汗液在胆碱能性荨麻疹中的作用

doi:10.35541/cjd.20230055

中华皮肤科杂志 ›› 2025, Vol. 58 ›› Issue (6): 573-577.doi: 10.35541/cjd.20230055

汗液在胆碱能性荨麻疹中的作用

郑雅萱,苏惠春

福建医科大学附属协和医院皮肤科，福州 350001

收稿日期:2023-02-06 修回日期:2024-03-06 发布日期:2025-06-03
通讯作者: 苏惠春 E-mail:suhuichun@163.com
基金资助:
福建医科大学附属协和医院科研项目（2021XH026）

Role of sweat in the pathogenesis of cholinergic urticaria

Zheng Yaxuan, Su Huichun

Department of Dermatology, Fujian Medical University Union Hospital, Fuzhou 350001, China

Received:2023-02-06 Revised:2024-03-06 Published:2025-06-03
Contact: Su Huichun E-mail:suhuichun@163.com
Supported by:
Introduction of Talent Research Start-Up Fund of Fujian Medical University Union Hospital（2021XH026）

摘要/Abstract

摘要： 【摘要】胆碱能性荨麻疹（CholU）是一种由于运动或被动受热后身体核心体温升高并出现一过性针尖大小瘙痒性或刺痛性风团和红斑的诱导性荨麻疹，部分合并血管性水肿，严重影响患者生活质量。CholU的发病机制涉及汗液过敏和特应性体质、汗液中的组胺释放增多和马拉色菌的影响、少汗区域胆碱能受体的减少以及胆碱酯酶表达下降、血清因子和自身抗体等。常规或加倍剂量的第二代组胺H1受体拮抗剂是CholU的一线治疗。对于难治性排汗正常的CholU患者可进一步选择生物制剂、汗液脱敏等治疗，严重少汗型可以选择糖皮质激素冲击治疗等。本文从汗液与CholU关系的角度，综述CholU的发病机制、分类、临床特点、诊断及治疗等。

关键词: 荨麻疹, 乙酰胆碱, 瘙痒症, 胆碱能性荨麻疹, 汗液过敏, 少汗或无汗症

Abstract: 【Abstract】 Cholinergic urticaria （CholU） is a special type of chronic inducible urticaria characterized by transient, needle-sized wheals and erythema with stinging pain and/or itching, precipitated by increased core body temperature as a result of exercise or passive heating. Some cases were accompanied by angioedema, which seriously affects their quality of life. The pathogenesis of CholU involves sweat allergy and atopic diathesis, increased histamine release in sweat and the influence of Malassezia, decreased cholinergic receptors in hypohidrotic areas, decreased expression of cholinesterase, serum factors and autoantibodies, etc. Standard-dose and updosed second generation H1-antihistamines are the first-line therapy for CholU. For refractory CholU patients with normal sweating, biological agents, sweat desensitization and other therapies could be further chosen, while patients with severe hypohidrosis could be further treated with glucocorticoid pulse therapy and so on. This review summarizes the pathogenesis, classification, clinical manifestations, diagnosis and treatment of CholU from the perspective of the role of sweat in the pathogenesis of CholU.

Key words: Urticaria, Acetylcholine, Pruritus, Cholinergic urticaria, Sweat allergy, Hypohidrosis/anhidrosis

郑雅萱苏惠春. 汗液在胆碱能性荨麻疹中的作用[J]. 中华皮肤科杂志, 2025,58(6):573-577. doi:10.35541/cjd.20230055

Zheng Yaxuan, Su Huichun. Role of sweat in the pathogenesis of cholinergic urticaria[J]. Chinese Journal of Dermatology, 2025, 58(6): 573-577.doi:10.35541/cjd.20230055

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汗液在胆碱能性荨麻疹中的作用

Role of sweat in the pathogenesis of cholinergic urticaria

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