The physician writes with an object on the patient’s skin, applying moderate pressure. Immediately afterwards, the skin reddens and also rises. What the doctor has written on the skin can now be read on the strongly reddened skin. This brings us to the explanation of this form of urticaria. It is caused by rubbing, scratching or shearing (shearing forces). It is a subtype of the physical types of urticaria (i.e. pressure, light, cold, heat or water). The biggest difference in this urticaria from all the others is that it only occurs when there is exposure to the skin.
Again, the exact cause is not known. The most likely suspects are intolerances to various pain medications and/or local anesthetics.
Medications known to be triggers:
Antipyretic analgesics: ace, ibuprofen, diclofenac, penicillin, codeine, sulfonamides, lidocaine
Diseases known as triggers: