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Objective:To investigate the correlation between food-specific IgG (sIgG) antibodies and phenotypes of chronic spontaneous urticaria (CSU) .Methods:Serum samples were collected from outpatients with active CSU, symptomatic dermographism (SD) , or acute urticaria (AU) , and healthy controls from 5 third-grade class-A hospitals such as the First Hospital of China Medical University between April 2014 and March 2015. Enzyme-linked immunosorbent assay was conducted to detect serum levels of 90 food-sIgG antibodies and total IgE, Western blot analysis to detect levels of 20 allergen-specific IgE antibodies, and chemiluminescent microparticle immunoassay to detect levels of anti-thyroid peroxidase IgG antibodies and anti-thyroglobulin IgG antibodies. Comparisons of normally distributed quantitative data between two groups and among several groups were performed by t test and one-way analysis of variance, respectively; comparisons of non-normally distributed quantitative data between two groups were performed by Mann-Whitney U test; for comparisons of proportions, chi-square test and Fisher′s exact test were used. Results:A total of 248 patients with CSU, 22 with SD, 15 with AU and 13 healthy controls were recruited. The cut-off level for sIgG positivity was 100 U/ml (at least 2+) , and the positive rate of food-sIgG antibodies was slightly higher in the patients with CSU (176/248, 70.97%) , SD (15/22, 68.18%) and AU (11/15) than in the healthy controls (7/13; χ2 = 1.80, P = 0.615) . Among the 248 CSU patients, the proportion of patients with family history of allergic diseases was significantly higher in the sIgG-positive group (71/176, 40.34%) than in the sIgG-negative group (19/72, 26.39%; χ2 = 4.30, P = 0.042) , while no significant difference was observed in the 1-day urticaria activity score (UASday) between the two groups ( Z = 0.18, P = 0.859) . Totally, 177 CSU patients completed 12- to 40-week treatment; their condition could be completely controlled by second-generation H1-antihistamines, and there was no significant difference in the required dosage of second-generation H1-antihistamines between the sIgG-positive group (128 cases) and sIgG-negative group (49 cases; Z = -1.06, P = 0.298) . Conclusions:The prevalence of family history of allergic diseases was relatively high in food-sIgG-positive patients with CSU. However, food-sIgG could not be used as an indicator to reflect the disease activity of CSU and treatment response.
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A pandemia de COVID-19 afetou drasticamente a vida de todos ao redor do planeta, interferindo também na forma de atuarmos como médicos e especialistas. Neste artigo revisamos aspectos importantes da infecção pelo novo coronavírus e sua relação com a urticária.
The COVID-19 pandemic has dramatically affected people's lives around the world and has interfered with how we act as physicians and specialists. In this paper, we review important aspects of the new coronavirus infection and its connection with urticaria.
Subject(s)
Humans , Urticaria , Coronavirus Infections , Chronic Urticaria , COVID-19 , Skin Manifestations , CoronavirusABSTRACT
Urticaria is a common cutaneous disease characterized by recurrent and transient wheals and pruritus, sometimes accompanied angioedema. The classification of urticaria is based on the duration of the disease and whether extrinsic triggers are identified or not. Acute urticaria is usually occurred by specific causes, such as drug, food, and infection, etc. Therefore, acute urticaria can be remitted within 6 weeks just by avoiding the exposure to the causes. However, chronic urticaria defined as repeatedly occurred itchy wheals and/or angioedema for at least 6 weeks, has a significant effect on patients' quality of life. Chronic inducible urticaria can be triggered by various physical stimuli including dermographism, delayed pressure, cold, heat, cholinergic stimuli, sunlight, and exercise. Chronic spontaneous urticaria (CSU) is diagnosed when no specific extrinsic cause is identified in the patients. CSU due to autoimmune mechanism accounts for 30–50%, autologous serum skin test and anti-thyroid autoantibody can be evaluated. However, various physical stimuli, emotional or physical stress, drugs, particularly aspirin and non-steroidal anti-inflammatory drugs can exacerbate urticaria in 30–75% of patients with CSU. Allergic diseases and autoimmune diseases are more common in CSU patients than in general populations. To assess the severity of urticaria and to adjust treatment step, urticaria activity score over 7 days, calculated by the number of wheals and the severity of pruritus, is recommended by recent international guidelines.
Subject(s)
Humans , Angioedema , Aspirin , Autoimmune Diseases , Classification , Diagnosis , Hot Temperature , Pruritus , Quality of Life , Skin Tests , Sunlight , UrticariaABSTRACT
Antecedentes. A pesar de la frecuencia de la urticaria aguda (UA), no existen estudios epidemiológicos sobre su prevalencia y distribución en Argentina. Objetivo. Determinar la prevalencia y otras características epidemiológicas de la UA en los miembros de una organización privada de salud de Buenos Aires, la mayor área poblada de Argentina. Marco de referencia: Hospital Italiano (HIBA) de la Ciudad de Buenos Aires, Argentina. Diseño: Cohorte retrospectivo. Población. Pacientes con diagnóstico de UA miembros del HIBA, y con al menos 12 meses de seguimiento. Métodos. Se analizaron todos los registros médicos para calcular las tasas de prevalencia de UA por 100.000 habitantes con intervalo de confianza del 95% (IC95%) para el período comprendido entre el 1 de enero de 2013 y el 31 de diciembre de 2014. La tasa de prevalencia se calculó para toda la población y luego se discrimino para pacientes adultos y pediátricos (menores de 18 años en el momento del diagnóstico). Resultados. Se analizaron 158.926 miembros de la prepaga. Se identificó un total de 2100 casos de UA en el período analizado (1151 en pediatría, 949 en adultos), con una tasa de prevalencia de 1,32% (IC95%: 1,11-1,55%). La prevalencia de UA en la población adulta fue de 0,83% (IC95%: 0,64-0,97%), mientras que en la población pediátrica fue del 2,5% (IC95%: 1,9-2,8%). Conclusiones: este es el primer estudio que describe la prevalencia de UA en una población cerrada de Argentina y de la región.(AU)
Background. In spite of the frequency of acute urticaria (AU), there are no epidemiological studies on its prevalence and distribution in Argentina. Objetive. Was to estimate the prevalence and other epidemiological characteristics of AU in the members of a health maintenance organization of Buenos Aires, the largest populated area in Argentina. Setting: Italian Hospital, Buenos Aires, Argentina. Design. Retrospective cohort. Population. All patients with diagnosis of AU who are members of the IHMCP, and with at least 12 months of follow up were included in the study. Methods. All medical records were analyzed to calculate the prevalence rates for AU per 100,000 population with 95% CI for the period of January 1, 2013 and December 31, 2014. Prevalence rate was calculated for the entire population and then discriminated for adults and pediatric members (less than 18 years old at diagnosis). Results. 158,926 members were analyzed. A total of 2100 cases of AU were identified on prevalence period (1151 in pediatrics, 949 in adults), yielding a prevalence rate of 1.32% (CI 95% 1.11-1.55%). The prevalence of AU in adult population observed was 0.83 % (95% CI 0.64-0.97%), while in pediatrics it was 2.5 % (95% CI 1.9-2.8%). Conclusions. This is the first study to describe the prevalence of AU in a closed population of Argentina and the region(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Urticaria/epidemiology , Health Maintenance Organizations , Argentina , Allergens , AngioedemaABSTRACT
La urticaria es la aparición súbita de habones en la piel con o sin angioedema, es una enfermedad con un curso benigno, pero con un impacto negativo en la calidad de vida de quien la padece; se trata de una entidad relativamente común, desencadenada por varios gatillos, muchas veces reconocibles con una buena historia clínica, sin embargo, en la mayoría de los casos estos son desconocidos, como en la urticaria crónica. Su fisiopatología está mediada por una respuesta inmune y su tratamiento es sintomático con antihistamínicos, aunque en ocasiones se debe recurrir a inmunomoduladores.
Urticaria is a sudden onset of hives with or without angioedema, it is a disease with a benign course but with a negative impact on the quality of life of patients. It is a relatively common entity, triggered by various stimuli, often recognizable with a good clinical history, however in most cases these are unknown like in chronic urticaria. Its pathophysiology is usually mediated by an immune response and treatment is symptomatic with antihistamines, however some patients have to be immune regulated.
Subject(s)
Classification , Cyclosporine , Diagnosis , UrticariaABSTRACT
Objective To study the changes in number and function of peripheral blood T helper cell 17(Th17) in acute urticaria patients .Methods The percentages of Th17 in peripheral blood from 50 acute urticaria patients and 50 healthy persons were ana‐lyzed by immunofluorescence staining and bicolor flow cytometry (FCM ) in vitro .Retinoic acid‐related orphan nuclear receptor γt (RORγt) mRNA from the same research objects were detected by quantitative realtime PCR (qPCR) method .Peripheral blood transforming growth factor‐β(TGF‐β) ,interleukin(IL)‐6 ,IL‐17A and IL‐17F were tested by enzyme linked immunosorbent assay (ELISA) from the same research objects .Results The quantity of percentages of Th17(t= 36 .634 1 ,P< 0 .05) and levels of RORγt mRNA(t=23 .840 1 ,P<0 .05) in urticaria patients were higher than those in healthy persons obviously .Meanwhile ,the levels of TGF‐β(t=15 .521 1 ,P<0 .05) ,IL‐6(t=7 .247 3 ,P<0 .05) ,IL‐17A(t=15 .415 3 ,P<0 .05) and IL‐17F(t=13 .032 1 , P<0 .05) in urticaria patients were higher than those in healthy persons significantly .Conclusion Dysfunction of Th17 in periph‐eral blood may involve in the immunopathogenesis of acute urticaria .
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BACKGROUND: The multiple allergosorbent test chemiluminescent assay (MAST-CLA) is a simple system with high sensitivity and specificity for measuring total and allergen-specific IgE antibodies in patients with allergic skin diseases such as urticaria. OBJECTIVE: The purpose of this study was to evaluate total IgE class, allergen frequencies, and their correlations in MAST-CLA in acute and chronic urticaria. METHODS: We performed a retrospective study using medical documents of 2,028 urticaria patients (average age= 34.85 years) who visited Yonsei Wonju Severance Christian Hospital, Yeongseo Province, Korea, between 2003 and 2012. Positive rates of specific IgE and total serum IgE levels in acute and chronic urticaria patients were analyzed. RESULTS: Among the total 2,028 patients, 1,263 (62.3%) had acute urticaria, and 765 (37.7%) had chronic urticaria. The number of patients with higher than class 2 level of serum total IgE was 1,496 (73.8%): 964 (76.3%) of the acute urticaria group and 532 (69.5%) of the chronic urticaria group. More than half of the patients (1,048; 51.7%) showed a positive reaction to at least one allergen-specific IgE. The positive rate of acute urticaria was 53.0% and chronic urticaria 49.5%. In both acute and chronic urticaria, the most commonly detected allergen was Dermatophagoides farinae, followed by D. pterony and house dust. Most patients showed lower positive reactions to food allergens. Peach was the most common food allergen in both groups. Of the patients who showed positive total IgE, 40.4% did not react to any allergen-specific IgE. Also, 26.3% of the patients who were negative for total IgE showed a positive reaction to more than one allergen-specific IgE. The level of total IgE and the number of positive allergen-specific IgE responses were positively correlated in both acute and chronic urticaria patients. CONCLUSION: Our results showed that the positive rate of total IgE was higher in acute urticaria patients than in chronic urticaria patients. Both acute and chronic urticaria patient groups showed the highest positive rates for D. farinae. Positive rates for response to food allergens, such as soybean, chicken, yeast, tuna, and salmon, were lower in the chronic urticaria group. For inhalant allergens, the positive rates of response to white oak and Aspergillus were higher in the acute urticaria group. The level of total IgE and the number of positive allergen-specific IgE responses showed a positive correlation in both groups. Thus, MAST-CLA appears to be a simple and convenient method for determining causative allergens in the occurrence and exacerbation of urticaria, but other studies are necessary to confirm these preliminary findings.
Subject(s)
Humans , Allergens , Antibodies , Aspergillus , Chickens , Dermatophagoides farinae , Dust , Immunoglobulin E , Korea , Luminescent Measurements , Prunus persica , Retrospective Studies , Salmon , Sensitivity and Specificity , Skin Diseases , Soybeans , Tuna , Urticaria , YeastsABSTRACT
Objective According to the basic theory of Yin and Yang,acute urticaria should be treated with divergent medicine instead of convergence medicine.In order to prove the theory,we carry out the quantifiable and repeatability traditional Chinese medicine screening tests in acute urticaria patients,with double controls of experimental group (divergent Chinese medicine),control group (convergence Chinese medicine)end instrumental quality-control standard substance MEBE.Methods Germany MORA-Super bio-resonance instrument (medical mode) as adopted as objective index.32 cases of acute phase urticaria were selected and treated with divergent or convergence Chinese traditional medicine,to observe the results whether conform to traditional Chinese medicine basic theory of Yin and Yang (That is whether the acute phase urticaria should be treated with divergent Chinese medicine).Results Through the 32 cases repeat experiments,22 out of 23 kinds of Divergent Chinese medicine have been screened out in experimental group; while none has been screened out in 12 kinds of convergence Chinese medicine in control group.There was significant difference between two groups (P＜0.01).The result was entirely consistent with TCM basic theory of opposite relationship between yin and yang.The top five divergent Chinese medicines were divaricate saposhnikovia root,cicada slough,catnip,shrub chastetree rruit,and lily magnolia.Conclusion Treated acute urticaria with divergent Chinese medicine conforms to the basic theory of traditional Chinese medicine.
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Although there are several studies showing the association between cancer and urticaria, the mechanisms by which these events occur are not yet known. In this report, a case of acute urticaria with a diagnosis of thyroid papillary carcinoma is presented. Disappearance of treatment-resistant urticarial lesions after thyroidectomy suggests that this association was not a coincidence. The fact that urticaria which was nonresponsive to treatment disappeared spontaneously as a result of tumorectomy, strongly suggests that this association is not a coincidence. To our knowledge, this is the first report of the coexistence of acute urticaria and thyroid papillary carcinoma. This case provides further support that detailed history taking and a thorough physical examination are of paramount importance.
Subject(s)
Carcinoma, Papillary , Physical Examination , Thyroid Gland , Thyroidectomy , UrticariaABSTRACT
La urticaria aguda en niños es una entidad frecuente, sin embargo su incidencia no está bien establecida. Una variante es la urticaria anular aguda o gigante que ha sido caracterizada en varios trabajos. Objetivo: Caracterizar la urticaria anular aguda en el Instituto Nacional de Salud del Niño. Material y métodos: Estudio observacional no concurrente de serie de casos. Se revisaron historias clínicas de pacientes hospitalizados del servicio de Dermatología del Instituto Nacional de Salud del Niño, Lima-Perú, con criterios de inclusión y exclusión. Resultados:Se hallaron 27 niños con diagnóstico de urticaria anular aguda,las lesiones más frecuentes fueron las placas violáceas y manchas residuales. El área más afectada fue el tórax y dentro de los factores desencadenantes más importantes se encontró el uso de furazolidona en el 59% de los casos. Conclusiones: La urticaria anular aguda o gigante es una reacción de hipersensibilidad con características propias asociada en un alto porcentaje al uso de furazolidona (AU)
Acute urticaria in children is a frequent disorder; however its incidence has not been established. Annular acute urticaria or giant urticaria is a variant which has been reported in several surveys. Objetive: Characterize acute annular urticaria at Instituto Nacional de Salud del Niño, Lima-Peru. Methods: Observational non-concurrent series of cases. We reviewed the medical records of hospitalized patients at Dermatology Service, Instituto Nacional de Salud del Niño, with inclusion and exclusion criteria. Results: We found 27 children with diagnosis of acute annular urticaria; the most frequent lesions were lilaceous plaques and residual patches.The most frequently affected area was chest and the most important triggering factor was the use of furazolidone. Conclusions: Acute annular urticaria is a hypersensitivity reaction with special characteristics, which is associated in a high percentage to use of furazolidone (AU)
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Humans , Male , Female , Infant , Child, Preschool , Urticaria , Child, Hospitalized , Furazolidone , PeruABSTRACT
0.05);while great significances were found between group C and group B and A(P
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Minocycline is a semisynthetic tetracycline derivative that is widely prescribed systemic antibiotic for acne. But it is associated with a variety of adverse cutaneous reactions including fixed drug eruption, photosensitivity, hyperpigmentation, contact dermatitis, and generalized dermatitis of a morbilliform, urticarial, or exfoliative type. We herein report a case of acute urticaria in a 26-year-old woman who had taken minocycline for the treatment of acne.
Subject(s)
Adult , Female , Humans , Acne Vulgaris , Dermatitis , Dermatitis, Contact , Drug Eruptions , Hyperpigmentation , Minocycline , Tetracycline , UrticariaABSTRACT
In dermatologic practice, acute urticaria showing leukocytosis and fever suggesting syatemic bacterial infection is often observed. The clinician in dealing with such patients is tempted to use antibiotics in addition to corticosteroids and antihistamines before the patient can be sure that there is no bacterial infection. Authors observed the degree of the leukocytosis with its differential counts in 106 cases of acute urticaria to evaluate what percentages of acute urticaria patients are showing similar data with the changes seen in leukocyte counts of patients of erysipelas, and evaluated the effect of aqtibiotics-administered group with non-administered group of acute urticaria patients. The results were as follows: 1. In 106 acute urticaria patients, 42% showed higher total leukocyte count ( >12, 500/cu mm) than the mean total leukocytes of 20 erysipelas patients(12, 412/cu mm) and 29% showed greater neutrophilia(>70%) than the mean neutrophil differential count of the erysipelas (69.1%). In the cases showing both leukocytosis (>12,500/cu mm) and fever (>37. 5C) there was no difference in the course of treatment between the antibiotics-administered group and non-administered group. 3. The corticosteroid hormone reduced the total WBC count toward normal level generally within a week.