What lessons can we learn? Clinical and epidemiological retrospective analysis of 267 patients with urticaria in a Brazilian tertiary center

Abstract Background: There are few epidemiological studies of urticaria, published in the indexed literature (PubMed/Medline). Objective: The study aimed to evaluate the epidemiological and clinical data among patients with urticaria/angioedema attending a reference clinic in Brazil. Methods: Two hundred sixty-seven patients were evaluated retrospectively considering demographic data, time course of the disease, triggering symptoms, the presence of angioedema, complementary laboratory tests including total blood count, reactive-C protein, erythrocyte sedimentation rate, IgE serum levels, and other, as necessary. Results: The most commonly diagnosed type of urticaria was chronic spontaneous urticaria (56.93%). Angioedema was associated with chronic urticaria in 108 patients (40.08%). Study limitations: Unicentered and retrospective. Conclusion: Some relevant findings in this study are the observation of a female prevalence of cases (4-females: 1-man), a result more elevated than demonstrated in previous studies in Europe and Asia, the median age was 43-years old and the delay of time between the diagnosis of urticaria and the admission for treatment in a specialized center was approximately 2-years. Other multicenter studies can better establish these differences in Brazilian patients.

Effects of Temperature on Outpatient Visits for Urticaria among Lanzhou Residents Based on Distributed Lag Non-linear Model / 中国医学科学院学报

Objective To evaluate the influence of temperature on the outpatient visits for urticaria in Lanzhou City and its hysteresis and to find out the sensitive populations by sex and age stratification.Methods We collected the urticaria outpatient data in three grade A class three hospitals as well as the meteorological data and air pollutant data in Lanzhou from January 2011 to December 2017.The distributed lag non-linear model(DLNM)was employed to analyze the influence of daily mean temperature on the outpatient visits for urticaria.Stratification analysis was performed for different age groups(0-14,15-59,≥60 years)and different sex populations.Results Temperature had a non-linear relationship with the outpatient visits for urticaria,and there existed hysteresis.During the research period,the average daily outpatient visits for urticaria at the three hospitals in Lanzhou was 25,ranging from 1 to 76.With the rise in the daily mean temperature within 0-10 ℃,the risk of outpatient visits for urticaria first increased and then decreased.When the daily mean temperature was 2 ℃,hysteresis occurred on the 18th day,and the relative risk(

Chronic urticaria in a health maintenance organization of Buenos Aires, Argentina - new data that increase global knowledge of this disease

Abstract: Background: In spite of the frequency of chronic urticaria, there are no epidemiological studies on its prevalence in Argentina. Objective: The objective of this study was to define the prevalence and epidemiological characteristics of chronic urticaria patients in Buenos Aires. Methods: The population studied were the members of the Italian Hospital Medical Care Program, a prepaid health maintenance organization located in the urban areas around the Autonomous City of Buenos Aires, Argentina. All patients with diagnosis of chronic urticaria members of the Italian Hospital Medical Care Program, and with at least 12 months of follow up were included in the study. All medical records obtained between January 1st, 2012 and December 31, 2014 were analyzed. The prevalence ratio for chronic urticaria per 100,000 population with 95% CI for December 31, 2014 was calculated. The prevalence rate for the entire population and then discriminated for adults and pediatric patients (less than 18 years old at diagnosis) was assessed. Results: 158,926 members were analyzed. A total of 463 cases of chronic urticaria were identified on prevalence date (68 in pediatrics, 395 in adults), yielding a crude point prevalence ratio of 0.29% (CI 95% 0.26-0.31%). The observed prevalence of chronic urticaria in the adult population was 0.34 % (95% CI 0.31-0.38%), while in pediatrics it was 0.15 % (95% CI 0.11-0.20%). Study limitations: the main weakness is that the results were obtained from an HMO and therefore the possibility of selection bias. Conclusions: chronic urticaria is a global condition. Its prevalence in Buenos Aires is comparable with other countries.

Urticaria papular y sus agentes causales en Colombia / Papular urticaria: A review of causal agents in Colombia

Resumen La urticaria papular es una enfermedad alérgica causada por la picadura de insectos, la cual predomina en el trópico. El objetivo de esta revisión fue profundizar en sus aspectos epidemiológicos e inmunológicos, particularmente con base en datos publicados en Latinoamérica. Se hizo una revisión no sistemática mediante la búsqueda electrónica de artículos sobre la epidemiología de la urticaria papular, las características entomológicas de los agentes causales y los mecanismos inmunológicos asociados. Según los diversos reportes de centros médicos de Latinoamérica la urticaria papular es frecuente; el único estudio de prevalencia publicado indica que afecta a una cuarta parte de los niños escolares de Bogotá. Hay información sobre la relación causal entre la exposición domiciliaria a la pulga, la pobreza y la urticaria papular en Bogotá, una ciudad representativa de las altitudes andinas. No hay estudios que indaguen directamente sobre los insectos causales en zonas cálidas, aunque se sospecha clínicamente de los mosquitos Aedes aegypti y Culex quinquefasciatus. En cuanto a su patogenia, se destaca la participación de mecanismos celulares que involucran las células colaboradoras Th2, lo cual explica que sea una condición de hipersensibilidad retardada. El papel de la inmunoglobulina E (IgE) en la urticaria papular no está tan claro. Se desconocen los antígenos derivados de los insectos que causan la enfermedad, aunque se plantea que existen moléculas comunes de reacción cruzada entre los insectos, tales como el alérgeno Cte f 2 en la pulga, y sus homólogos en los mosquitos. La urticaria papular es una condición frecuente en Latinoamérica que debe investigarse en profundidad. La caracterización inmunológica de los componentes moleculares que causan esta condición puede resolver interrogantes sobre su etiología y su patogenia.

Abstract Papular urticaria is a chronic allergic reaction induced by insect bites, which is common in the tropics. The objective of this review was to deepen on epidemiological and immunological aspects of this disease, focused on data published in Latin American countries. We conducted a non-systematic review of the literature through electronic search on the epidemiology of papular urticaria, the entomological characteristics of the causative agents and associated immunological mechanisms. Several reports from medical centers suggest that papular urticaria is common in Latin America. Only one epidemiological survey designed to estimate prevalence of papular urticaria has been published, reporting that about a quarter of children under six years of age is affected by this condition in Bogotá. There is evidence on the causal relationship among exposure to indoor fleas, poverty and papular urticaria in Bogotá, a representative city of the Andean altitudes. Information about causal insects in tropical warmer areas is scarce, although from clinical reports Aedes aegypti and Culex quienquefasciatus appear to be the most common. Th2 cellular-mediated mechanisms are involved in its pathogenesis, which explains its delayed hypersensitivity. The role of immunoglobulin E is not clear in this disease. Insect-derived antigens directly involved in papular urticaria etiology are unknown. However, it is possible that common molecules among causal insects mediate cross-reactive reactions, such as Cte f 2 allergen, found in cat fleas, and its counterparts in mosquitoes. Papular urticaria is a frequent disease in Latin America that should be further investigated. Immunological characterization of the molecular components that cause this condition may solve questions about its pathogenesis.

Incidence of allergic contact sensitization in central Chinese subjects with chronic urticaria

Abstract BACKGROUND: Chronic urticaria (CU) can be provoked by a wide variety of causes. Some studies suggest contact sensitization may play a role in the disease. OBJECTIVE: To investigate the incidence and distribution characteristics of allergic contact sensitization in central Chinese subjects with CU, and assess contact allergen avoidance measures in managing CU. METHODS: Patch tests were performed, following the recommended standard procedure, with 20 selected allergens, in line with the European baseline series. All subjects with positive results were prescribed appropriate avoidance measures for the sensitizing substances, while subjects with negative results served as the control group. CU severity was assessed daily from week1 to week4 and for each subject, applying the Urticaria Activity Score. RESULTS: 42.9% (233/543) of subjects with CU showed positive reactions to one or more contact allergen(s). Potassium dichromate, benzene mix and carba mix were more common in male patients, while nickel sulfate was more frequent in females. The positive rates for different allergens varied with age and occupation. The median (interquartile range) severity scores at week 1 were 20 (14-21) and 15 (14-27) for the allergen avoidance group and control group, respectively (P>0.05); and 12 (7-15) and 14 (12-17) at week 4 (P<0.001). CONCLUSION: The incidence of allergic contact sensitization in CU patients was high, and appropriate contact allergen avoidance measures benefitted CU management. Contact allergens may play a role in the pathogenic mechanism of CU and patch tests are an option for CU patients.

EPIDEMIOLOGÍA DE LA URTICARIA AGUDA EN UN SISTEMA DE SALUD PREPAGO DE LA CIUDAD DE BUENOS AIRES, ARGENTINA / Epidemiology of acute urticaria in a health maintenance organization of Buenos Aires, Argentina

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)

Epidemiology of angioedema without wheals in an allergy and immunology center

We describe the diagnostic epidemiology, the clinical course, the family history and the response to treatment of patients with angioedema without wheals (AWW) at an Allergy and Immunology Clinical Center. We reviewed the case records of all patients at our office from January 1997 to April 2013. We recorded sex, age, age at onset of symptoms, family history of angioedema, number of visits to the office, type of angioedema, and response to treatment from those patients with angioedema without wheals. We classified angioedema according to its pathophysiology. We also describe those patients with angioedema mimics. From a total of 17 823 new patients, 303 had a presumptive diagnosis of angioedema without wheals. Twenty-three patients had an angioedema mimic. Forty percent were male and 60% were female. Average age at first visit was 40.6. Average number of visits was 2.4. Fifty-seven patients referred a family history. We attributed idiopathic angioedema to 55.7% of patients, 24.3% were drug related, 15.7% were due to C1 inhibitor deficiency, 2.1% were drug related + idiopathic angioedema, 1.4% were type III and 0.7% had exercise-induced angioedema. Ninety six percent of 53 evaluable idiopathic angioedema patients referred a benefit with anti-histamine therapy. AWW was a rare cause of consultation. Most of our patients had anti H1 responsive idiopathic angioedema and none had allergic angioedema. Women cases prevailed over men´s. Family history and average age of onset of symptoms were different among the different types of angioedema.

Describimos la epidemiología, historia clínica, antecedentes familiares y respuesta al tratamiento de los pacientes consultando por angioedema sin urticaria en nuestra clínica especializada en Alergia e Inmunología. Revisamos retrospectivamente todas las historias clínicas de nuestro consultorio entre enero de 1997 y abril de 2013. Seleccionamos aquellos pacientes que habían consultado por angioedema sin urticaria y registramos el sexo, edad, edad de comienzo de síntomas, antecedentes familiares de angioedema, número de consultas, tipo de angioedema y respuesta al tratamiento. Clasificamos el angioedema de acuerdo a su fisiopatología. Describimos también los diagnósticos diferenciales que encontramos. De un total de 17 823 pacientes, 303 consultaron por angioedema sin ronchas. Veintitrés presentaban un diagnóstico alternativo. El 40% eran hombres y el 60% mujeres. La edad promedio de la primera visita fue 40.6 años. El promedio de consultas fue 2.4. Cincuenta y siete refirieron antecedentes familiares. El 55.7% fue clasificado como angioedema idiopático, el 24.3% secundario a drogas, el 15.7% secundario a deficiencia del inhibidor C1, 2.1% por drogas + idiopático, 1.4% angioedema tipo III y 0.71% asociado al ejercicio. Noventa y seis por ciento de 53 pacientes evaluables con angioedema idiopático se beneficiaron con antihistamínicos. El angioedema sin urticaria fue una causa rara de consultas. Las mujeres prevalecieron sobre los hombres. Los antecedentes familiares y la edad de comienzo de síntomas variaron de acuerdo al tipo de angioedema.

Urticaria crónica / Chronic urticaria

La urticaria crónica (VC), es una variante común de la urticaria que se define como un síndrome reactivo de la piel y mucosas caracterizado por la presencia de placas eritematosas, habones o ronchas edematosas y pruriginosas que se prolonga durante más de seis semanas. La etiología de la VC no es muy clara en la mayoría de los casos, multitud de causas se han implicado. La patogenia es compleja. El conocimiento y estudio de cada uno de los factores celulares y solubles, su interacción dinámica, vías efectoras y trama de citoquinas conducirá al logro de una terapéutica efectiva y racional de la urticaria crónica.

Chronic urticaria (VC) is a common variant of urticaria which is defined as a reactive skin and mucous membranes syndrome characterized by the presence of plaques erythematous, wheals, or swollen and itchy hives that lasts more than six weeks. The etiology of the VC is not very clear in the majority of cases, multitude of causes have been implicated. The pathogenesis is complex. Knowledge and study of each cell and soluble factors, their dynamic interaction, effector pathways and cytokines plot will lead to the achievement of an effective and rational therapy of chronic urticaria.

Urticaria aguda / Acute urticaria

La urticaria es una reacción de la piel caracterizada clínicamente por la aparición de elevaciones cutáneas eritematosas o blanquecinas, edematosas, pruriginosas y transitorias, que pueden localizarse en cualquier parte de la superficie cutáneao en las mucosas. Su etiología es variada y sus mecanismos etiopatogénicos también suelen ser múltiples. La lesión típica es el habón o roncha, el cuál cambia de lugar en horas, su forma y tamaño son variables, puede persistir minutos, horas o semanas. La mayoría de las urticarias no presenta sintomatología sistémica. Suele clasificarse regularmente en urticaria aguda, cuando lleva menos de 6 semanas de aparición, y en urticaria crónica, cuando lleva más de 6 semanas. El diagnóstico es fundamentalmente clínico. Es una entidad frecuente que por su gran expresividad motivan constantes y reiteradas consultas a los servicios de urgencia. En este artículo se examinarán los mecanismos que llevan a la urticaria y angioedema, y se revisará la patogénesis, los aspectos clínicos, los estudios de laboratorio necesarios y el tratamiento de la urticaria aguda.

The urticaria is a skin reaction characterized clinically by the on set of erythematous skin elevations or whitish, oedematous,pruritic and transient, you can locate anywhere on the surface of the skin or the mucous membranes. Its etiology is varied and its mechanisms etiopathogenic also tend to be multiple. The typical lesion is the wheal or bump, which changes from place with inhours, its size and shape are variable, may persist for minutes, hours or weeks. The majority of the hives does not pose systemic symptoms. Usually qualify regularly in acute urticaria, when it takes less than 6 weeks of appearance, and chronic urticaria, when it takes over 6 weeks. The diagnosis is primarily clinical. Itis a common entity that by their expressivity motivate constants and repeated consultations to emergency services. This article will xamine the mechanisms that lead to angioedema and urticaria, he pathogenesis, clinical aspects, necessary laboratory studies and eatment.

Qualidade de vida em urticária crônica: inquérito em ambulatório público universitário, Botucatu (Brasil) / Quality of life in chronic urticaria: a survey at a public university outpatient clinic, Botucatu (Brazil)

OBJETIVO: Avaliar o impacto da urticária crônica na qualidade de vida dos pacientes de ambulatório universitário a partir do questionário DLQI (Dermatology Life Quality Index). MÉTODOS: Inquérito sobre o impacto na qualidade de vida infligido pela urticária crônica a partir do questionário DLQI validado para a língua portuguesa. Pacientes foram entrevistados durante suas consultas em ambulatório especializado, entre maio de 2009 e maio de 2010, em serviço público brasileiro (Botucatu-SP). Os escores do DLQI foram analisados segundo subgrupos: idade, gênero, escolaridade, tempo de doença e presença de angioedema. RESULTADOS: Foram entrevistados 100 pacientes com urticária crônica. Predominou o gênero feminino (86 por cento), a idade média foi de 41,8 anos, duração média da doença foi de seis anos e angioedema ocorreu em 82 por cento dos pacientes. O escore médio do DLQI foi de 13,5, caracterizando grave impacto à qualidade de vida, superior a hanseníase, psoríase, eczema atópico e carcinoma basocelular. Presença de angioedema se associou a maiores escores: 14,5 x 9,9 (p < 0,01). Pacientes do gênero feminino referiram maior impacto quanto ao vestuário, já o gênero masculino referiu quanto ao tratamento, trabalho e estudo (p < 0,05). CONCLUSÃO: Urticária crônica inflige grave comprometimento da qualidade de vida nos pacientes avaliados em serviço universitário brasileiro, especialmente nos portadores de angioedema.

OBJECTIVE: To evaluate the impact of chronic urticaria on quality of life of outpatients through the university questionnaire Dermatology Life Quality Index (DLQI). METHODS: Survey of the impact on quality of life caused by chronic urticaria, using the DLQI questionnaire validated for the Portuguese language. Patients were interviewed during visits to a specialized outpatient clinic between May 2009 and May 2010 at a Brazilian public service (Botucatu-SP). DLQI scores were analyzed according to the following subgroups: age, gender, education, disease duration, and presence of angioedema. RESULTS: We interviewed 100 patients with chronic urticaria. There was a female predominance (86 percent), mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82 percent of patients. The mean DLQI score was 13.5, characterized by serious impact on quality of life, higher than Hansen's disease, psoriasis, atopic eczema, and basal cell carcinoma. The presence of angioedema was associated with higher scores: 14.5 x 9.9 (p < 0.01). Female patients reported greater impact on clothing, while male patients reported treatment interference with work and study (p < 0.05). CONCLUSION: Chronic urticaria seriously compromises the quality of life of patients evaluated at a university service in Brazil, particularly of patients with angioedema.

Prevalencia de dermografismo y sus factores asociados en estudiantes de medicina de una universidad particular de Lima - Perú / Dermographism prevalence and associated factors in medicine students from a private university, Lima - Peru

Objetivo: determinar la prevalencia de dermografismo y sus factores asociados en alumnos de la Facultad de Medicina de la Universidad Peruana Cayetano Heredia. Material y métodos: se realizó un estudio observacional de tipo caso control. Se incluyó a 74 alumnos de medicina con diagnóstico de dermografismo y a 77 controles comparables en sexo y edad. Resultados: la muestra de alumnos estuvo conformada por 47% mujeres, con una edad promedio de 21.13±2.7 años. Entre los casos, 28 (38%) tenían dermografismo sintomático (DS). Se encontró mayor frecuencia de prurito en los casos comparado con los controles (36% vs. 15.6%, p <0.05); de igual manera para el prurito asociado al ejercicio 53% vs. 33% (OR: 2.32; IC95%: 1.20-4.49), a quitarse la ropa 28% vs. 13% (OR: 2.66; IC95%: 1.15-6.12), al permanecer sentado prolongadamente 43% vs. 19% (OR: 3.15; IC95%: 1.52-6.52), estrés 47% vs. 30% (OR 2.11; IC95%: 1.11-4.11) y en el antecedente de asma/rinitis también fue mayor en los casos que en los controles 53% vs. 32% (OR: 2.32; IC95%: 1.20-4.49) con un p<0.05 en todos los casos. En el análisis de regresión logística multivariado se consideraron como factores asociados el permanecer sentado en forma prolongada y el antecedente de asma/rinitis con un p<0.05. Conclusión: Los factores asociados a dermografismo en los alumnos de la facultad de medicina fueron los antecedentes de asma y rinitis, así como el mayor prurito al permanecer sentado en forma prolongada.

Aim: to determine the prevalence of dermographism and its associated factors in medical students of the Universidad Peruana Cayetano Heredia. Methods: observational case control study. We compared 74 students diagnosed with dermographism with those 77 controls comparable in age and sex. Results: the student sample consisted of 47% women, with an average age of 21.13±2.7 years. Among cases, 28 (38%) had symptomatic dermographism (SD). A higher frequency of itching was found in the studied cases compared with controls (36% vs. 15.6%, p<0.05), as well as for itching associated to exercise (53% vs. 33%; OR: 2.32; IC95%: 1.20-4.49), itching when taking off clothes (28% vs. 13%; OR: 2.66; IC95%: 1.15-6.12), itching when seated from prolonged periods (43% vs. 19%; OR: 3.15; IC95%: 1.52-6.52), and itching associated to stress (47% vs. 30%; OR: 2.11; IC95%: 1.11-4.11). The history of asthma/rhinitis was detected more commonly in the cases than in controls (53% vs. 32%; OR: 2.32; IC95%: 1.20-4.49) with a p<0.05 in all cases. In the logistic regression analysis , variables such as remaining seated for prolonged periods and the asthma/rhinitis antecedent were considered of significant independent value, with a p<0.05. Conclusion: factors associated to dermographism in students were a previous history of asthma and rhinitis, as well as a significant itching when seated for prolongued periods.

Urticaria crónica y autoinmunidad tiroidea utilidad del testintradérmico de suero autólogo / Chronic urticaria and thyroid autoimmunity utility of autologous intradermal serum test

Introducción: La Urticaria Crónica (UC) es una patología de prevalencia creciente. La relación entre UC y autoinmunidad tiroidea tiene una asociación significativa. El test intradérmico de suero autólogo (TISA) es capaz de inducir un test positivoen la piel de pacientes con urticaria. Objetivo: Determinar la prevalencia de la enfermedad tiroidea autoinmune en pacientes que concurren a la consulta por UC. Correlacionar en pacientes con UC y enfermedad tiroidea autoinmune la positividad de TISA. Comparar resultados del TISA en pacientes con UC y controles sanos. Materiales y Métodos: Se estudiaron51 pacientes, 30 con UC y 21 pacientes sanos del grupo control. Edades: entre 22 y 77 años, desde 01/11/07 hasta el30/04/10. Se realizó historia clínica detallada; dosaje de hormonas tiroideas: hormona estimulante de tirotrofina (TSH), tiroxina libre (T4 libre); dosaje de anticuerpos antitiroideos: anticuerpo antiperoxidasa (ATPO), anticuerpo antitiroglobulina (ATG) y test de TISA. Resultados: Entre los pacientes con UC el 80 % (24) correspondieron al sexo femenino, la franja etaria predominantefue de 51 a 59 años. La mayoría de los pacientes fueron eutiroideos (50%), seguidos de hipotiroideos (30%) y porúltimo hipertiroideos (20%). La prevalencia de enfermedad tiroidea autoinmune en pacientes con UC fue de un 17%. El TISAresultó positivo en un 47% (14), de los sujetos con UC. En todos los pacientes con tiroiditis autoinmune el TISA resultó positivo. Sin embargo se encontró TISA positivo en 8 pacientes con disfunción tiroidea sin autoinmunidad y en un paciente del grupo control (sano). Conclusiones: Se objetivó una tendencia a la autoinmunidad en pacientes con UC. Un TISApositivo enpacientes sin autoinmunidad tiroidea, debería contemplar otros posibles autoanticuerpos y otros factores liberadores de histamina.Un TISA negativo es un marcador útil para determinar ausencia de anticuerpos funcionantes circulantes.

Introduction: Chronic urticaria (UC) is a disease of increasing prevalence. The relationship between UC and thyroid autoimmunityhas a significant association. The autologous intradermal serum test (TISA) is capable of inducing a positive test inthe skin of patients with urticaria. The chemical nature of the factors, defined UC as an antibody-mediated autoimmune disease.Objetive: Determine the prevalence of autoimmune thyroid disease in patients attending the consultation by UC.Correlate the TISA positivity in patients with UC and autoimmune thyroid disease. Compare results of the TISA in UC patientsand healthy controls. Material and Methods: 51 patients were studied, 21 and 30 with UC patients healthy control group.Age: between 22 and 77 years, from 01/11/07 to 04/30/10. It made detailed clinical history; dosing of thyroid hormones: thyrotrophin(TSH)- stimulating hormone, thyroxine l free thyroxine (free T4); dosing of antithyroid antibodies: antibody antiperoxidasa(ATPO), antibody antithyroglobulin (IGT) and test of TISA. Results: Among patients with UC 80% (24) werefemale, the predominant age Strip was 51 to 59 years. The majority of patients were eutiroideos (50%), followed by additivehypothyroid (30%) and finally hipertiroideos (20%). The prevalence of autoimmune thyroid disease in patients with UC was17%. The TISA resulted positive in a 47% (14) of the subjects with UC. The TISA was positive in all patients with autoimmunethyroiditis. However found positive TISA in 8 patients with thyroid without autoimmune dysfunction and a patient of(healthy) control group. Coclusions: We find a tendency to Autoimmunity in patients with UC. A positive TISA in patients withoutthyroid Autoimmunity should consider other possible autoantibodies and other histamine releasing factors. A negativeTISA is a marker that is useful to determine lack of circulating funcionantes antibodies.

Prevalence of common skin diseases among the elderly patients at Assiut University Hospital

To identify the prevalence of common skin diseases among elderly patients attending to the Dermatology Outpatient Clinics at Assiut University Hospital. Patient and methods: This study was conducted in Dermatology Out-patient Clinics at Assiut University Hospital. The sample of this study included all elderly patients attending to the previously mentioned setting during one year starting from the first of May 2009 to the end of April 2010. The total numbers of them were 450 elderly patients suffering from skin diseases. An interview sheet, which include Part I: It includes items related to socio-demographic characteristics such as age, sex, resident, marital status, level of education. Part II: Present, past history of skin diseases, and Family history of skin diseases. Among elderly patients 75.3% aged between [60- <70] years, 68.9% were males and 80.7% from rural areas. Also, 72.2% of the elderly patients had non-infectious skin diseases, while 27.8% of them had infectious skin disease. The highest percent 29.8% of skin diseases among of the elderly patients were in spring season. Less than three quarters of the studied sample had non-infectious skin diseases, while more than one quarters of them had infectious skin disease. Encouragement of the elderly people about the importance of follow up and periodic check-up to detect early health deviation to make early management and to prevent complication or any deterioration of the skin health. Utilizing the mass media, health classes in different health agencies could be achieved to increasing awareness of elderly people about the importance of prevention, early detection and control of skin diseases

Avaliação da associação entre doença auto-imune de tireóide e urticária crônica idiopática / Assessment of association between autoimmune thyroid disease and chronic urticaria

Vários estudos encontraram maior prevalência de Doença Auto-imune de Tireóide (DAT) em pacientes com Urticária Crônica (UC). Essa relação pode ocorrer devido à possível etiologia auto-imune em até um terço dos casos de Urticária Crônica Idiopática (UCI). No entanto, a freqüência de DAT variou de 1,14 por cento a 28,6 por cento. O princípio deste estudo foi determinar se ocorre associação entre DAT e UCI em uma população atendida em um mesmo centro de saúde. Comparamos a freqüência de anticorpos anti-tireoidianos e disfunção tireoidiana entre 49 pacientes com UCI (grupo 1) e 112 controles (grupo 2). Com a finalidade de fortalecer o resultado encontrado, estudamos a prevalência de UCI em 60 pacientes com DAT (grupo 3) comparados com 29 com doença não auto-imune de tireóide (DNAT) (grupo 4). Não encontramos diferença estatística quanto à presença de anticorpos anti-tireoidianos ou disfunção tireoidiana entre os grupos 1 e 2 (12,24 por cento x 9,82 por cento e 12,24 por cento x 7,14 por cento, respectivamente). O mesmo ocorreu quanto à presença de UCI entre os grupos 3 e 4 (3,33 por cento x 3,44 por cento). Em nosso estudo não foi possível demonstrar uma relação entre DAT e UCI, o que significa que diferentes populações podem apresentar maior ou menor grau de associação entre essas doenças.

Several studies found a higher prevalence of Autoimmune Thyroid Disease (ATD) in patients with Chronic Urticaria (CU). This relationship may be due to the possible autoimmune etiology in up to one third of the cases of Chronic Idiopathic Urticaria (CIU). However, the frequency of ATD ranged from 1.14 percent to 28.6 percent. The study began by determining whether there is an association between ATD and CU, in a population seen at the same clinic. We compared the frequency of anti-thyroid antibodies and thyroid dysfunction in 49 patients with CIU (group 1) and 112 controls (group 2). In order to support the result found, we studied the prevalence of CIU in 60 patients with ATD (group 3) and compared with 29 patients who had non-immune thyroid disease (NITD) (group 4). We did not find a statistical difference for the presence of anti-thyroid antibodies or thyroid dysfunction between groups 1 and 2 (12.24 percent x 9.82 percent and 12.24 percent x 7.14 percent, respectively). The same occurred for the presence of CIU among groups 3 and 4 (3.33 percent x 3.44 percent). In our study it was not possible to demonstrate a relationship between ATD and CIU, which means that different populations may present a higher or lower degree of association between these illnesses.

Food induced urticaria in children.

We conducted a prospective study at King Chulalongkorn Memorial Hospital, from June 2001 to November 2003, to identify the contribution of food allergy to urticaria in children. During the study period, 100 children with urticaria were enrolled, 36 of whom had a history suspicious of food allergy. Fifteen of 100 patients had fever (9 from upper respiratory tract infections, 4 from diarrhea and 2 from skin infections). A skin prick test (SPT) was positive in 15 of the 36 children who were suspected of having food allergy; 5 patients out of the positive SPT group had anaphylaxis due to food (2 from cow milk, 2 from wheat and 1 from egg). Six patients in the positive SPT group had a negative food challenge test (4 from open challenges and 2 from double-blind placebo-controlled food challenges [DBPCFC]). The other 4 patients of the positive SPT group refused the food challenge test. The parents of a patient who had urticaria from egg refused the skin prick test; an oral challenge test confirmed the diagnosis of egg allergy. One of the 21 patients that had a negative SPT had shrimp allergy proven by DBPCFC. Of the 64 patients who had no history related to food, SPT was done in 27 patients and revealed a positive result in 7 patients, all of whom had a negative food challenge test (4 with open challenge and 3 with DBPCFC). Urticaria from food was found in 7% and was suspected in another 4% of the patients. Severe reactions to food like anaphylaxis may occur. SPT alone is not adequate in making the diagnosis of food allergy; it must be confirmed by a food challenge test. Thirty percent of patients that did not have a history related to food had false positive SPT. Without a history suspicious of food allergy, SPT yields only minimal benefit.

Urticária- angioedema crônico: caracterização sociodemográfica, clinica e etiológica - Estudo em doentes atendidos no HC - FMB - UNESP no período de 1990 a 1998 / Urticaria - chronic angioedema: sociodemographic, clinical and etiological characterization - Study in patients attended at HC - FMB - UNESP from 1990 to 1998

Urticaria cronica-angioedema e uma enfermidade complexa, multicausal, de facil diagnostico clinico, representando cerca de 1,1% das consultas ambulatorial dermatologicas do H.C. da F.M.B., no periodo de 1990 a 1998. Os objetivos deste estudo visaram caracterizar a populacao atendida quanto aos aspectos sociodemograficos, clinicos e etiologicos, assim como o estudo de fatores agravantes e a evolucao da enfermidade nos doentes atendidos no referido periodo. Para os objetivos propostos, foram avaliados 125 doentes atraves de um protocolo previamente elaborado e constava de: identificacao, anamnese dirigida, exame dermatologico, fisico e subsidiario. Na avaliacao dos resultados, observou-se predominancia no sexo feminino, no grupo etario de 20 a 50 anos, principalmente na faixa dos 30 a 40 anos, com idade media de 35 anos para o sexo feminino e 32 para o masculino. Houve predominancia da cor branca e em moradores da zona urbana. Nao houve ocupacao prevelente e cerca de 60% eram casados. Com relacao aos aspectos clinicos, o tempo medio de duracao da enfermidade foi de 45,26 meses, as lesoes tiveram duracao media de 5,6 horas e o surto 6,5 horas. Nao houve horario preferencial para o aparecimento dos surtos e o periodo noturno foi o mais citado para piorar o quadro ja estabelecido. Nao houve fatores associados na maioria dos casos e o estresse foi o fator agravante mais citado. Na metade dos doentes houve associacao com angioedema e o quadro clinico ocorria diariamente, seguido de reaparecimento a intervalos irregulares. A renite foi o antecedente alergico pessoal mais citado e a bronquite a antecedente alergico familiar. A maioria dos doentes nao apresentavam urticaria na 1ª consulta ambulatorial e em 37% havia outra enfermidade associada. Entre outras doencas associadas, as alteracoes no aparelho genito-urinario, digestivo e respiratorio foram os mais citados, seguidos das doencas endocrinas, nutricionais ou metabolicas, transtornos circulatorios e mentais. Ao c...

Síndrome urticariano crónico. Estudio clínico epidemiológico / Acute urticarian syndrome. Clinical-epidemiological study

Se estudiaron 30 pacientes de edad comprendidas entre 1 y 14 años siendo el mayor porcentaje en el grupo etario de 5 a 14 años, así como la mayor frecuencias en el sexo femenino, no se pudo demostrar relación entre los casos estudiados y los antecedentes patológicos personales y antecedentes patológicos familiares de atopia, en la mayoría de los casos fue encontrada la giardiasís como causa fundamental y la respuesta al tratamiento fue satisfactoria.

Urticaria: uma revisao sobre os aspectos clinicos e ocupacionais / Urticaria: a review on clinical and occupational aspects

A urticaria, manifestacao clinica de uma serie de patologias, apresenta um perfil epidemiologico relativamente desconhecido para os profissionais da saude, em razao de suas caracteristicas peculiares, porque somente uma parcela dos casos (os de grande intensidade, os intercorrentes ou cronicos) chega aos servicos de saude...

A profile of skin disorders in children in Saurashtra.

Four hundred children, up to the age of 12 years, attending dermatological outpatients' department (OPD) in Irwin group of hospitals, Jamnagar were studied in detail. Desired investigations were done in addition to routine blood, urine, and stool examinations. Maximum number of cases (43.50%) were found in school going children. Highest number of cases were of skin infections (83.25%) followed by allergic (8.5%) and miscellaneous disorders (8.25%). Out of 333 cases of skin infections, 137 (41.14%) were of pyoderma, 113 (33.93%) of parasitic infections, 45 (13.51%) of fungal infections and 35 (10.51%) of viral infections. Amongst allergic disorders, atopic dermatitis was commonest followed by papular urticaria, unclassified eczema and contact dermatitis. Thirteen types of miscellaneous disorders (33 cases) were noted. Commonest being vitiligo (8 cases) and epidermolysis bullosa and ichthyosis, 6 cases each. Unhygienic living conditions seem to be an important factor responsible for higher incidence of skin infections in developing countries.