Cholinergic urticaria, also known as small papular urticaria or generalized heat urticaria, is mostly seen in adolescents and generally appears after heat (hot water, hot bath), emotional excitement and exercise. The rash is 1~3MM in size, surrounded by redness, itching is obvious, mostly accompanied by pins and needles, some only have pins and needles or stinging sensation without rash, some patients have systemic reactions with acetylcholine, such as salivation, headache, slow pulse, pupil narrowing and spasmodic abdominal pain, diarrhea and other symptoms, severe cases can lead to fainting. It occurs when the body temperature rises due to exercise, heat, emotional stress, hot drinks or alcoholic beverages, etc., and is especially likely to occur when sweating. The wind mass usually subsides 0.5~2 hours after stopping exercise or calming down, and the course of the disease usually gradually improves after several years. The pathogenesis of the disease is not fully understood, but there are two main views: 1. The central nervous system is stimulated by cholinergic afferent nerves, which cause the release of acetylcholine in the mast cells. 2, allergic reaction to their own sweat, and may be the same as atopic dermatitis is allergic to the same sweat components. Hydroxyzine has a good effect on the disease, but also can be applied loratadine, cetirizine and other 2 generations of antihistamines, along with anticholinergic drugs such as probenecid, atropine and other treatment, recurrent episodes of immunomodulatory drugs can be used to improve the body. Patients with a history of cholinergic urticaria should pay attention to diet, hygiene, avoid adverse stimuli, maintain a healthy state of mind, and improve physical resistance.