Clinical and laboratory features of chronic idiopathic urticaria in the elderly

Magen, Eli; Mishal, Joseph; Schlesinger, Menachem

doi:10.1111/ijd.12109

Cited by 32 publications

(51 citation statements)

References 21 publications

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“…In our study, we found a lack of female predominance in the elderly CU group, despite a 57.9% proportion of females in the total study population. This finding is in concordance with a previous report of an almost equal sex distribution in an elderly CU group [17]. All age groups can be affected by CU, but the peak age is between 20 and 40 years [21]; therefore, few studies on CU in the aged population have been performed.…”

Section: Discussionsupporting

confidence: 92%

“…The features of elderly CU are not due to structural and physiological changes in aging skin; therefore, our results showing no significant differences between the two groups in UAS or in the prevalence of severe CU exist despite changes in dermal thickness and the number of mast cells. This similarity in UAS for both groups is in agreement with a previous report [17]. To estimate urticarial activity accurately, recent trials have used UAS 7, which averages the daily UAS over 1 week [24].…”

Section: Discussionsupporting

confidence: 89%

“…Studies of the prevalence of AD accompanied by CU in the elderly are limited; however, one population-based cross-sectional survey reported higher rates of eczema and urticaria in adults [28]. The higher prevalence of AD in elderly CU patients in our study may be due to presumptive diagnosis of AD based on clinical signs [17]. In patients with AD, impaired skin barrier function facilitates the colonization of S. aureus ; ceramidases from this organism degrade ceramide (a component in the lipid matrix of the skin barrier).…”

Section: Discussionmentioning

confidence: 65%

“…All age groups can be affected by CU, but the peak age is between 20 and 40 years [21]; therefore, few studies on CU in the aged population have been performed. In this study, despite a less stringent definition of elderly as those over 60 years (versus over 65 years used in previous studies), only 4.4% of the subjects were elderly, versus 9.4% in a previous study [17]. Despite the small percentage of CU patients defined as elderly, it is important to identify the specific clinical features of this group due to the aging of the population.…”

Section: Discussionmentioning

confidence: 82%

“…Therefore, it is essential to identify specific features of chronic diseases in aged populations. Several studies have investigated the clinical presentation and etiopathogenesis of urticaria in the elderly population [15,16]; however, few have compared the clinical features of CU in the elderly to those of the nonelderly [17]. We investigated the prevalence and clinical features of CU in elderly versus nonelderly patients in Korea.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features of elderly chronic urticaria

Ban

Kim

Yoo

et al. 2014

Korean J Intern Med

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Background/AimsChronic urticaria (CU) is defined as itchy wheals lasting 6 weeks or more. As the aged population increases worldwide, it is essential to identify the specific features of this disease in the elderly population.MethodsWe investigated the prevalence and clinical features of CU in elderly patients. Medical records of 837 CU patients from the outpatient Allergy Clinic of Ajou University Hospital, Korea were analyzed retrospectively. Patients with chronic spontaneous urticaria according to the EAACI/GA2LEN/EDF/WAO guidelines were included. Patients older than 60 years were defined as elderly.ResultsOf the 837 patients, 37 (4.5%) were elderly. In elderly versus nonelderly CU patients, the prevalence of atopic dermatitis (AD) was significantly higher (37.8% vs. 21.7%, respectively; p = 0.022), while that of aspirin intolerance was lower (18.9% vs. 43.6%, respectively; p = 0.003) in terms of comorbid conditions. The prevalences of serum specific immunoglobulin E antibodies to staphylococcal enterotoxin A and staphylococcal enterotoxin B were considerably higher in elderly CU patients with AD than in those without AD (37.5% vs. 0%, respectively).ConclusionsElderly patients with CU had a higher prevalence of AD. Therefore, there is a need to recognize the existence of AD in elderly CU patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Clinical features of elderly chronic urticaria

Ban

Kim

Yoo

et al. 2014

Korean J Intern Med

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Chronic Spontaneous Urticaria

Kolkhir,

Bonnekoh,

Metz

et al. 2024

JAMA

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ImportanceChronic spontaneous urticaria affects approximately 1% of the general population worldwide, including approximately 3 million people in the US, impairs patients’ quality of life, and is associated with multiple comorbidities.ObservationsChronic spontaneous urticaria affects patients of any age but is most common in females aged 30 to 50 years. Diagnosis is based on clinical presentation, ie, spontaneously recurring wheals, angioedema, or both. Chronic spontaneous urticaria persists for more than 1 year in most patients (1 or repeated episodes) and may present with comorbidities including chronic inducible urticaria (&gt;10%), autoimmune thyroiditis (approximately 20%), metabolic syndrome (6%-20%), and anxiety (10%-31%) and depression (7%-29%). Known autoimmune endotypes (subtypes of urticaria defined by distinct pathogenesis) of chronic spontaneous urticaria are mediated by mast cell–activating IgE and/or IgG autoantibodies (&gt;50%). Approximately 40% of patients with chronic spontaneous urticaria have a Dermatology Life Quality Index of more than 10, corresponding to a very large or extremely large negative effect on quality of life. Second-generation H1 antihistamines are first-line treatment; partial or complete response, defined as a reduction in urticaria symptoms of greater than 50%, is observed in approximately 40% of patients. The 2022 international urticaria guideline recommends the monoclonal anti-IgE antibody omalizumab as second-line treatment for antihistamine-refractory chronic spontaneous urticaria. However, at least 30% of patients have an insufficient response to omalizumab, especially those with IgG-mediated autoimmune urticaria. Cyclosporine, used off-label, can improve symptoms in approximately 54% to 73% of patients, especially those with autoimmune chronic spontaneous urticaria and nonresponse to omalizumab, but has adverse effects such as kidney dysfunction and hypertension.Conclusions and RelevanceChronic spontaneous urticaria is an inflammatory skin disease associated with medical and psychiatric comorbidities and impaired quality of life. Second-generation H1 antihistamines are first-line treatment, omalizumab is second-line treatment, and cyclosporine is third-line treatment for chronic spontaneous urticaria.

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Clinical and laboratory features of chronic idiopathic urticaria in the elderly

Abstract: CIU in the elderly population is nearly equally distributed in both sexes and is characterized by fewer wheals, lower rates of concomitant symptomatic dermographism, lower rates of angioedema, and lower ASST positivity.

Cited by 32 publications

References 21 publications

Clinical features of elderly chronic urticaria

Clinical features of elderly chronic urticaria

Chronic Spontaneous Urticaria

Recurrent spontaneous clearance of psoriasis during exacerbations of concomitant chronic spontaneous urticaria

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