Adrenergic urticaria is a skin disease characterized by the eruption of small, red papules with a pale or white halo of vasoconstriction, appearing within 10 to 15 minutes after an extreme emotional upset. It is a very rare but different subtype of physical urticaria. It is the most easily identifiable type of urticaria due to the unique symptoms. Some people refer to it as a new form of stress induced urticaria. These papules are different from those seen in papular urticaria (which is caused by insect bites), and their treatment is also somewhat different from papular urticaria treatment.

Adrenergic urticaria can occur by a positive response to intradermal adrenaline and noradrenaline injections. However, the actual pathogenesis of adrenergic urticaria is still unknown.

The rashes are usually associated with a burning sensation and pruritus over the palms and soles, lasting for minutes and disappearing impulsively. Patients usually report daily attacks, occurring mainly in the afternoon, following emotional stress and the intake of food items such as coffee, spices, ginger, and aubergine. The episodes respond instantly but only partially to antihistamine therapy.

However, antihistamine medication does not control the underlying causes of histamine release and the rashes may recur when the antihistamine therapy is stopped. Therefore, you feel better only when you take antihistamine for the time being, and the condition may reappear. For a proper and permanent treatment, the underlying causes should be cured. To avoid any complications, it is advisable to consult a doctor for treating adrenergic urticaria, especially if the symptoms persist for more than a few hours.

Though not very common yet, in some cases, adrenergic urticaria can outbreak in response to intradermal adrenaline and noradrenaline injections. However, the genuine causes of adrenergic urticaria are still unidentified.