title: Severe refractory cholinergic urticaria treated with danazol.
abstract: BACKGROUND
  Cholinergic urticaria is a form of physical urticaria triggered by a rise in core body temperature. Antihistamines are the mainstay of treatment; however, adequate symptom control can sometimes be difficult to maintain. Limited data suggest danazol may be an effective alternative in severe, refractory cases.
  
  
  RESULTS
  We present a case of a 22-year-old male with severe, refractory cholinergic urticaria. Despite treatment with high doses of antihistamines, he continued to have symptoms that impaired his ability to function. Treatment with danazol resulted in a significant improvement in the control of his urticaria.
  
  
  CONCLUSIONS
  Cholinergic urticaria can sometimes be severe. In cases that fail to respond to traditional forms of treatment, danazol is a viable alternative for the treatment of cholinergic urticaria. Given the potential adverse effects associated with its use, danazol should be reserved for more severe and refractory cases.
authors.affiliation: Department of Primary Care, Yokota AFB, Japan. mark.lashell@yokota.af.mil
authors.forename: Mark S
authors.initials: MS
authors.lastname: La Shell
authors.forename: Ronald W
authors.initials: RW
authors.lastname: England
mesh_terms: D000328:Adult; D017668:Age of Onset; D003613:Danazol / Q000627:therapeutic use*; D004965:Estrogen Antagonists / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D017211:Treatment Failure; D014581:Urticaria / Q000188:drug therapy*
chemical_list: D004965:Estrogen Antagonists; D006634:Histamine H1 Antagonists; D003613:Danazol