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Dermatology/Slow time for skin to go back to normal

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Question
Lately I've noticed that my skin takes a long time for it to change back to normal after temporary depressions caused by pressure.  If I hold a child in my arms a longtime the impression or temporary marks on my arms changes quite slowly back to its normal form.  Also, when I hold a package such as a shoe box and it makes a temporary mark on my arm there is swelling near the crease and it too takes long to go back to its normal form.  Perhaps unrelated: My feet have a burning sensation when I sit or lie down.

Answer
You could have a condition called dermatographism.


Dermographism or dermatographism is an exaggerated wealing tendency when the skin is stroked. It is the commonest form of physical urticaria.

In 25-50% of normal people firm stroking of the skin produces first a white line, then a red line, then slight swelling down the line of the stroke, and a mild red flare in the surrounding skin. In 5% of the population this response is exaggerated enough to be called dermographism. In only a minority of these does it cause any symptoms.

        
Dermographism

What is the cause of dermographism?

The exact cause of dermographic urticaria is unknown. Histamine is the main chemical released by mast cells when the skin is stroked, but other chemical mediators may also be involved.

Some patients with severe dermographism may have an antibody in their serum.

Occasionally dermographism is triggered by an allergy to some external agent such as penicillin, scabies or a worm infestation.

Clinical features

Dermographism can appear at any age but is most common in young adults. The onset is usually gradual, but in some the condition develops over a few days.

People with dermographism are usually otherwise healthy. Occasionally patients may have thyroid disease.

Many authors have noted there is an important nervous factor. Attacks of itching and subsequent weals from scratching occur at intervals and may be related to agitation and worrying situations.

Symptoms are often worse in hot conditions, for example, after a warm bath.

Minor pressure from clothing, chair seats, working with various tools, clapping the hands or energetic kissing, etc., may start up the weals.

They may develop after exercise if it is accompanied by knocks or pressure on the skin such as in rugby, wrestling or boxing.

Towelling after bathing may start weal production.

Once a few weals develop, subsequent scratching readily starts others in the vicinity. The weals are usually on the surface but some deep extension may occur and giant weals develop. However, these swellings die away rapidly and usually clear after half to one hour.

Dermographism can occur with other types of urticaria (hives) including those due to cold or pressure.

Dermographism may last for months or go on indefinitely. In many patients, however, it clears within a year or two, or at least the wealing is reduced to a degree which no longer causes significant symptoms.

Treatment

Antihistamines often give good relief from symptoms. The new non-sedating ones are generally preferred. Treatment may need to be continued regularly for at least several months; intermittent therapy is of less value.

You should also avoid hot baths or showers, rough towelling down and rough clothing against the skin.

Resistant cases may find phototherapy helpful.

Since I cannot see your skin, you would benefit from seeing a dermatologist.  

Dermatology

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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