Woman reports allergy to water- a rare case of aquagenic urticaria

United Kingdoms: A unique presentation of water allergy has put doctors in a dilemma. A woman presented an extraordinary condition claiming her skin to break out into swollen pale red bumps after she comes in contact with water, particularly during shower.

Aquagenic urticaria commonly known as water allergy is a rare condition in which urticaria (hives) develop rapidly after the skin comes in contact with water, regardless of its temperature. It most commonly affects women and symptoms often start around the onset of puberty. It is a form of physical urticaria and the patients may report severe itching also. Aquagenic urticaria (AU) was first described by Shelley and Rawnsley who reported three cases in 1964, and fewer than 100 cases have since been published in the literature.

Speaking to media, 26 years old Cherelle Farrugia, of Cardiff, Wales, claimed that her skin breaks into excruciatingly painful and very itchy rashes after it comes in contact with water for e.g. during shower. According to her, this was not the case with her prior to delivering her baby who is now 18 months old. She used to take shower multiple times a day. Cherelle calls this allergy "Mind Blowing".

Explaining the appearance of the allergy Cherelle told the media- "Physically, it's quite painful and it's very itchy. It's kind of like a prickly feeling and then it's a full-blown rash,"

You might be thinking that how this lady drinks water?

According to Cherelle, when it comes to drinking water the allergy does not affect her. It is only when her skin touches water the rashes appear. It particularly appears on her shoulder, stomach, back, neck, and sometimes her face. She consulted a doctor but the doctor had trouble in identifying her condition. Therefore, the doctor suggested her to change her soap and bath towels.

As told to the media, Cherelle was getting disappointed thinking that nobody will ever understand her condition until her condition was identified by an allergist as aquagenic urticaria.

A case study published in the journal Annals of Dermatology demonstrated the case of a 19-year-old man and a 4-year-old boy who complained of recurrent episodes of urticaria. Urticaria appeared while taking a bath or a shower, in the rain, or in a swimming pool. Well-defined pinhead to small pea-sized wheals surrounded by variably sized erythema was provoked by contact with water on the face, neck, and trunk, regardless of its temperature or source.

Treatment of the 19-year-old man with 180 mg fexofenadine daily was successful to prevent the wheals and erythema. Treatment with 5 ml ketotifen syrup bid per day resulted in improvement of symptoms in the 4-year-old boy.

However, the exact cause of this allergy is not known.