Delayed pressure urticaria, called physical urticaria, is a type of chronic hives. Physical urticaria is a stimulus on the body caused by sustained pressure on the skin. With approximately 37% of urticaria sufferers, suffering from delayed pressure urticaria, it is considered somewhat uncommon but not rare. The average age range for delayed pressure urticaria is between 20′s and 30′s.

In comparison to other urticarias, these lesions are quite severe and can impair the patient’s quality of life. Hives formed from delayed pressure are deeper and a great deal more painful than hives cause by other stimuli. The hives will start forming between 2 — 6 hours after pressure is applied and last from 8 to 72 hours. Many patients experience a low grade fever, fatigue, chills, headaches and muscle aches.

Delayed pressure urticaria’s pathogenesis is not clearly defined and can therefore be under diagnosed, making treatment very difficult. Because this disease is chronic, on average, it can last for 9 years.

Preventative Methods:

Avoid sitting or stand on hard surfaces for long periods of time and refrain from wearing tight fitting clothing, including socks and shoes. When working with tools, do not apply constant pressure to your hands and wear gloves that can reduce the stimulus causing severe lesions to erupt.

Diagnosis is based on the appearance of the rash in areas where pressure has been applied to the skin. Many times delayed pressure urticaria is mis-diagnosed as other forms of urticaria, due to a lack of knowledge as to its cause. This form of hives is caused by constant pressure being applied to the skin.

This includes, but is not limited to:

• Under the waistband of tight clothing
• The buttocks area after sitting on a hard surface too long
• Soles of feet
• Tight fitting shoes
• Under the elastic area of socks
• Palms after using various
•  The severity of DPU on a patient’s quality of life has been documented in comparison to someone who suffers chronic ordinary urticaria. In general, patients suffering from delayed pressure urticaria experience significant restrictions of mobility and types of the clothing they can wear. During an outbreak, a patient’s work performance can suffer greatly as well. DPU is considered significantly more painful and debilitating then other forms of urticaria and most difficult treat successfully
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