Commentary

A Case of Idiopathic Plantar Urticaria

Sugiura K* and Sugiura M
Department of Environmental Dermatology and Allergology, Daiichi Clinic, Japan


*Corresponding author: Keiji Sugiura, Department of Environmental Dermatology and Allergology, Daiichi Clinic, Nittochi Nagoya Bld. 2F, 1-1 Sakae 2, Nakaku, Nagoya, 468-0008, Japan


Published: 27 May, 2016
Cite this article as: Sugiura K, Sugiura M. A Case of Idiopathic Plantar Urticaria. Ann Clin Case Rep. 2016; 1: 1007.

Abstract

Now, we show a rare case of plantar idiopathic urticarial that is not contact urticaria or cholinergic urticaria. A 62-year-old male is under treatment for chronic urticaria. His urticaria has been under good control. One day, he experienced itching and found somewhere in the left plantar area. His plantar urticaria disappeared after 30 minutes. Generally, the locations of urticaria are mainly the trunk, limbs, neck and face. It is likely that many physicians have not seen plantar urticarial as urticaria. There was no definite origin (contact or irritant) of his plantar wheal, and our diagnosis was idiopathic urticaria.

Commentary

Urticaria is often seen in daily life; its frequency is 0.11-25% [1-5]. It has been believed that urticaria can occur anywhere, although most cases of chronic and acute urticaria do not develop in the plantar area. Contact urticaria sometimes develops in the plantar area, but idiopathic urticaria may develop very occasionally in the plantar area. Chronic or acute urticaria had a prevalence of 2.88% in a total of 21266 patients in 2015 at our clinic, but we have not seen any patients with plantar idiopathic urticaria. Now, we show a rare case of plantar idiopathic urticaria that is not contact urticaria.
A 62-year-old male is under treatment for chronic urticaria using two kinds of anti-histamine tablets. His skin condition was idiopathic chronic urticaria and not cholinergic urticaria. His urticaria has been under good control; urticaria occasionally develops on his legs or abdomen when his body temperature increases, although this relation between urticaria and temperature was not significant. One day, he experienced itching and found some wheal in the left plantar area (Figure 1). His plantar urticaria disappeared after 30 minutes. There was no definite origin (contact or irritant) of his plantar wheal, and our diagnosis was idiopathic urticaria.
There have been some reports on the frequency of urticaria, which has been found to range from 0.11-25% [1-5]. The locations of urticaria are mainly the trunk, limbs, neck and face. It is likely that many physicians have not seen plantar urticarial, either because plantar urticaria is rare or because most cases of plantar urticaria disappear before the patient visits a hospital or clinic. Vascular permeability in the skin of the plantar area might not arise easily for some reasons, including the thick keratin layer, the absence of hair follicles, and the constant application of pressure in the area due to walking, running and standing.

Figure 1

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Figure 1
A wheal shaped scar appearance at left plantar area on foot.

References

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