Imagine taking a bumpy bus ride or clapping your hands and coming out with a rash. These activities for some people, sometimes even drying their hands with a towel or running, can lead to a form of haves called vibratory urticaria.
What is vibratory urticaria?
It is a rare condition in which exposing the skin to vibration, repetitive stretching, or friction, results in experiencing allergy symptoms such as hives, swelling, redness, and itching in the affected area. It belongs to a class of disorders called physical urticarias, which is estimated to occur in up to 5 per 1,000 people. Allergic reaction occurs when these stimuli cause mast cells in the skin to release histamine and other inflammatory chemicals in the bloodstream and surrounding tissue. This process is called degranulation.
Other names for this condition are:
- Dermodistortive urticaria
- Vibratory angioedema
Vibratory urticaria can be caused by a mutation in the ADGRE2 gene, which provides instructions for making a protein that is found in various immune system cells, including mast cells. Mast cells are important for the normal protective functions of the immune system and they also are involved in allergic reactions. This gene mutation alters a structure in the mast cells, causing them to react and produce the allergy symptoms in the skin that is seen in vibratory urticaria.
Red, itchy bumps on the skin are the common symptoms of vibratory urticaria. However, headache, fatigue, blurred vision, widespread swelling and metallic taste in the mouth can also occur during episodes. An allergic reaction usually occurs within a few minutes of the stimulation and generally lasts up to an hour. Affected individuals can have several episodes per day.
Avoidance of the vibratory stimulus is the main treatment of vibratory angioedema. While the hives are itchy, they usually fade on their own within 30 minutes to an hour of exposure. Certain antihistamines may be useful but it is still best to consult an allergist to get appropriate diagnosis and treatment. For snoring-induced vibratory angioedema, continuous positive airway pressure therapy (CPAP) may be helpful.