Author Affiliations: Department of Dermatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
A 25-year-old atopic Turkish woman presented with a 6-month history of widespread, slightly elevated, pruritic red plaques over her face, trunk, and extremities occurring each time after prolonged contact with water of any temperature. Skin biopsy findings were consistent with urticaria. Bathing exceeding 20 to 30 minutes always resulted in syncope followed by spontaneous recovery in 30 minutes. Angioedema or respiratory symptoms did not occur. While sweating, producing tears, drinking water, or washing hands for a short duration did not provoke lesions, washing dishes by hand induced localized lesions. No spontaneous attacks of syncope were reported. None of the family members were similarly affected.
Özkaya E, Elin ç-Aslan MSÇ, Yazici S. Aquagenic Urticaria and Syncope Associated With Occult Papillary Thyroid Carcinoma and Improvement After Total Thyroidectomy. Arch Dermatol. 2011;147(12):1461-1462. doi:10.1001/archderm.147.12.1461