A 42-year-old labourer reports deep, painful swellings over his shoulders and buttocks that develop 4 to 6 hours after carrying heavy loads, persist for 2 days, and leave no bruising. Prick testing and autologous serum skin test are negative. Which form of inducible urticaria fits this description?

• A Delayed pressure urticaria ✓
• B Symptomatic dermographism
• C Cholinergic urticaria
• D Urticarial vasculitis

Explanation

Delayed pressure urticaria produces deep, painful or burning swellings at sites of sustained pressure, with a characteristic latency of 3 to 12 hours after the stimulus and individual lesions lasting 24 to 72 hours. Symptomatic dermographism appears within minutes of light stroking and fades within an hour. Cholinergic urticaria follows exercise and heat as tiny wheals. Urticarial vasculitis lesions are fixed, last over 24 hours, and often leave bruising, which this patient lacks.

Reference: Rook's Textbook of Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.