피부묘기증, Dermographism(dermatographism, urticaria factitia, dermographic urticaria)

피부묘기증에는 2가지 형태가 있습니다. Simple dermographism은 좀 더 흔한 장애로 긁거나 만지면 피부에 두드러기성 부푼 자국 형태가 생기는 것인데 가렵지는 않습니다. Symptomatic dermographism은 덜 일반적이며, 영향을 받은 피부는 두드러기성 부푼 자국이 있으면서 가렵습니다. Simple dermographism 유병률은 일반 인구에서 약 2-5% 정도이며 symptomatic dermographism은 훨씬 덜 일반적입니다.

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Urticaria: Dermatographism

These lesions of dermatographism developed five minutes after stroking the skin with a wooden stick.

Reproduced with permission from: Fitzpatrick TB, Johnson RA, Wolff K, et al. (Eds). Color Atlas and Synopsis of Clinical Dermatology, 3rd ed, McGraw-Hill, New York, 1997. Copyright © 1997 McGraw Hill.

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Dermatographism ("skin writing")

These lesions occurred three minutes after stroking with the wooden tip of a cotton swab.

Reproduced with permission from: Goodheart HP. Goodheart's Photoguide of Common Skin Disorders, 2nd Edition. Philadelphia: Lippincott Williams & Wilkins, 2003. Copyright © 2003 Lippincott Williams & Wilkins.

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가렵지 않은 simple dermographism은 치료가 필요하지 않으며 치료는 유발 인자를 피하는 것입니다. 만일 피부가 건조하다면 emollients(hydrated petrolatum applied daily immediately after bathing)가 도움이 될 수 있습니다. Symptomatic dermatographism의 치료는 다음과 같습니다.

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H1 항히스타민제, 1세대와 2세대 항히스타민 모두 이득이 있습니다.

H1 antihistamines have been shown to be effective for treatment of pruritus and reduction of whealing and are the initial drug of choice. Both first-generation antihistamines, such as hydroxyzine, and second-generation H1 antihistamines, such as cetrizine, have demonstrated benefit, although studies comparing different antihistamine regimens are lacking. It is the authors' practice to initiate therapy for symptomatic dermographism with second-generation H1 antihistamines as described above.

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H2 항히스타민제의 추가는 몇 가지 연구에서 이득이 있었습니다.

The addition of an H2 antihistamine was beneficial in several studies, although not all concluded that there was an additive effect. A trial of combination therapy with an H1 and H2 antihistamine is warranted if the response to H1 antihistamines alone is inadequate.

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일부 환자는 sun exposure가 질병을 개선시켰습니다.

Some patients report that sun exposure improves the condition, and one uncontrolled study of 43 patients reported that 39 improved or cleared with ultraviolet B light treatment. Such aggressive therapy could be considered in a patient refractory to standard medications and with a severe decrease in quality of life (eg, poor sleep, poor performance at work or school, negative effect on social life).

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오말리주맙으로 성공적으로 치료한 케이스 보고가 있습니다.

Case reports describe successful treatment with omalizumab.

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REF. UpToDate 2019.09.22