Patient complains of excessive itching whenever she runs or jogs. She says that the itchiness starts about 20 minutes of jogging and begins from the ankles and goes up the legs. Sometimes, the itch can rise up the stomach and will prevent her from continuing her exercise. Patient has an active lifestyle and is suffering from this problem for years already. She typically uses Nike Air Max running shoes and running pullover typically made of soft wool or micro fleece. Patient reports no history of skin disease or allergies. Symptoms ease around 3 to 4 hours after cessation of exercise. Treadmill exam with temperature controlled environment performed on the patient. Patient reported difficulty in breathing and leg itching after 20 minutes. Patient registers a 1В°F increase in core body temperature. Further physical exam shows wheals in the calf and larger red lesions in the areas above the ankle heels.

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