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1.
Arch. argent. pediatr ; 122(5): e202310202, oct. 2024. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1571405

ABSTRACT

Introducción. La urticaria crónica es una afección inflamatoria de la piel caracterizada por presencia de habones evanescentes y/o angioedema, que ocurren durante un período ≥ 6 semanas. Objetivo. Determinar la prevalencia de esta enfermedad y describir características clínicas en niños y adolescentes menores de 19 años de un hospital general. Población y métodos. Estudio corte transversal, realizado entre el 2015 y el 2020, en una población de niños y adolescentes de un sistema de salud privado. Resultados. Se revisaron 1567 historias clínicas de pacientes con urticaria atendidos durante el período de estudio. Se identificaron 36 pacientes con urticaria crónica; se estableció una prevalencia del 0,16 % (IC95% 0,11-0,22). Conclusión. La prevalencia de urticaria crónica en niños y adolescentes fue del 0,16 %. Se observó mayor frecuencia en el sexo femenino y adolescentes.


Introduction. Chronic urticaria is an inflammatory skin condition characterized by the presence of evanescent wheals or angioedema that last for ≥ 6 weeks. Objective. To determine the prevalence of urticaria and describe its clinical characteristics in children and adolescents under 19 years of age in a general hospital. Population and methods. This was a cross-sectional study carried out between 2015 and 2020 in a population of children and adolescents seen at a private healthcare facility. Results. A total of 1567 medical records of patients with urticaria seen during the study period were reviewed. Thirty-six patients with chronic urticaria were identified; the prevalence was 0.16% (95% CI: 0.11­0.22). Conclusion. The prevalence of chronic urticaria in children and adolescents was 0.16%. A higher frequency was observed among girls and adolescents.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Chronic Urticaria/epidemiology , Hospitals, General , Urticaria/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective Studies
2.
Diagn. tratamento ; 29(3): 92-96, jul-set. 2024. tab
Article in Portuguese | LILACS, SES-SP | ID: biblio-1561623

ABSTRACT

Contexto: Urticária crônica caracteriza-se pela presença de urticas e/ou angioedema, com tempo de evolução superior a 6 semanas. Classifica- se em urticária crônica espontânea (UCE), com causas conhecidas ou não conhecidas e urticária crônica induzida (UCI). Objetivo: Esta revisão de UCE visa abordar os aspectos clínico-laboratoriais e indicações terapêuticas, de acordo com as diretrizes brasileira e internacional. Métodos: para esta revisão de UCE foi realizada pesquisa nas bases de dados PubMed, Embase, Google Acadêmico e Web of Science. Resultados: Foram incluídos artigos em inglês publicados entre 2018 e 2024, de acordo com sua relevância. Discussão: A patogênese da UCE engloba mecanismos imunológicos do tipo I e IIb. O diagnóstico da afecção é clínico, podendo ser realizados exames laboratoriais complementares, incluindo hemograma, VHS, D-dímero, PCR, anticorpos anti-peroxidase tireoidiana e IgE total. O diagnóstico diferencial da UCE apresenta diversas condições clínicas com morfologia semelhante à UCE. O tratamento indicado da UCE envolve medidas como suspensão de eventuais fatores desencadeantes e abordagem farmacológica, com utilização de anti-histamínicos não-sedantes, omalizumabe e uso eventual de ciclosporina. Conclusões: O impacto da UCE para os pacientes e para o sistema de saúde é de extrema relevância e avanços nas pesquisas permitirão um tratamento individualizado, com melhores perspectivas em relação à terapêutica e qualidade de vida dos pacientes.


Subject(s)
Chronic Urticaria , Chronic Inducible Urticaria
3.
Article | IMSEAR | ID: sea-228665

ABSTRACT

Chronic urticaria is a common disorder of unknown origin, which is often associated with normal routine laboratory values and no evidence of systemic disease. Cutaneous vasculitis is one of the rare presentation of chronic urticaria. We reported a 13-year-old female child, who presented to us with tender urticarial wheals all over the body, who on further evaluation was found to have positive anti-thyroid peroxidase antibodies and was diagnosed to have urticarial vasculitis.

4.
Article | IMSEAR | ID: sea-242597

ABSTRACT

Urticaria is a skin disorder marked by wheals and/or angioedema. It mostly presents in two forms: Chronic and acute. There is a probability of the progression of urticaria into the chronic form which exerts a substantial burden on the patient’s routine life and health-care setup. Insights into the disease mechanism can help physician’s optimize clinical outcomes. Histamine is found in the mast cells of the skin, and activated histamine receptors play a prime role in triggering manifestations of urticaria. Second-generation antihistamines are the optimal treatment option for antagonizing the action of histamine. These medicines help control the skin’s reactivity to the histamine and are the preferred first-line treatment approach for managing all forms of urticaria. Levocetirizine stands out as a highly effective antihistamine, exhibiting effective clinical outcomes and offering rapid onset, high bioavailability, and effective relief from the symptoms of urticaria for a prolonged period of up to 24 h. This expert opinion article highlights the potency of second-generation antihistamines, particularly levocetirizine in the effective treatment of allergic skin conditions such as urticaria and its subtypes such as chronic urticaria.

5.
Article | IMSEAR | ID: sea-242595

ABSTRACT

Histamine is central to allergic reactions and is primarily concentrated in mast cells throughout the body. The four types of histamine receptors (H1, H2, H3, and H4) influence both the peripheral and central nervous systems. H1 receptors, found in various tissues, induce itching, mucosal secretion, muscle contraction, and blood vessel dilation. Histamine stabilizes the active state of H1 receptors, while H1-antihistamines, such as levocetirizine, bind to different sites, inducing the inactive state and counteracting histamine effects. Levocetirizine, a second-generation antihistamine, selectively binds to H1 receptors and effectively inhibits allergic responses without significant sedative effects. It is recommended for both seasonal and perennial rhinitis and exhibits a favorable long-term safety profile. Studies on levocetirizine in pediatric patients show its efficacy in reducing allergy-related symptoms with good tolerability and safety. Notably, levocetirizine demonstrates superiority in managing symptoms of chronic idiopathic urticaria and allergic rhinitis compared to other commonly used antihistamines. This paper discusses the role of levocetirizine as a safe option for treating allergic conditions in the pediatric population and is further supported by insights from clinical experts.

6.
Article | IMSEAR | ID: sea-226741

ABSTRACT

Background: Various drugs are responsible for different cutaneous adverse drug reactions (CADRs). Considering variation in drug responses and the day-to-day increasing burden of ADRs, this study was done with emphasis on the need for effective evaluation and the reporting of the ADR reporting programme. Methods: This was an observational cross-sectional study conducted for the duration of six months in the dermatology department to evaluate various clinical patterns of CADRs. Results: A total of 60 CADRs were reported. Among them, 51.67% were present in males and 48.33% were present in females. The most common CADR was FDE (35%), followed by macula-papular rash (25%). Antimicrobials were most commonly responsible for CADRs, followed by NSAIDs, antiepileptic, anti-gout, and anti-hypertensive medications. Conclusions: For better patient care, drug safety, and rational use of medicines, knowledge of various drugs responsible for CADRs can be useful for health care professionals to reduce mortality and morbidity by monitoring, reporting, and assessment of CADRs whenever detected.

7.
Arq. Asma, Alerg. Imunol ; 8(2): 91-115, 20240600. Ilus
Article in English, Portuguese | LILACS | ID: biblio-1585239

ABSTRACT

A urticária é uma condição caracterizada pela presença de urticas, angioedema, ou ambos, que pode ser classificada de acordo com o tempo de duração em aguda, quando persiste por menos de 6 semanas, ou crônica, quando por mais de 6 semanas e afeta significativamente a qualidade de vida. A atualização das recomendações quanto ao seu diagnóstico e tratamento é elaborada por especialistas de todo o mundo, que se reúnem a cada quatro anos em Berlim para revisar todas as novas evidências que justifiquem modificações na diretriz internacional. Este artigo discute as principais recomendações propostas na versão atual da diretriz internacional.


Urticaria is a condition characterized by the presence of hives, angioedema, or both. It can be classified according to its duration as acute, when it persists for less than 6 weeks, or chronic, when it persists for more than 6 weeks and greatly affects quality of life. Updated recommendations on diagnosis and management are developed by experts from all over the world who meet every 4 years in Berlin and review all new evidence that supports changes to the international guideline. This paper discusses the main recommendations proposed in the current version of the international guideline.


Subject(s)
Humans , Therapeutics , Urticaria , Angioedema , Quality of Life , Epidemiology , Cyclosporine , Adrenal Cortex Hormones , Histamine H1 Antagonists, Non-Sedating , Diagnosis, Differential , Allergy and Immunology , Omalizumab
8.
Arq. Asma, Alerg. Imunol ; 8(2): 146-150, 20240600. Ilus
Article in English | LILACS | ID: biblio-1585264

ABSTRACT

This retrospective study aimed to investigate the relationship between peripheral blood basophil counts and response to treatment with omalizumab in patients with chronic spontaneous urticaria (CSU). Most patients included in the study had a normal basophil count, but a significant correlation was found between a low basophil count and daily use of antihistamines still required to control symptoms. This suggests the potential utility of basophil count as a prognostic marker of response to anti-IgE monoclonal antibody therapy in CSU.


Este estudo retrospectivo procurou investigar a relação entre os níveis de basófilos periféricos em doentes com urticária crônica espontânea (UCE) em tratamento com omalizumab e a sua resposta terapêutica. Dos pacientes incluídos, a maioria apresentou níveis normais de basófilos, mas uma correlação significativa foi encontrada entre valores baixos de basófilos e o uso diário de anti-histamínicos ainda necessários para controle sintomático, colocando a hipótese da potencial utilidade destes como marcador prognóstico na UCE na resposta à terapêutica monoclonal anti-IgE.


Subject(s)
Humans , Basophils , Immunoglobulin E , Omalizumab , Chronic Urticaria , Histamine Antagonists , Antibodies, Monoclonal , Patients , Therapeutics , Retrospective Studies
9.
Article | IMSEAR | ID: sea-242581

ABSTRACT

Urticaria, commonly referred to as hives, is a skin condition characterized by itchy, raised welts that can vary in size and shape, often triggered by the release of histamine and inflammatory mediators. It can be acute, lasting <6 weeks or chronic, lasting longer. Treatment options include antihistamines, corticosteroids, and immunotherapy. Antihistamines, such as levocetirizine, effectively block the action of histamine and have been shown to alleviate symptoms in chronic urticaria. Clinical studies have reported improved efficacy of levocetirizine in chronic idiopathic urticaria and highlighted its potency compared to other antihistamines. Furthermore, levocetirizine has also demonstrated improved quality of life and symptom reduction in patients with chronic urticaria. This paper discusses the role of levocetirizine in optimizing urticaria treatment and the clinical expertise of different physicians on levocetirizine use in chronic urticaria patients

10.
Arq. Asma, Alerg. Imunol ; 7(4): 339-366, abr.jun.2024. ilus
Article in English, Portuguese | LILACS | ID: biblio-1552683

ABSTRACT

Os anticorpos monoclonais são uma nova classe de medicamentos que representa um marco na evolução da terapia de doenças alérgicas graves. Além de possibilitar uma terapia imunológica alvo específico, proporciona maior controle de sintomas, redução de exacerbações, melhoria da qualidade de vida e da segurança. A eficácia e a segurança dos anticorpos monoclonais no tratamento de doenças alérgicas estão bem documentadas nos estudos clínicos pivotais, de extensão e de vida real. No Brasil, estão licenciados atualmente pela Agência Nacional de Vigilância Sanitária (ANVISA) imunobiológicos para asma, dermatite atópica (DA), esofagite eosinofílica (EoE), granulomatose eosinofílica com poliangeíte (GEPA), rinossinusite crônica com pólipo nasal (RSCcPN), síndromes hipereosinofílicas (SHE) e urticária crônica espontânea (UCE). Com a incorporação do uso dessas novas terapias no dia a dia do médico alergologista e imunologista, naturalmente emergem aspectos práticos que exigem orientações práticas perante as evidências científicas mais atuais, a fim de se manter a boa prática médica, com uso criterioso e consciente pelo especialista capacitado. Assim, nesse guia prático, abordaremos os imunobiológicos aprovados até o momento para doenças alérgicas graves, com objetivo de auxiliar o especialista em Alergia e Imunologia na prescrição e manejo dessas medicações, incluindo indicações, contraindicações, monitoramento da eficácia e segurança, notificação de eventos adversos, bem como aspectos associados aos cuidados com vacinas, populações especiais, acesso, transporte, armazenamento e aplicação domiciliar.


Monoclonal antibodies are a new class of drugs that represent a milestone in the evolution of therapy for severe allergic diseases. In addition to allowing targeted immunologic therapy, they can improve symptom control, reduce exacerbations, and increase quality of life and safety. The efficacy and safety of monoclonal antibodies in the treatment of allergic diseases are well documented in pivotal, extension, and real-life clinical studies. In Brazil, immunobiologic agents are currently licensed by the National Health Surveillance Agency (ANVISA) for use in asthma, atopic dermatitis (AD), eosinophilic esophagitis (EoE), eosinophilic granulomatosis with polyangiitis (EGPA), chronic rhinosinusitis with nasal polyps (CRSwNP), hypereosinophilic syndrome (HES), and chronic spontaneous urticaria (CSU). With the incorporation of these new therapies into the daily practice of the allergist and immunologist, practical aspects will naturally emerge and require practical guidelines in light of the most current scientific evidence in order to maintain good medical practice, with judicious and conscious use by a qualified specialist. Therefore, in this practical guide, we will address the immunobiologic agents currently approved for severe allergic diseases, aiming to assist allergy and immunology specialists in the prescription and practical management of these medications, including indications, contraindications, efficacy and safety monitoring, adverse event reporting, as well as health care factors associated with vaccination, special populations, access, transport, storage, and home use.


Subject(s)
Humans
11.
Arq Asma Alerg Imunol ; 8(1): 30-34, jan.mar.2024. ilus
Article in English, Portuguese | LILACS | ID: biblio-1562875

ABSTRACT

A síndrome da urticária de contato (SUC), a urticária de contato (UCO) e a dermatite de contato por proteínas (DCP) são entidades descritas sob o rótulo de reações cutâneas imediatas por contato. Geralmente as urticas surgem 20-30 minutos após a exposição por contato com uma substância, e desaparecem por completo em algumas horas, sem deixar lesão residual.Entretanto, a SUC pode apresentar sintomas generalizados graves. Estima-se uma prevalência, entre trabalhadores europeus, entre 5-10%, enquanto na população geral estima-se de que seja de 1-3%. Os mecanismos envolvidos na patogênese da SUC não foram totalmente elucidados. Uma abordagem inicial, para melhorar a sua compreensão, pode ser dividir esta condição em urticária não imunológica (UCNI) e imunológica (UCI). A primeira não necessita de sensibilização prévia ao alérgeno, enquanto a segunda necessita. O diagnóstico da SUC necessita de uma anamnese detalhada e exame físico seguido de teste cutâneo com as substâncias suspeitas. O afastamento do agente desencadeante é o melhor tratamento. Para isso é necessário o diagnóstico apropriado e precoce, a confecção de relatórios ocupacionais e o desenvolvimento de medidas preventivas.


Contact urticaria syndrome (CUS), contact urticaria, and protein contact dermatitis (PCD) are entities described under the umbrella term of immediate contact skin reactions (ICSR). Generally, hives appear 20-30 minutes after contact with the offending substance, and disappear completely in a few hours, without leaving residual lesions. However, the CUS may be associated with severe systemic symptoms. A prevalence of 5-10% has been estimated among European workers; in the general population it is 1-3%. The mechanisms involved in CUS pathogenesis have not been fully elucidated. An initial approach to improving its understanding involves dividing this condition into non-immune and immune contact urticaria. The former does not require prior sensitization to the allergen, while the latter does. Diagnosis of CUS is established by a detailed history and physical examination, followed by skin tests with suspected substances. Removal of the triggering agent is the best treatment. This requires early proper diagnosis, occupational reporting, and development of preventive measures.


Subject(s)
Humans
12.
Journal of Chinese Physician ; (12): 53-57, 2024.
Article in Chinese | WPRIM | ID: wpr-1026061

ABSTRACT

Objective:To explore the correlation between serum levels of interleukin-9 (IL-9), platelet activating factor (PAF), total immunoglobulin E (IgE), interferon γ (IFN-γ), and interleukin-4 (IL-4) in patients with chronic spontaneous urticaria (CSU).Methods:Sixty CSU active phase patients admitted to the First Affiliated Hospital of Hebei North University from March 2018 to March 2019 were selected and included in the CSU active phase group. Based on the 7-day Urticaria Activity Score (UAS7), they were divided into three groups: 15 mild group, 25 moderate group, and 20 severe group; And 19 patients who entered the quiescent phase of the disease after 28 days of standardized antihistamine treatment were included in the CSU quiescent phase group. Another 30 healthy subjects who participated in the physical examination at the same time at our hospital′s physical examination center were selected to be included in the healthy control group. 5 ml of fasting elbow vein blood was collected from CSU active and stationary patients, as well as healthy subjects. The serum levels of IL-9, PAF, total IgE, IFN-γ, and IL-4 were detected using enzyme-linked immunosorbent assay. Pearson correlation test was used to analyze the correlation between serum IL-9, PAF levels and total IgE, IFN-γ, and IL-4 levels in CSU active patients.Results:The serum levels of IL-9, PAF, total IgE, and IL-4 in the CSU active phase group were higher than those in the CSU stationary phase group and healthy control group (all P<0.05), and the serum IFN-γ levels were lower than those in the CSU stationary phase group and healthy control group (all P<0.05). There was no statistically significant difference in the levels of the above indicators between the healthy control group and the CSU stationary group (all P>0.05). The serum levels of IL-9, PAF, total IgE, and IL-4 in the severe group were significantly higher than those in the mild and moderate groups (all P<0.05), and the serum IFN-γ levels were significantly lower than those in the mild and moderate groups (all P<0.05); The serum levels of IL-9, PAF, total IgE, and IL-4 in the moderate group were significantly higher than those in the mild group (all P<0.05), and the serum IFN-γ levels were significantly lower than those in the mild group ( P<0.05). Pearson correlation analysis showed that serum IL-9 and PAF levels were positively correlated with serum total IgE and IL-4 levels in CSU active phase patients (IL-9: r=0.726, 0.870, PAF: r=0.788, 0.795, all P<0.01), and negatively correlated with serum IFN-γ levels (IL-9: r=-0.831, PAF: r=-0.816, all P<0.01). Conclusions:The serum levels of IL-9 and PAF in patients with active CSU are elevated and correlated with total IgE, IFN-γ, and IL-4 levels, suggesting that IL-9 and PAF may be related to the occurrence and development of CSU.

13.
Article in Chinese | WPRIM | ID: wpr-1031520

ABSTRACT

The membranous tube of sanjiao (三焦) is not only the path of the transport of fluid and qi, but the way of the invasion of pathogenic factors, therefore, it cooperates with the skin mucous membrane physically and influence on each other pathologically. It is believed that the core pathogenesis of chronic urticaria is pathogens intruding sanjiao, membrane collaterals acute spasm, and fluid and qi disturbance, of which defense qi insufficiency and pathogens intruding sanjiao initiates the disease, while struggle between healthy and pathogenic qi and membrane collaterals acute spasm is the intermediate stage, and disturbed fluid, qi and blood movement is the terminal stage. Following the core treatment principle of dredging sanjiao, the internal treatment is to open striae and interstices and dispel pathogens out using self-made Guben Shufeng Decoction(固本疏风汤)modifications, and the external treatment is to dredge and regulate membrane collaterals, move qi and fluid, and treat sanjiao simultaneously, commonly using cutting therapy on Danzhong (RN 17) to move qi and fluid, seal umbilical therapy on Shenque (RN 8) to supplement and nourish ying-wei (营卫), and natural moxibustion on Xuehai (SP 10) to move blood and unblock collaterals.

14.
Article in Chinese | WPRIM | ID: wpr-1032325

ABSTRACT

Vaccination is the most economical and effective measure to prevent infectious diseases targeted by vaccines. Despite this, the safety of vaccines has garnered increased attention due to recent vaccine incidents. The tetravalent human papillomavirus vaccine (HPV) is one of the effective means to prevent cervical cancer and in situ adenocarcinoma caused by infection with corresponding serotypes. The inactivated novel coronavirus vaccine is an emergency vaccine developed to prevent novel coronavirus infection after the COVID-19 outbreak, and is also the main measure used to control the spread of COVID-19 at present. The monitoring data show that both vaccines have good safety after inoculation, but due to individual differences and other reasons, rare reactions may occur in a very small number of recipients. This article presents two cases of urticaria vasculitis following inoculation of the tetravalent HPV and the novel corona virus inactivated vaccine.

15.
Article in Chinese | WPRIM | ID: wpr-1039651

ABSTRACT

Chronic urticaria (CU) is a common skin disease worldwide, and its incidence is increasing year by year in various regions. Clinical manifestations such as severe itching can affect normal work, sleep, and daily life and increase the negative psychological burden caused by stress, anxiety, and depression. Mast cell activation and degranulation induced by immunoglobulin(Ig)E hypersensitivity is one of the core pathogenic mechanisms of CU, and there is no cure. Antihistamines such as cetirizine and loratadine are preferred for the clinical treatment of CU. Although they can effectively improve clinical manifestations such as itchiness, long-term application can increase the risk of adverse reactions and drug resistance. The phosphatidylinositol kinase/serine-threonine protein kinase B(PI3K/Akt) signaling pathway, as a classical signaling pathway regulated by phosphatidylinositol and tyrosine kinase receptor (RTK), is a key target regulating the production and release of cytokines in macrophages and affecting the migration of leukocytes and the activation of mast cells and inflammation, and it can be involved in a variety of metabolic processes, such as mast cell activation and degranulation induced by IgE hypersensitivity and abnormal activation of the complement system so that the PI3K/Akt molecular pathway could be an important target for the future eradication of CU. However, the mechanism and potential role of the PI3K/Akt signaling pathway in the treatment of CU are less reported in China. Now, this paper reviewed the molecular mechanism of PI3K/Akt signaling pathway regulation in the treatment of CU and provided corroborative evidence and therapeutic strategy choices for the treatment of CU with traditional Chinese medicine (TCM) from the perspectives of molecular regulation and network pharmacology analysis.

16.
Article in Chinese | WPRIM | ID: wpr-1030203

ABSTRACT

[Objective]To summarize Professor MA Lili's academic thoughts on treating chronic urticaria based on the spleen theory,providing references for clinical practice.[Methods]Through collecting and recording outpatient medical records,sorting out Professor MA's experience of treating chronic urticaria based on the spleen theory,summarizing the etiology and pathogenesis of the disease and the rule of prescription,and taking a medical case to prove it.[Results]Professor MA believes that the core pathogenesis of chronic urticaria is spleen deficiency and pathogenic invasion of human body.The chronic urticaria belongs to deficiency in origin and excess in superficislity,and the main inducement is spleen deficiency leading to disharmony between Ying-Qi and Wei-Qi,stagnation of dampness,stagnation of liver Qi.In treatment,Professor MA uses the methods of tonifying and transporting to invigorate the spleen,such as harmonizing Ying-Qi and Wei-Qi,clearing dampness by transporting the spleen,and regulating the liver Qi by tonifying the spleen.At the same time,she will use different treatments for different patients,individualized treatment is her unique experience.In this case,the patient was diagnosed as spleen deficiency and stagnation of dampness based on the patient's old age and recurrent rash.The treatment method was to remove dampness by transporting the spleen,eliminating the pathogenic factors and relieving itching,and paid attention to the deficiency in the later stage.This medication was flexible according to the change of the condition,with significant curative effect.[Conclusion]Professor MA treats chronic urticaria with a diagnosis and treatment philosophy centered around the spleen,therefore the experience derived is worthy of reference and promotion.

17.
Article in Spanish | LILACS, CUMED | ID: biblio-1565600

ABSTRACT

Desde su aparición en Wuhan, China, y luego de más de dos años de ser declarada como pandemia, la COVID-19 ha provocado más de cinco millones de muertes en el mundo. Es ampliamente conocido que no solo afecta al sistema respiratorio, sino que aparecen manifestaciones digestivas, cardiovasculares, endocrinometabólicas, neurológicas, renales y cutáneas. El espectro dermatológico que guarda relación con la COVID-19 se ha definido en cinco grupos principales de manifestaciones: lesiones maculopapulares, lesiones acrales, patrón urticariforme, patrón vesiculoso y lesiones de livedo o necrosis, según su frecuencia de aparición. Se describe un caso con presencia de rash urticariforme como único síntoma reportado en un paciente con diagnóstico de COVID-19(AU)


Since its appearance in Wuhan, China, and after more than two years after being declared a pandemic, COVID-19 has caused more than five million deaths in the world. It is widely known that it not only affects the respiratory system, but also has digestive, cardiovascular, endocrine-metabolic, neurological, renal and skin manifestations. The dermatological spectrum that is related to COVID-19 has been defined in five main groups of manifestations: maculopapular lesions, acral lesions, urticarial pattern, vesicular pattern and livedoid or necrotic lesions, according to their frequency of appearance. A case is described with the presence of urticarial rash as the only symptom reported in a patient diagnosed with COVID-19(AU)


Subject(s)
Humans , Male , Female , Skin Manifestations , Urticaria/etiology , COVID-19/epidemiology
18.
Rev. cuba. hig. epidemiol ; Rev. cuba. hig. epidemiol;612024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1569837

ABSTRACT

Introducción: Globalmente, Blastocystis spp. es el protozoo más frecuentemente encontrado en las heces de humanos y otros animales. En Cuba, la Encuesta Nacional de Parasitismo Intestinal de 2009 demostró que la infección por Blastocystis spp. era la parasitosis más prevalente. La asociación entre blastocistosis y urticaria ha sido reportada de manera creciente en la literatura internacional. Esa asociación, poco conocida entre los profesionales de la salud cubanos, no ha sido estudiada en nuestro país. Objetivos: Describir la asociación entre blastocistosis y urticaria. Métodos: Mediante búsqueda electrónica en las bases de datos PubMed, Medline y Google Scholar, se realizó una revisión de los artículos publicados durante el período 2003-2023 sobre las evidencias y los mecanismos de asociación entre blastocistosis y urticaria. Puntualmente, también fueron consultados monografías y artículos originales fechados con anterioridad al intervalo mencionado. Resultados: Se expone y analiza, con un enfoque académico y asistencial, la información actualizada sobre los temas seleccionados. Conclusiones: Evidencias epidemiológicas, clínicas y terapéuticas demuestran asociación entre la infección por Blastocystis spp. y el desarrollo de urticaria. Trabajos recientes, insuficientes aún, describen los mecanismos que explicarían esa asociación. Algunos de esos mecanismos son similares a los relacionados con el desarrollo de lesiones urticarianas en el curso de otras infecciones parasitarias. Por ese motivo, el diagnóstico y tratamiento de lesiones urticarianas de posibles etiologías parasitarias debe hacerse desde un enfoque que tenga en cuenta no solo las condiciones socioeconómicas y sanitarias comunes que las propician, sino también el posible efecto potenciador de los mecanismos de las de una causa sobre los de otras.


Introduction: Globally, Blastocystis spp. is the protozoan most frequently found in the feces of humans and other animals. In Cuba, the 2009 National Survey of Intestinal Parasitism demonstrated that infection by Blastocystis spp. was the most prevalent parasitism. The association between blastocystosis and urticaria has been increasingly reported in the international literature. This association, little known among Cuban health professionals, has not been studied in our country. Objectives: To describe the mechanisms of the association between blastocystosis and urticaria. Methods: Through an electronic search in PubMed, Medline and Google Scholar databases, a review was carried out of the articles published during the period 2003-2023 on the evidence and mechanisms of association between blastocystosis and urticaria. Purposely, monographs and original articles dated prior to the aforementioned interval were also consulted. Results: Updated information on the selected topics is presented and analyzed with an academic and healthcare approach. Conclusions: Epidemiological, clinical and therapeutic evidence demonstrates an association between infection by Blastocystis spp. and the development of urticaria. Recent works, still insufficient, describes the mechanisms that would explain this association. Some of these mechanisms are similar to those related to the development of urticarial lesions during other parasitic infections. For this reason, the diagnosis and treatment of urticarial lesions of possible parasitic etiologies must be done from an approach that takes into account not only the common socioeconomic and health conditions that promote them, but also the possible enhancing effect of the mechanisms of those of a cause on those of others.

19.
Medicina (B.Aires) ; Medicina (B.Aires);83(5): 772-792, dic. 2023. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1534881

ABSTRACT

Resumen La urticaria es un patrón distintivo de respuesta inflamatoria de piel y/o mucosas caracterizada por la aparición súbita de ronchas evanescentes, angioedema o ambos, asociados a prurito. Las formas agudas son frecuentes y se limitan a brotes de menos de 6 sema nas; mientras que las crónicas tienen una prevalencia menor al 1%, mayor duración y pueden ser espontáneas o inducibles. Los mecanismos etiopatogénicos involucrados en esta enfermedad incluyen la autoalergia, la autoinmunidad y la inflamación con la activación celular, principalmente del mastocito, lo que lleva a su degranulación con libe ración de mediadores vasoactivos. En su abordaje son fundamentales la confirmación diagnóstica; la búsqueda de indicadores de su etiopa togenia; la detección de cofactores que pueden modular su actividad; el reconocimiento de comorbilidades; la evaluación de posibles biomarcadores y, el impacto en la calidad de vida, el registro de la actividad y el control de la enfermedad. El manejo farmacológico tiene por objetivo controlar los síntomas, mientras la urticaria resuelve de forma espontánea. Este se describe de forma escalonada con una complejidad creciente.


Abstract Urticaria is a distinctive pattern of inflammatory re sponse of the skin and/or mucous membranes charac terized by the sudden appearance of vanishing wheals, angioedema, or both, associated with pruritus. Acute forms are frequent and limited to outbreaks of less than 6 weeks; while the chronic ones have a prevalence of less than 1%, longer duration and can be spontaneous or inducible. The etiopathogenic mechanisms involved in this disease include autoallergy, autoimmunity, and inflam mation with cell activation, mainly of the mast cell, leading to its degranulation with the release of vasoac tive mediators. Along its approach, diagnostic confirmation, search for indicators of its etiopathogenesis, detection of cofactors that can modulate its activity, recognition of comorbidi ties, evaluation of possible biomarkers and the assess ment of disease activity, impact and control are essential. The pharmacological management aims to control the symptoms, until the urticaria, which is self-resolv ing, is gone. This is described in a stepwise fashion with increasing complexity.

20.
Article | IMSEAR | ID: sea-235189

ABSTRACT

Urticaria, a complex inflammatory skin disorder, impacts up to 20% of the global population. It is characterized by mast cell activation, histamine release, and subsequent sensory nerve stimulation, leading to itchy wheals and angioedema. Chronic urticaria (CU) has erratic prevalence across regions, with females being the most affected. It is also highly prevalent in individuals older than 30 years. Comorbidities such as anxiety and depression often accompany CU, worsening its impact on daily life and imposing substantial direct and indirect burdens. Antihistamines, particularly second-generation histamine H1 receptor antagonists like levocetirizine, are pivotal in managing urticaria. Levocetirizine, the active R-enantiomer of cetirizine, offers improved treatment outcomes and quality of life for CU patients. Recent studies report its efficacy, and it surpasses other antihistamines in terms of duration of effect. Levocetirizine emerges as a valuable addition to the management regime against CU, promising relief for patients who previously showed poor response to treatment. Its prolonged duration of effect and favorable safety profile make it a valuable addition to the treatment armamentarium for CU, enhancing patients’ quality of life.

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