Vibratory angioedema: lesion induction, clinical features, laboratory and ultrastructural findings and response to therapy

We report the investigation and treatment of a 28-year-old woman with the rare condition of non-familial vibratory angiodema. Lesions were reproduced using a vibrator set at pre-determined frequencies and amplitudes, applied for a fixed time period. There was no indication of the production of tolerance in the patient with repeated vibration, but terfenadine produced a good therapeutic response. There was no evidence of mast cell degranulation at the ultrastructural level. The patient also had mild delayed pressure urticaria and dermographism, thus demonstrating the clustering frequently found in the physical urticarias.