https://oamjms.eu/index.php/mjms <p><strong>An Open Access, International Peer-reviewed Journal</strong></p> <p>Published by Scientific Foundation SPIROSKI, Skopje (<a title="OAMJMS published by Scientific Foundation SPIROSKI" href="https://oamjms.eu/index.php/mjms/index" target="_blank" rel="noopener">https://oamjms.eu/index.php/mjms/index</a>)<br />Co-published by Paradigm Publishing Services, Warsaw, Poland (<a title="Paradigm" href="https://reference-global.com/journal/OAMJMS" target="_blank" rel="noopener">https://reference-global.com/journal/OAMJMS</a>)</p> Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia in partnership with Paradigm Publishing Services, Warsaw, Poland en-US Open Access Macedonian Journal of Medical Sciences 1857-9655 <p>This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0)</p> https://oamjms.eu/index.php/mjms/article/view/12145 <p><strong>BACKGROUND:</strong> Cholinergic urticaria (CholU) is a condition characterized by small, highly pruritic wheals triggered by sweating. Treatment with histamine H1-receptor antagonists (H1RAs) is often insufficient.</p> <p><strong>CASE PRESENTATION:</strong> We report the case of a 20-year-old male who developed CholU following a period of physical inactivity with reduced sweating. Symptoms were reproducibly triggered by exercise or emotional stress and were most severe after prolonged inactivity. The patient undertook a self-directed desensitization approach using weekly dry sauna bathing. Over eight weeks, he experienced progressive improvement, with complete resolution of symptoms that was sustained with continued sessions.</p> <p><strong>CONCLUSION:</strong> This case suggests that controlled, repeated sweating may reduce disease activity in selected patients. Sauna bathing may represent a feasible, low-cost, non-pharmacologic adjunct in CholU that warrants further investigation.</p> Michał Szklarz Mikołaj Madeksza Wojciech Matuszewski Copyright (c) 2026 Michał Szklarz, Mikołaj Madeksza, Wojciech Matuszewski (Author) http://creativecommons.org/licenses/by-nc/4.0 2026-09-18 2026-09-18 14 2 60 63 10.3889/oamjms.2026.12145