contagious, so patients should reassure family, friends, and colleagues if they think it may be. If you think the breakouts are out of control, don’t hesitate to see a dermatologist to try some therapy.

  • Kimyai-Asadi, A., & Usman, A. The role of psychological stress in skin disease. Journal of cutaneous medicine and surgery. 2001; 5(2): 140-145.
  • Mecoli, C. A., Morgan, A. J., & Schwartz, R. A. Symptomatic dermatographism: current concepts in clinical practice with an emphasis on the pediatric population. Cutis. 2011; 87(5): 221-225.
  • Nobles, T., & Schmieder, G. J. Dermatographism. 2018.

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