Urticaria vibratory

Patterson et al. 1972

Localized physical urticaria that can develop after moderate to severe vinbration trauma, such as after the use of pneumatic hammers. Systemic remote reactions are rare. However, patients are observed who already react to slight vibrations.

The etiopathogenesis of the acquired form is unknown.

Autosomal-dominantly inherited familial cases of vibrational urticaria based on a missense mutation in the ADGRE2 gene (ADGRE2 stands for the acronym "Adhesion G Protein-Coupled Receptor E2" which is located on chromosome 19p13.12) have been reported. The endogenous ligand of ADGRE2 is dermatan sulfate. The encoded protein ADGRE2 leads to an IgE-independent destabilization of mast cells to vibration events.

Within a few minutes, but also delayed after the trauma, an extensive urticaria develops on the spot. Less frequent is the development of angioedema painful on the palms of the hands.

The cause is usually clear because the urticarial response is limited to the site of the vibratory action.

Avoidance of triggering factors.

1. Boyden SE et al (2016) Vibratory Urticaria Associated with a Missense Variant in ADGRE2. N Engl J Med 374:656-663.
2. Kaplan AP et al (2016) Vibratory Urticaria and ADGRE2. N Engl J Med 375):94-95.