Urticária aquagênica familiar: relato de dois casos e revisão da literatura

Seize, Maria Bandeira de Melo Paiva; Ianhez, Mayra; Souza, Patricia Karla de; Rotta, Osmar; Cestari, Silmara da Costa Pereira

doi:10.1590/s0365-05962009000500015

Cited by 17 publications

(3 citation statements)

References 8 publications

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“…All of the above is consistent with our case presentation. Nonetheless, isolated reports have documented familial occurrence 9‐11 and concomitance with Bernard‐Soulier syndrome, 12 polymorphic light eruption, 13 familial lactose intolerance, 11 and papillary carcinoma of the thyroid 14 . Due to the paucity of these observations, it remains unknown whether these conditions share a common background or whether there are various predisposing factors (genetic and/or environmental).…”

Section: Discussionmentioning

confidence: 99%

Aquagenic urticaria: Water, friend, or foe?

Robles‐Tenorio

Tarango-Martínez

Sierra-Silva

2020

Clinical Case Reports

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Water, one of the fundamental symbols of life, can become a nuisance for some individuals. Aquagenic urticaria (AU) is an extraordinary type of physical or chronic inducible urticaria (CI-U) elicited by water exposure. With around 100 cases been described in the literature, the disease has received little to no attention by the scientific community. Presently, pathogenesis remains unknown. The diagnosis is supported by clinical history and confirmed by provocation tests, which include the discrimination from other CI-Us. Since trigger avoidance is nearly impossible, treatment is based on symptomatic control. Here, we present the first case of sporadic AU in Mexico, as well as an updated revision of the relevant literature. This work contributes to the scant reports documented in the Latin-American population. 1,2 Our patient showed an adequate therapeutic response to a second-generation antihistamine and a skin barrier-repairing cream. Treatment efficacy was assessed by applying two validated questionnaires aimed at measuring disease-related symptom severity and quality of life (QoL). 2 | CASE REPORT An otherwise healthy 53-year-old Mexican female patient presented with a 40-year history of generalized pruritus and wheal formation during bathing and dishwashing, which lasted for 30-60 minutes after ceasing water contact. The patient had been previously self-treated with unspecified cleansers, soaps, and commercial creams, noting variable but insufficient relief. Symptoms did not occur during physical activity, emotionally stressful situations, or exposure to temperature changes. Angioedema and dyspnea had never been present during active disease or under any other circumstance. The patient denied previous history of asthma, atopy, or allergies. No family members were affected. On physical examination, skin appeared clear and dermographism was negative. In order to induce the appearance of lesions, water-provocation tests were performed according to current recommendations. 3-6 Wet compresses were applied for 20 minutes, yielding a negative result. Next, in-office water immersion of the right arm was performed. After 5 minutes, multiple wheals, intense erythema, and pruritus developed over the wet area (Figure 1). Cold and heat urticaria were excluded by exposing the patient to an icepack and a heating pad, as per suggested by urticaria guidelines. 3,4,6 Testing for other types of CI-Us was omitted based on the history of present illness and the positive water-challenge test. Accordingly, the diagnosis of sporadic AU was established. Symptomatic treatment was initiated with cetirizine 10 mg daily and frequent use of a ceramide-containing moisturizing cream. After 1 month of treatment, cetirizine was

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Section: Discussionmentioning

confidence: 99%

Aquagenic urticaria: Water, friend, or foe?

Robles‐Tenorio

Tarango-Martínez

Sierra-Silva

2020

Clinical Case Reports

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“…Because aquagenic urticaria may be associated with other types of physical urticaria, such as dermographism, cholinergic urticaria, and cold urticaria167891011, these condition should be excluded, especially cholinergic urticaria, in which the wheals are similar morphologically2. Previously reported cases of aquagenic urticaria are described in Table 11234567891011121314151617.…”

Section: Discussionmentioning

confidence: 99%

“…However, the various emollients and water-resistant creams investigated have not yielded conspicuous success14, except in a few cases in which a petrolatum-containing ointment was applied before water exposure414. Anticholinergics such as scopolamine may also offer relief15. Most of the patients were successfully controlled with antihistamines, although some of them changed treatment modalities because of drowsiness.…”

Section: Discussionmentioning

confidence: 99%

Aquagenic Urticaria Diagnosed by the Water Provocation Test and the Results of Histopathologic Examination

et al. 2017

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An 18-year-old male visited our department complaining of recurrent episodes of an itchy rash after hand washing, showering/bathing, drinking water, and getting rain-soaked. He was diagnosed with aquagenic urticaria after a water provocation test and histopathologic examination. Five months of antihistamine treatment successfully prevented further wheal formation. Aquagenic urticaria is a very unusual form of physical urticaria caused by contact with water. It manifests as pruritic small wheals surrounded by erythema within 30 minutes of exposure. The condition can be diagnosed by a water provocation test. Systemic antihistamines are the first-line treatment, with anticholinergics, phototherapy, or barrier cream used alternatively or additionally. Four cases of aquagenic urticaria have been reported in Korea, but no histopathologic evaluation was reported in the English or Korean literature. Herein, we provide both a case report of aquagenic urticaria diagnosed by the water provocation test and histopathologic examination results for this patient.

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