Some people are really allergic to sports! Playing ball can cause itching and rashes all over the body, and even dizziness and shock...

Recently, a 13-year-old boy named Xiao Xiang found that he would itch and develop rashes all over his body whenever he played basketball. Although the rashes would fade away after a while, this situation had lasted for more than a year and was obviously abnormal. Therefore, his parents took Xiao Xiang to the hospital for professional help.

The doctor considered Xiaoxiang's symptoms of erythema and small wheals, which only occurred after intense exercise and profuse sweating, and finally made a diagnosis: cholinergic urticaria, also known as "exercise allergy."

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I have heard of pollen allergies and food allergies, but this is the first time I have heard of exercise allergies. How does this type of urticaria come about? Is it serious? Let's find out together~

What is cholinergic urticaria?

To understand what cholinergic urticaria is, we must first understand what cholinergic (neural) is.

Cholinergic nerves are a biological concept, which refers to nerve fibers that release acetylcholine as a chemical transmitter from the extremities . They mainly include the secretory nerves that control sweat glands and the vasodilator nerves of skeletal muscles, all preganglionic fibers of sympathetic and parasympathetic nerves, all postganglionic fibers of parasympathetic nerves, a very small number of postganglionic fibers of sympathetic nerves, motor nerves, and somatic motor nerves.

The most important substance among them is acetylcholine, which is a neurotransmitter that transmits information between nerves . It is not just a neurotransmitter, but also has many functions on the human body, such as causing our sweat glands to secrete sweat. On the sympathetic nerves, it only plays the role of transmitting information; on the parasympathetic nerves, it not only transmits information, but also directly secretes and acts on the sweat glands that we are most concerned about .

So it occurs when you are nervous and your sympathetic nerves are activated, or when you are hot and your parasympathetic nerves receive instructions to tell your sweat glands to secrete sweat.

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Cholinergic urticaria is a special type of urticaria caused by allergy to cholinergic energy (acetylcholine) or lack of cholinesterase that breaks down acetylcholine in the body. It accounts for about 5% to 7% of chronic urticaria and mostly occurs in adolescence .

Generally, urticaria is caused by exercise, heat, sweating, mental stress, emotional excitement, intake of hot food or beverages, etc., which excite the cholinergic nerves and release acetylcholine, which then increases the level of cyclic guanosine monophosphate in basophils and mast cells and releases histamine, thereby causing urticaria.

Cholinergic urticaria is manifested by the appearance of round papular wheals with a diameter of 1 to 3 mm a few minutes after stimulation, surrounded by varying degrees of redness, and sometimes satellite wheals. They are often scattered on the upper body and upper limbs and do not merge with each other. There will be severe itching, tingling or burning sensation, and sometimes there is only severe itching without wheals, which can last for 30 to 90 minutes, or even several hours.

In severe cases, systemic symptoms may occur, such as drooling, headache, slow pulse, pupil constriction, spasmodic abdominal pain, diarrhea, and even syncope.

How to prevent cholinergic urticaria?

Therefore, it is very important to take preventive measures for this type of urticaria. In daily life, it is recommended that you pay attention to the following points:

① Exercise less and sweat less .

For cholinergic urticaria, the effective prevention method is to exercise less, sweat less, and it is best not to do extensive sweating exercises .

②Pay attention to diet and avoid inducements .

The prevention of cholinergic urticaria should pay attention to diet, some foods may induce urticaria, such as seafood, yeast containing preservatives, etc. Canned and pickled foods and drinks can also induce the disease .

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③Pay attention to hygiene and reduce stimulation as much as possible

Keep your home clean and reduce allergic factors, such as animal hair, pollen, etc. Do not clean your skin excessively, such as not rubbing it hard when taking a bath. The water temperature should be appropriate to avoid skin irritation.

④Maintain a healthy mentality .

Pay attention to adjusting your mood in time. Excessive stress can lead to illness, so you must learn to release stress in time and participate in more activities that can cultivate your sentiments.

⑤ Improve body resistance .

Don't do strenuous exercise, but you can strengthen your body through some light exercise, eat more fruits and vegetables, have a balanced nutrition, and improve your body's resistance.

In what situations do you need to go to the hospital?

So if symptoms of urticaria have appeared, do you need to go to the hospital?

If the symptoms have obviously affected your life, it is recommended to go to the hospital in time for treatment to improve your quality of life. If the symptoms are not obvious, you can take some antihistamines and anti-acetylcholine drugs as prescribed by the doctor, and you can also do some heat adaptation training to improve your tolerance level. Through active prevention and treatment, this disease can generally be controlled or alleviated to a great extent.

In short, each person's own situation is different, and the symptoms caused are also different. In special cases, you must go to the hospital for some examinations and treatments in time. Only targeted treatment can fundamentally solve our own situation. Don't blindly follow the treatment methods of others .

Author: Wang Fang, attending physician of cosmetic dermatology, master of medicine

Review | Feng Jun, Deputy Chief Physician, Dermatology Department, General Hospital of Datong Coal Mine Group Co., Ltd.