Follicular traction urticaria

Abstract

To the Editor: A 32-year-old nonatopic Turkish woman presented with a 7-month history of pruritic wheals of 1 to 3 mm developing within 10 to 15 minutes every time she waxed or used an electrical epilator on her legs. The reaction spontaneously resolved within 2 to 3 hours. Although shaving or depilatory creams did not provoke lesions, plucking eyebrows by tweezers induced localized lesions. No spontaneous attacks of urticaria were reported. There was no history of any drug intake. No urticarial lesions could be elicited by stroking the patient's forearm, leg, and back with a blunt object. Skin traction or gentle hair traction did not provoke lesions whereas hair removal test with the electrical epilator on one leg led to reddish, exclusively follicular urticarial papules within 10 minutes (Fig 1). The papules showed some coalescence at 30 minutes (Fig 2), and the reaction resolved completely within 3 hours. Skin biopsy findings were consistent with urticaria. The other leg was epilated with a depilatory cream. Using the electrical epilator on the hairless control leg caused no reaction. Fig 2Follicular traction urticaria. A, Close-up to follicular urticarial papules at 10 minutes of hair removal test. B, Follicular urticarial papules showing some coalescence at 30 minutes of hair removal test. View Large Image Figure Viewer Download Hi-res image