To investigate the hidrotic condition and sweat recovery after corticosteroid pulse therapy, we performed hyperthermia sweating test, acetylcholine dermal injection test, and histopathological examinations on seven patients with acquired idiopathic generalized anhidrosis (AIGA)/anhidrotic or hypohidrotic cholinergic urticaria. All the patients were male, and decreased sweating was found on the more than 80% of their body surfaces. Six of 7 patients had cholinergic urticaria. The predilection sites of anhidrosis were mainly the lower extremities, while the hypohidrotic areas included the upper limbs and trunk. After treatment with corticosteroid pulse therapy, sweating recovery was observed in all patients, and cholinergic urticaria appeared in the sweating recovery sites. Our study showed that cholinergic urticaria appears in the hypohidrotic sites but not in the anhidrotic areas.
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