Cholinergic urticaria presents as an eruption of multiple small 2-3 mm monomorphic papular weals in response to sweat-inducing stimuli such as physical exertion, hot baths, spicy foods or sudden emotional stress. The weals tend to be pink in milder cases but white with surrounding macular erythema when the oedema is more intense. Angioedema and systemic manifestations including faintness, headache, palpitations and wheezing may occur in severe cases.