How is dermographism identified in the evaluation of acute urticaria (hives)?

Updated: Mar 21, 2018
  • Author: Henry K Wong, MD, PhD; Chief Editor: Michael A Kaliner, MD  more...
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Examine for dermographism, as it is often observed in conjunction with urticaria. Itching, erythema, and a raised wheal occur in areas that are scratched or stroked with a blunt object, such as a tongue blade. [36] The examiner can use the end of a tongue blade or similar blunt object to scratch the patient's skin and observe the area over the next 5-15 minutes for the development of whealing with erythema, as shown in the following image.

Photograph of dermographism. Photograph of dermographism.

The remainder of the physical examination should be used to investigate any suspicions that were raised by the history.

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