Assessment of Dermographism at Different Anatomical Body Regions by Dermographometer
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2010-03-24
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Vajira Medical Journal
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Abstract Assessment of Dermographism at Different Anatomical Body Regions by Dermographometer Vilaval Termlinchan MD Sainoi Hospital Nonthaburi Background: Dermographism is a form of physical urticaria. Classic dermographism refers to the ability of the skin to produce a linear wheal with a scratch pressure of 4,900 gm/cm2 . Generally, diagnosis of dermographism involves a simple stroking of the skin with moderate pressure. There are a variety of apparatus for the standardized production of dermographism. However, these are most commercial available. Objective: A dermographometer was devised in order to have a precise and consistent measurement, and calibrated it with moderate pressure from the blunt penhead. The instrument was tested at different body regions. Material and Methods: Twelve patients with symptomatic dermographism and ten patients with chronic idiopathic urticaria and dermographism, attending skin clinic of the Bangkok Metropolitan Administration Medical College and Vajira Hospital, during August-October 2004 were enrolled. The pressure was applied to the volar aspect of left forearm using dermographometer, and to the right forearm by the penhead. Then the pressure was applied to the upper back, abdomen, and shin using dermographometer. The time onset and size of wheal, erythema, flare were recorded. Results: Of the 22 cases, 19 were female. The mean age war 32 years (range 14-52 years). Positive dermographism was defined by wheal with or without flare response. The positive yield at left forearm by the dermographometer was 72.7%. The positive yield of back, abdomen and skin were 68.2%, 68.2% and 13.6% respectively. The abdominal region gave the shortest onset time of wheal produced by dermographometer (median 130 seconds) and the widest wheal size (median 5 mm). Fifteen patients gave positive results at both forearms. Conclusions: The dermographometer had comparable sensitivity to diagnose dermographism with the penhead. The onset and size of wheal and flare varied considerably from site to site. Volar forearm, back and abdomen were the sensitive area to produce dermographism. Shin was the least sensitive area. Keywords: dermographism, wheal, dermographometer, urticaria, strokeVajira Med J 2005 ; 49 : 133 - 138
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Vajira Medical Journal; Vol. 49 No. 3 September - December 2005; 133-138