Symptomatic Dermographism Is More Than Skin Writing

A patient may arrive with photographs of raised, intensely itchy wheals, yet have little to show on examination. In symptomatic dermographism, that fleeting presentation can make the condition easy to underestimate. Jill Cowan, FNP-BC, discusses how to recognize and assess this common form of chronic inducible urticaria, from simple in-office provocation testing to more standardized threshold testing and measures of disease control and quality of life. She also examines the importance of documenting symptom severity, reproducibility, and the impact on daily life, particularly for patients whose disease burden is far greater than their skin findings might suggest.