Case Report
Pete Prashamsa S, Bilori, Davi
Abstract
Aquagenic urticaria is a form of physical urticaria characterized by a development of wheals and pruritus to exposure of water, regardless of its temperature or content [1]. It is a chronic spontaneous urticaria where patients demonstrate a spontaneous episodic appearance of self-limiting wheal of about 0.2 cm-5.0cm for longer than 6 weeks in response to exposure of water [1,2]. The pathogenesis of this condition is unclear, given its infrequent presentation, but is believed to be both histamine-mediated and histamine-independent pathway [1,2]. In addition, there have been associations with other forms of physical urticaria. Patients with this condition may have a family history [1]. It is a self-limiting condition and thus diagnosis is based on history and water challenge test. It is treated with antihistamine agents for symptomatic relief. The patient denies any other systemic symptoms such as allergies, eczema and wheezing. Although the presentation is mostly on her torso and extremities, it also appears on her face and other parts of the body. Patient symptoms have been related to all water sources and symptoms do not appear on mucosal surfaces and are not related to oral intake of water, demonstrating its physical character. The prescribed non-sedating anti H1 antihistamines (levocetirizine) and asked to follow up 1 month and the patient reported significant relief in symptoms within 1 week of starting levocetirizine.