Abstract
Physical urticarias occur in only 0.05% of children. The combination of cholinergic and cold urticaria in children with atopy is rare. Combined physical urticarias most commonly occur in young adults. Patients with cholinergic urticaria have been shown to have bronchial hyperreactivity, which is distinct from exercise-induced anaphylaxis. Pollen exposure in sensitized patients has been reported to decrease the threshold for exercise-induced anaphylaxis, but this has not been described in cholinergic urticaria. Children with physical urticarias and allergic conditions have a worse prognosis than those without atopy.
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