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At least 19 recordsLinked to original sources
PubMed1995

[Chronic urticaria caused by penicillin. Results of monitoring cases of acute penicillin urticaria which developed into chronic urticaria].

Penicillin is known to cause allergic reactions with different clinical manifestations and possible immunologic mechanisms. The purpose of this study was to follow cases of established hypersensitivity to penicillin and its possible development into chronic urticaria. 35 patients with a clinical picture of acute urticaria and with or without angioedema were examined. Three kinds of tests to penicillin were performed: patch test, scarification test and PPL test. Hypersensitivity to penicillin was confirmed in 12 (34.27%) patients with positive PPL test. Seven (58.33%) out of these 12 developed the clinical picture of chronic urticaria. As food was assumed to be the hidden source of penicillin, eliminatory diet was included. In 4 (57.14%) patients there was a complete remission of the disease during the course of diet without milk and milk products (intradermal test to milk and specific IgE antibodies were negative). The gathered results show that acute urticaria caused by penicillin can get a chronic character. It is the consequence of prolonged penicillin's activity in some so called "hidden sources of penicillin".

Acute Disease↗
PubMed1993

Diagnosis and incidence of delayed pressure urticaria in patients with chronic urticaria.

BACKGROUND: The incidence of delayed pressure urticaria (DPU) may have been underestimated, particularly in patients with widespread wheals of concurrent idiopathic urticaria, because of difficulty in recognizing the association between pressure-related swellings and the preceding physical stimulus. Diagnostic tests for DPU have not been done routinely in studies of urticaria and have not been compared. OBJECTIVE: Our purpose was to establish the incidence of DPU and other physical urticarias in patients with chronic urticaria and to compare two reproducible pressure challenge tests. METHODS: One hundred thirty-five patients were tested for immediate dermographism, for DPU and, when indicated by the history, for cholinergic and/or cold urticaria. In patients with pressure-related symptoms, pressure challenge testing with a dermographometer (100 gm/mm2) was compared with a test that involves the application of 1.5 cm diameter weighted rods and more closely resembles a naturally occurring pressure stimulus. RESULTS: Physical urticarias were present in 96 patients (71%). Thirty patients (22%) had immediate dermographism, 50 (37%) had DPU, 15 (11%) had cholinergic urticaria, and 3 (2%) had cold urticaria. A 70-second pressure challenge with the dermographometer gave results comparable to the use of the weighted rods. CONCLUSION: DPU appears to be more common in chronic urticaria than previously reported and is present in some patients who do not report pressure-related wheals.

Adolescent↗
PubMed2001

Efficacy of leukotriene receptor antagonist in chronic urticaria. A double-blind, placebo-controlled comparison of treatment with montelukast and cetirizine in patients with chronic urticaria with intolerance to food additive and/or acetylsalicylic acid.

BACKGROUND: The cause and pathogenesis of chronic urticaria are still poorly understood. IgE-independent reactions, are common in adult patients with chronic urticaria, who have daily spontaneous occurrence of weals. H(1)-receptor antagonists (antihistamines) are the major class of therapeutic agents used in the management of urticaria and angioedema. Nevertheless, chronic urticaria is often difficult to treat and may not be controlled by antihistamines alone. It has been postulated that mediators other than histamine, such as kinins, prostaglandin and leukotrienes, may be responsible for some of the symptoms in urticaria which are not controlled by antihistamines. In this study, which was randomized double-blind, placebo-controlled, we compare the clinical efficacy and safety of montelukast (MT) 10 mg given once a day and cetirizine (CET) 10 mg given once a day with placebo (PLA), in the treatment of patients with chronic urticaria who have positive challenge to acetylsalicylic acid (ASA) and/or food additives. PATIENTS AND METHODS: A group of 51 patients, ranging in age from 15 to 71 years, with chronic urticaria and positive challenge to food additives and/or ASA, participated in this study for a period of 4 weeks, starting from a 3-day run-in. The assessment of the efficacy was based on scores of daily urticaria symptoms. RESULTS: MT significantly increased the percentage of symptom-free days for hive and itch. Analysis of frequency distribution of urticaria scores for each symptom gave similar results (MT vs. CET and MT vs. PLA, P < 0.001). The interference with sleep due to their skin condition was also lower in the group treated with MT (P < 0.001). In addition, the median number of days without the rescue medication was significantly higher in the MT group (24 days) than both the CET and the PLA groups (18 days, P < 0.001, and 20 days, P < 0.001, respectively). Finally, a low incidence of adverse events was observed in this study. CONCLUSION: The results of this comparative study demonstrate that montelukast orally administered once a day is very effective for the treatment of cutaneous symptoms in patients with chronic urticaria due to food additives and/or ASA.

Acetates↗
PubMed1981

Identification of a new physically induced urticaria: cold-induced cholinergic urticaria.

Four patients with symptoms suggestive of either cold urticaria or a combination of cold and cholinergic urticaria were studied. However, all patients were negative to an ice-cube test or cold-immersion test and had no urticaria after exercise in a warm environment. When each patient was seated in a cold room (4 degree C) for 5 to 15 min, generalized urticaria appeared, consisting of puncture wheals and surrounding erythema as seen in cholinergic urticaria. Two patients had weakly positive methacholine skin tests and the other two had completely negative tests. When serial venous blood samples were obtained to test for mediator release, three of four patients had evidence of histamine release and the time course was similar to that previously reported for patients with cholinergic urticaria. These four cases represent a new syndrome with features suggestive of cold and/or cholinergic urticaria, but the results of all the tests usually utilized to diagnose these conditions were negative. We have called this disorder cold-induced cholinergic urticaria to indicate that it is cold dependent and visually indistinguishable from cholinergic urticaria.

Adolescent↗
PubMed2003

Comparison of chronic autoimmune urticaria with chronic idiopathic urticaria.

BACKGROUND: Chronic urticaria has been described in patients with Helicobacter pylori infection. Despite numerous studies, the correlation between H. pylori infection and chronic urticaria is doubtful. Our study was performed to determine the prevalence of H. pylori infection in autoimmune urticaria and in patients suffering from autoimmune urticaria and autoimmune thyroiditis. METHODS: The authors widely investigated 48 patients. The examinations were extended principally to autologous serum skin test, antithyroid antibodies, and the presence of H. pylori infection as well as detection of antibodies against H. pylori. RESULTS: Out of the 48 patients, 26 were regarded as having autoimmune origin. The prevalence of antithyroid antibodies was different in the two groups of patients with urticaria. There were 11 patients (42.3%) in the autoimmune group compared with three patients (13.6%) in the nonautoimmune group with antithyroid peroxidase antibody (P = 0.03). The difference in the prevalence of H. pylori infection was significant between autoimmune urticaria with and without thyroid autoimmunity (90.9% vs. 46.7%; P = 0.02). Autoimmune thyroiditis was connected with CagA +H. pylori strains, as the H. pylori- specific IgG antibodies revealed significant differences in a prevalence of 120 kDa (P < 0.05). CONCLUSIONS: The authors observed a relationship between autoimmune urticaria and autoimmune thyroiditis. The results strengthen the possibility of cross-reactivity being triggered between CagA plus H. pylori strains and some other organ-specific autoimmune diseases such as autoimmune urticaria and autoimmune thyroiditis. This indicates a possible role of H. pylori in triggering autoimmune urticaria in at least a select group of patients.

Adolescent↗
PubMed1975

In vivo studies of mediator release in cold urticaria and cholinergic urticaria.

Six patients with cold urticaria were found to possess elevated plasma histamine levels after cold challenge by placing one hand in ice water for 4 minutes. A single patient became hypotensive during the procedure and had a level of 260 ng/ml. histamine in the venous effluent from his hand. No elevation of plasma serotonin or bradykinin was observed. Two patients with cholinergic urticaria possessed elevated plasma histamine levels during and after vigorous exercise for 10 minutes; these patients also gave a positive test for vibration-induced angioedema. A single patient with cholinergic urticaria possessed elevated baseline serotonin levels and elevated levels during and after exercise but no elevation of plasma histamine or bradykinin. The results suggest that histamine is the major mediator of urticaria and hypotension in cold urticaria. Histamine also appears to be released coincident with the development of urticaria in some patients with cholinergic urticaria, while elevated serotonin levels in a single atypical patient suggest that a subpopulation of patients with cholinergic urticaria possess a different pathogenesis.

Blood Pressure↗
PubMed1985

[Effect of ketotifen in urticaria factitia and urticaria cholinergica in a crossover double-blind trial].

Forty patients with urticaria, 13 with cholinergic urticaria, 22 with urticaria factitia, and 5 with both types of urticaria, were treated with ketotifen or placebo in a double-blind crossover study. Five patients dropped out, one because of excessive weight gain. In 23 of 24 patients with urticaria factitia, ketotifen caused a marked reduction of wealing and pruritus. In contrast, only 62% of the patients with cholinergic urticaria noticed a reduction of wealing, and 69% had reduced itching. Ketotifen caused few side effects, the most frequent one being mild tiredness in 9% of the patients. The beneficial effect of ketotifen in urticaria factitia and cholinergic urticaria may be due to its ability to reduce the liberation and the effectiveness of mast cell mediators.

Clinical Trials as Topic↗
PubMed2001

[The study of 18 cases of aspirin urticaria at dermatology of Yodogawa Christian Hospital--on the difference between aspirin asthma and aspirin urticaria].

Aspirin intolerance manifests itself as two clinical symptoms, urticaria/angioedema and asthma. However, there is seldom patient of aspirin intolerance who has the both symptoms, urticaria and asthma. So we suspect that the pathogenic mechanism for aspirin urticaria differs from that for aspirin asthma. We examined 18 patients of aspirin urticaria at dermatology of Yodogawa Christian Hospital, especially as to oral aspirin challenge test. All patients had no symptom of asthma. Threshold dose evoke urticaria/angioedema after ingesting 100 to 500 mg of aspirin (average, 311 mg). Urticaria/angioedema occurred within 50 minutes to 14 hours (average, 3 hours 16 minutes) after ingesting aspirin. The dose and the time of oral aspirin challenge test for these 18 patients were more spent than those for reported patients of aspirin asthma. These results support the opinion that aspirin urticaria has the different pathogenic mechanism from aspirin asthma. In addition, we experienced one patient of aspirin intolerance which caused hyperemia and edema of the bulbar conjunctiva. She had no symptom of urticaria and asthma, and had the both character of aspirin urticaria and asthma as to aspirin challenge test. We propose that aspirin intolerance is classified in reaction of the skin (urticaria/angioedema) and reaction of the mucosa (asthma), and it has an intermediate type.

Adolescent↗
PubMed1986

Clinical characteristics of cold-induced systemic reactions in acquired cold urticaria syndromes: recommendations for prevention of this complication and a proposal for a diagnostic classification of cold urticaria.

The acquired cold urticaria (ACU) syndromes consists of nonfamilial heterogeneous disorders characterized by urticaria, angioedema, and occasionally symptoms of hypotension after cold exposure. In a study of 50 consecutive patients with ACU syndromes, it was observed that 70% experienced cold-induced systemic reactions, most frequently with aquatic activities. Patients with ACU syndromes were categorized by their response to an experimental cold-stimulation time test (CSTT) i.e., minimum time threshold of cold stimulation required to induce a coalescent wheal. One subpopulation of patients with ACU syndromes with positive CSTTs of 3 minutes or less experienced the highest incidence (68%; 13/19) of severe systemic reactions with hypotensive symptoms after natural cold exposure. However, 32% of patients with ACU syndromes (6/19) who experienced cold-induced systemic reactions with hypotension had a negative CSTT or a positive test of greater than 3 minutes. These observations indicate that all patients with ACU with active histories of cold urticaria are at risk to develop systemic reactions to cold and should therefore refrain from participating in aquatic activities. In addition, high-risk patients should receive prophylactic medications (i.e., cyproheptadine or doxepin) that are effective in suppressing this disorder. A diagnostic classification of cold urticaria is presented. This classification permits a more specific definition of the various cold urticaria disorders that comprise the ACU syndromes.

Adolescent↗
PubMed1975

Reactions to aspirin and food additives in patients with chronic urticaria, including the physical urticarias.

In 131 patients with chronic urticaria, including physical urticarias, oral provocation tests were done with aspirin. A total of thirty-one patients showed a reaction on aspirin challenge. Reactions were seen in 35% of patients with idiopathic urticaria, 52% of patients with cholinergic urticaria, and 43% of those with pressure urticaria. The patients with reactions to aspirin were also tested with tartrazine, sodium benzoate, 4-hydroxybenzoic acid, sodium- and phenyl salicylate and the analgesics indomethacin, paracetamol and mefanamic acid. In nineteen of twenty three aspirin sensitive patients, positive reactions to one or more of these substances were observed. Indomethacin and tartrazine had the highest scores. There was no statistically significant correlation between aspirin reactions and the presence of nasal polyposis, sinusitis, asthma or atopy.

Aspirin↗
PubMed1975

Contact urticaria syndrome. Contact urticaria to diethyltoluamide (immediate-type hypersensitivity).

Contact urticaria refers to a wheal-and-flare response occurring on the application of chemicals to intact skin. Standard closed patch tests read at 48 hours after application yield misleading information; observations should be made instead using open patch tests 15 to 30 minutes after application. There are three major subdivisions of the syndrome: nonimmunologic cause (such as application of histamine), immunologic cause (immediate hypersensitivity), and uncertain cause (such as application of ammonium persulfate). Our patient had contact urticaria due to the insect repellent, diethyltoluamide. The experimental data suggest that this case was due to an immunologic response (immediate hypersensitivity) and demarcates the specificity of response. The immunologically mediated cases cover a broad spectrum of manifestations from contact urticaria only to local urticaria plus asthma and, in extreme sensitivity, includes anaphylactoid responses.

Adult↗
PubMed1981

[Diagnostic use of a radioenzyme test in urticaria-like disorders and in urticaria-angioedematous syndromes].

The Authors report the results obtained with the histamine radioenzymatic test in the evaluation of the histamine content of granulocytes of 91 subjects, suffering from urticaria and urticaria-angioedema syndrome. The laboratory investigation was also integrated, according to the clinical implications, by other in vitro tests such as: kallikrein, RAST, PRIST, secretory IgA, precipitins assays. In urticaria-angioedema syndrome the quantitative and functional evaluation of C1-esterase inhibitor was also performed, to exclude the heredity of these pathologic forms. Basing on the results obtained, the authors expect that the granulocyte histamine radioenzymatic assay is highly reliable from the diagnostic viewpoint in the urticaria and angioedema forms.

Adolescent↗
PubMed1988

Combined cold urticaria and cholinergic urticaria--clinical characterization and laboratory findings.

Thirteen patients with both cold and cholinergic urticaria are reported. There was considerable variability, particularly in the cold urticaria which was of the common cold contact type in seven patients, of the generalized cold induced cholinergic type in two and in four patients the lesions induced by direct contact with ice were morphologically like cholinergic urticaria, but appeared despite prior application of an acetyl choline antagonist. The natural history, laboratory findings and the effects of therapy are discussed.

Adolescent↗
PubMed1987

[Chronic urticaria--an inventory proposed by the Urticaria Study and Research Group].

The Urticaria Study and Research Group (Groupe d'Etudes et de Researches de l'Urticaria, G.E.R.U.) was formed in the Dermatology Department of the Hôpital Michel Levy in 1983 and now it continues to operate in the new Dermatology Department of the C.H.U. Timone Adultes. This has been possible because in four years 400 cases of urticaria have been seen and computerized information on these will appear in the next issue. As a result of this experience, we have been able to lay out a prospective study and develop a rigorous methodology.

Chronic Disease↗
PubMed1986

[Heat-contact urticaria and cold-contact urticaria (case report)].

A 40-year-old female patient has been suffering from localized heat urticaria for 8 years and, in addition, from localized cold urticaria for 1 year. Both diseases could be proved by adequate physical tests. Exposition to localized heat provoked decreased serum complement, suggesting activation of the alternative pathway.

Adult↗
PubMed1989

Basophil histamine release and lymphocyte proliferation tests in latex contact urticaria. In vitro tests in latex contact urticaria.

Basophil histamine release and lymphocyte proliferation tests were examined with latex allergen prepared from surgical gloves in 15 patients with latex contact urticaria. The basophil histamine release test (BHRT) yielded positive results in 13/14 (93%) patients, whereas commercial latex RAST was positive in only 9/15 (60%) patients. Lymphocyte proliferation test (LPT) was positive in 3/15 (20%) patients, suggesting that cell-mediated immune reactions may also occur in latex allergy. However, patch tests to latex were negative and neither were epidermal Langerhans cells able to present latex antigen to T lymphocytes in vitro.

Adult↗
PubMedDate not supplied

Clinical and therapeutical aspects of cold urticaria (urticaria a frigore).

A new drug with inhibitory properties on the Mast Cell degranulation, Ketotifen, was administered in 87 patients suffering from idiopathic urticaria a frigore (iUF). The first group (A), with 52 patients effectuated prophylactic management for 4 months with Ketotifen (K) (2 mg/day) and Clemastine (C) (2 mg/day) according to the double blind crossover method. Both the drugs were administrated in stages of 2 months each. The second group (B), with 35 patients (having previously failed a prophylactic attempt with Cyproheptadine) received only K, for two months. The results of group. A were favourable (clinical improvements over 50%) in 86.6% of the patients treated with K and in 50% of the patients treated with C. The mention is made that 36.6% from favourable results obtained with C in the second stage, appeared as a continuation of the improvements determined by K in the first stage. The lowering of the skin response to Cold Test (CT) was obtained in 55.8% of the patients treated with K and only in 7.6% of them who received C. Group B obtained favourable clinical results in 62% cases and the diminution of CT in 42% cases. Finally a few lesser known clinical and aetiopathogenic aspects of iUF resulting from the analysis of the patients investigated are presented.

Adolescent↗