Cholinergic urticaria is a specific type of urticaria, mostly seen in young patients. Urticaria, commonly known as “rash”, is a restrictive edema reaction due to increased vasodilation and permeability of small blood vessels in the skin and mucous membranes, resulting in erythema and urticaria with itching. Cholinergic urticaria is mainly due to exercise, heat, nervousness, hot drinks or alcoholic beverages, the deep body temperature rises, prompting the onset of acetylcholine action on mast cells. The clinical manifestations are mainly papular eruptions, mostly rounded papular eruptions 1-3 mm in diameter, surrounded by a varying degree of redness, usually in the upper part of the trunk and proximal extremities, and the eruptions do not fuse with each other. There is intense pruritus, tingling or burning sensation, and sometimes only severe itching without lesions, which may subside within 30-60 minutes. It is occasionally accompanied by systemic symptoms caused by acetylcholine (such as salivation, headache, slow pulse, narrow pupils and spasmodic abdominal pain, vomiting, diarrhea), etc. In severe cases, it can lead to syncope, hypotension and other symptoms of anaphylaxis. For the treatment of this type of urticaria, other drugs are used in combination with antihistamines, such as cetirizine, ketotifen, cyproheptadine, doxepin and others (a medical professional should be consulted for specific medications).