ABSTRACT
BACKGROUND: Chronic spontaneous urticaria (CSU) is an inflammatory skin disease with a complex physiopathology. Serum amyloid A (SAA), an acute-phase reactant, has been proposed as a potential biomarker in urticaria but has yet to be studied in a population with CSU or correlated with disease activity as indicated by the Urticaria Activity Score summed over 7 days (UAS7). OBJECTIVE: We sought to determine SAA-1 levels in patients with CSU and correlate them with its activity and control, as well as with clinical features of CSU and other potential blood biomarkers. METHODS: We conducted a retrospective multicenter study of 67 patients with CSU, from whom we obtained demographic and clinical data, UAS7 as an indicator of CSU activity, and blood and serum markers. RESULTS: SAA-1 levels positively correlated with UAS7 (rs = 0.47, P < .001). SAA-1 levels were higher in patients with noncontrolled (UAS7 > 6) CSU than in those with controlled (UAS ≤ 6) CSU (P < .001) and were also higher in patients with concomitant angioedema (P = .003) or delayed pressure urticaria (P = .003). CONCLUSION: We propose SAA-1 as a potential biomarker for activity in CSU. Further studies are required to evaluate its potential role as a biomarker for other CSU outcomes, such as response to treatment.
Subject(s)
Chronic Urticaria , Urticaria , Humans , Serum Amyloid A Protein/therapeutic use , Chronic Disease , Urticaria/diagnosis , BiomarkersABSTRACT
Intraoral contact allergy reactions are clinically poorly differentiated and understood, and are not very commonly described in the specialized literature. Although such reactions appear to be scantly relevant, evidence suggests that they may be more frequent than previously believed. No single or specific clinical picture of intraoral contact allergy exists, though lichenoid reactions appear to be the most common manifestations. Epicutaneous patch testing, together with the clinical manifestations, constitute the most widely used diagnostic approach in such situations. Metals used in dental practice--particularly amalgams and gold--are the most commonly reported causes of intraoral allergic reactions, though hypersensitivity to resins is increasingly mentioned in the literature, as a consequence of their increasingly widespread use. The systematic intraoral elimination or substitution of materials inducing cutaneous hypersensitivity has recently been questioned, while on the other hand it not possible to discard an allergic component in some nonspecific stomatological disorders. The present study offers clinicians an evidence-based update of current knowledge in this field.
Subject(s)
Dental Materials/adverse effects , Dermatitis, Contact/etiology , Mouth Diseases/immunology , Dermatitis, Contact/diagnosis , Dermatitis, Contact/physiopathology , Humans , Mouth Diseases/diagnosis , Mouth Diseases/physiopathologyABSTRACT
Las reacciones alérgicas de contacto intraoral son entidades clínicas pobremente diferenciadas y entendidas y que no se describen con demasiada frecuencia en la literatura especializada. Aunque parecen ser poco prevalentes, existen datos que sugieren que pudiesen ser mas frecuentes de lo que se pensaba. No existe un cuadro clínico único ni específico del proceso, si bien las reacciones liquenoides parecen ser la manifestación más habitual. El test del parche epicutaneo es la prueba, juntamente con la clínica, mas utilizada para el diagnóstico del proceso. Los materiales metálicos de uso odontoestomatológico, especialmente las amalgamas y el oro, son los que más se relatan como causantes de reacciones alergias intraorales, aunque cada vez se describen más casos de hipersensibilidad a las resinas, fruto de la univesalización de su uso. Recientemente se empieza a cuestionar la eliminación o sustitución intraoral sistemática de sustancias a las que existe hipersensibilidad cutánea y, del mismo modo, tampoco se puede descartar un componente alérgico en algunos cuadros clínicos estomatológicos inespecíficos. Pretendemos hacer una puesta al día para los clínicos, basada en la evidencia, del estado del conocimiento en esta materia (AU)
