Aguagenic Urticaria

           Aguagenic urticaria is a rare condition in which you are “allergic to water”. This condition is extremely rare. There are only 100 cases reported worldwide. Whenever the skin comes into contact with water, regardless of the temperature, painful, burning, and itchy hives would break out within one to fifteen minutes after exposure to water. Within ten minutes to two hours, painful lesions would develop.

Some people have experienced wheezing, difficulty swallowing water, and respiratory distress will occur after drinking water. The breakout of hives would usually be small, ranging from one to three millimeters with clearly defined edges. These hives would commonly develop on one’s neck, arms, and upper trunk. Once water is removed from the skin, the breakout would gradually go aware within thirty to sixty minutes. In some cases, the breakouts would be mild, with only a little bit of itchiness and discomfort. However, in most cases, the breakouts consist of terribly itchy and painful rashes. Many people with this disease would often resort to taking quick showers or not showering at all in order to avoid the pain. Symptoms of this disorder would often occur after any contact to water such as taking a bath or shower, walking in rain, or swimming. Certain individuals would also break out in hives if the emit sweat or tears.

Scientists have not yet found the exact cause of aquagenic urticaria because the cause of it is poorly understood. However, there are two popular theories that are proposed and supported. The first is that a substance is dissolved in water enters through the skin and triggers an immune response. In the end, the theory maintains that the outbreak is not caused by the water, but by the allergen that is dissolved in the water.

The second theory believes that the interactions between water and a substance that is found on or in the skin creates a toxic substance- and this causes the hives in the affected area. Some scientists proposed that there is a genetic component to this disease because there has been some circumstances in which this disorder has been transmitted from person to person. However, in most cases of this disorder, it occurs in different families with no relations. It has been found that those with lactose intolerance increase the risk for developing aquagenic urticaria. Furthermore, those with diseases such as atopy, light eruptions, HIV, Bernard-Soulier syndrome, polymorphous, and cholinergic urticarial increases the chances of developing aquagenic urticaria as well.

           Because this condition is so rare, it is often difficult to diagnose. When one has aquagenic urticaria, a water challenge test would be administered in order to check for the specific signs and symptoms of this rare disease.

During this water test, water would be compressed on the skin for thirty minutes. The water would usually be either be placed on the skin or applied on the skin with a wet towel. During the test, different water solutions would also be tested such as saline, tap water, and distilled water in order to test different reactions. If the appropriate symptoms occur, then the person would be diagnosed for aquagenic urticaria. Because this condition is so rare, there is very little information about the effectiveness of individual treatments for aquagenic urticaria. There have been some treatments that have been used to treat this disorder with a variety of effectiveness such as H1 antihistamines, propranolol, ultraviolet B (UVB) light treatments, skin creams that are used as a barrier between the water and skin, durabolin (an anabolic steroid), and a combination of low dose of selective serotonin reuptake inhibitor, methscopolamine, and cyproheptadine.

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