title: Rapid desensitization with autologous sweat in cholinergic urticaria.
abstract: BACKGROUND
  The majority of patients with cholinergic urticaria presents with strong hypersensitivity to autologous sweat. Patients with severe cholinergic urticaria are frequently resistant to H(1) antagonists which are used in conventional therapies for various types of urticaria. It has been reported that desensitization using partially purified sweat antigen was effective in a patient with cholinergic urticaria.
  
  
  METHODS
  The aim of this study is to determine the usefulness of rapid desensitization with autologous sweat in severe cholinergic urticaria, because rapid desensitization has proven to be a quick and effective immunotherapy for allergies to various allergens. Six patients with severe cholinergic urticaria who are resistant to H(1) antagonists and have sweat hypersensitivity were enrolled in a rapid desensitization protocol.
  
  
  RESULTS
  In all six patients, the responses for skin tests with autologous sweat were attenuated after rapid desensitization with autologous sweat. Two of the three cholinergic urticaria patients showed reduced histamine release with autologous sweat after the rapid desensitization with autologous sweat. Further, the rapid desensitization and subsequent maintenance treatment reduced the symptoms in five of the six patients.
  
  
  CONCLUSIONS
  This study provides evidence that rapid desensitization with autologous sweat is beneficial for treating cholinergic urticaria patients resistant to conventional therapy who have sweat hypersensitivity.
authors.affiliation: Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Hyogo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kozaru
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fukunaga
authors.forename: Kumiko
authors.initials: K
authors.lastname: Taguchi
authors.forename: Kanako
authors.initials: K
authors.lastname: Ogura
authors.forename: Tohru
authors.initials: T
authors.lastname: Nagano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Oka
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Horikawa
authors.forename: Chikako
authors.initials: C
authors.lastname: Nishigori
mesh_terms: D000293:Adolescent; D000328:Adult; D003888:Desensitization, Immunologic; D005260:Female; D006636:Histamine Release / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D012882:Skin Tests; D013542:Sweat / Q000276:immunology*; D016896:Treatment Outcome; D014581:Urticaria / Q000276:immunology / Q000628:therapy*; D055815:Young Adult