Clinical, pharmacological and immunological aspects of delayed pressure urticaria

Czarnetzki, Beate M.; Meentken, J.; Rosenbach, Thomas; Pokropp, A.

doi:10.1111/j.1365-2133.1984.tb04729.x

Cited by 48 publications

(15 citation statements)

References 16 publications

(9 reference statements)

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“…3,13 Clinicamente é caracterizada pelo surgimento de edema profundo, doloroso, eritematoso, ocorrendo de 30 minutos a 9 horas, após ter sido exercida uma pressão estática sobre a pele, e com duração de 12-72 horas. 4,5,13 O prurido é praticamente inexistente. 4 As lesões podem ser localizadas, em qualquer região do corpo.…”

Section: Discussionunclassified

“…2 Os sintomas perduram em média três anos, mas o curso natural da doença é variável, podendo persistir por vários anos, com períodos de remissão e de exacerbações. 2,[4][5][6] Na sua forma isolada, constituem menos de 2% de todas as urticárias. Dentre os pacientes com urticá-ria crônica idiopática, 37% têm UPT, enquanto mais de 90% dos pacientes com UPT têm urticária crônica idiopática ou angioedema associados.…”

Section: Introductionunclassified

“…4 O tratamento medicamentoso é, em geral, insatisfatório e inclui: anti-histamíni-cos, anti-inflamatórios não-esteroidais (AINES), corticosteroides tópicos ou sistêmicos, sulfasalazina e dapsona. 5 O uso de anti-histamínicos H1 tem pouco efei-…”

Section: Introductionunclassified

“…2,[4][5][6] Na sua forma isolada, constituem menos de 2% de todas as urticárias. Dentre os pacientes com urticá-ria crônica idiopática, 37% têm UPT, enquanto mais de 90% dos pacientes com UPT têm urticária crônica idiopática ou angioedema associados.…”

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Urticária de pressão tardia com manifestações sistêmicas: relato de caso

Dortas

Valle

Pires

et al. 2009

An. Bras. Dermatol.

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Resumo: A Urticária de Pressão Tardia é considerada uma doença rara, cujo quadro clínico é diferente da urticária clássica e pode envolver manifestações sistêmicas. Sendo assim, o diagnóstico é pouco frequente, até mesmo pelos especialistas. Neste artigo, apresentamos uma paciente, com história típica de lesões desencadeadas por pressão e que, por apresentar febre e leucocitose, foi internada para investigação de quadro infeccioso. Palavras-chave: Classificação; Diagnóstico diferencial; Urticária Abstract: Delayed Pressure Urticaria is considered a rare disease, with clinical diagnosis different from classical urticaria, with possible systemic manifestations. Therefore, it is frequently underdiagnosed, even by specialists. In this article, the case of a patient with a typical history of pressure-induced lesions is presented. Because the patient had fever and leukocytosis, she was admitted to a hospital for investigation of infection. Keywords: Classification; Diagnosis, differential; Urticaria 2 Clinicamente, a UPT se caracteriza pelo aparecimento de edema profundo, doloroso e eritematoso, ocorrendo de 30 minutos a 9 horas, após ter sido exercida uma pressão mecânica estática sobre a pele, 1,3,4 e com duração de 12 (doze) a 72 (setenta e duas)horas. 2Os sintomas perduram em média três anos, mas o curso natural da doença é variável, podendo persistir por vários anos, com períodos de remissão e de exacerbações. 2,[4][5][6] Na sua forma isolada, constituem menos de 2% de todas as urticárias. Dentre os pacientes com urticá-ria crônica idiopática, 37% têm UPT, enquanto mais de 90% dos pacientes com UPT têm urticária crônica idiopática ou angioedema associados. 4,6,7 É possível que esta doença não seja tão rara, mas pouco conhecida e subdiagnosticada, ou mesmo confundida com outras doenças, de caráter sistêmico. 6A UPT representa um dos tipos de urticária de mais difícil controle. A principal abordagem terapêuti-ca é a orientação para que o paciente evite situações que precipitem as lesões.4 O tratamento medicamentoso é, em geral, insatisfatório e inclui: anti-histamíni-cos, anti-inflamatórios não-esteroidais (AINES), corticosteroides tópicos ou sistêmicos, sulfasalazina e dapsona.5 O uso de anti-histamínicos H1 tem pouco efei-

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Urticária de pressão tardia com manifestações sistêmicas: relato de caso

Dortas

Valle

Pires

et al. 2009

An. Bras. Dermatol.

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“…12-Hydroxyeicosatetraenoic acid (12-HETE) is a less powerful leucocyte chemoattractant substance in vitro (PALMER et al 1980). In extracts of pressure lesions from a small number of patients with delayed pressure urticaria, chemotactic activity was found in L TB4 and 12-and 15-HETE, fractions though this was not statistically significant compared with controls (CZARNETZKI et al 1984). Thus, these compounds could be involved in the cellular response in the delayed urticarial reactions.…”

Section: Arachidonate Lipoxygenase Productsmentioning

confidence: 99%

Pharmacology of the Skin II

1989

Handbook of Experimental Pharmacology

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PrefaceThe recent interest in the pharmacology of the skin and the treatment of its diseases has come about for two reasons. The first is a realisation that many aspects of pharmacology can be studied as easily in human skin as in animal models, where they may be more relevant to human physiology and disease. Examples of this are the action of various vasoactive agents and the isolation of mediators of inflammation after UV irradiation and antigen-induced dermatitis. The second reason is the fortuitous realisation that a pharmacological approach to the treatment of skin disease need not always await the full elucidation of aetiology and mechanism. For example, whilst the argument continued unresolved as to whether the pilo-sebaceous infection which constitutes acne was due to a blocked duct or to a simple increase in sebum production, 13-cis retinoic acid, was found quite by chance totally to ablate the disease; again, whilst cyclosporin, fresh from its triumphs in organ transplantation, has been found able to suppress the rash of psoriasis, it has resuscitated the debate on aetiology.We are therefore entering a new era in which the pharmacology and clinical pharmacology of skin are being studied as a fascinating new way of exploring questions of human physiology and pharmacology as well as for the development and study of new drugs, use of which will improve disease control and at the same time help to define pathological mechanisms.It was because of this burgeoning interest in pharmacology of skin and its diseases, that this book came about. Indeed it is long overdue and was planned several years ago; we console ourselves with the thought that the delay may have served to help define certain principles which were then only just emerging.The book is divided into two volumes which are independent but complementary; the first being an account of the general pharmacology of skin, the second volume being more concerned with disease and drugs. The first volume is divided into two parts, the one dealing with the pharmacology of skin systems and their control and the other with autocoids in normal and inflamed skin. This second volume has three parts; the first part deals with the methods of measurement which are becoming of increasing importance both in studying the pharmacological effects of drugs and the clinical pharmacology of skin; the second deals with toxicology in its widest sense -including metabolism and percutaneous absorption; and the third is an account both of specific drugs and the drugs used for specific diseases.

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Delayed Pressure Urticaria Histologically Resembles Cutaneous Late-Phase Reactions

Mekori

Dobozin²,

Schocket³

et al. 1988

Arch Dermatol

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In a recent study, all patients with delayed pressure urticaria (DPU) developed late cutaneous reaction (LCR) after intradermal injection of compound 48/80 and after skin testing with certain food antigens. In the present study, we analyzed the histologic changes in the pressure lesions and compared them with those found in normal skin injected with diluent and in LCR to 48/80. The study included five patients with DPU associated with chronic urticaria (CU) and four patients with CU but without DPU. Six to eight hours after pressure challenge and intradermal skin testing with 48/80 and diluent, skin biopsy specimens were obtained from the pressure lesions, the LCRs, and normal skin (diluent injection). Specimens were assessed by Giemsa staining of 1-micron sections and immunofluorescence of frozen sections. Total cells were counted in each specimen. Interstitial deposits of fibrin were observed by immunofluorescence in LCR and pressure lesions. The total numbers of infiltrating cells in the dermis among LCR sites and pressure lesions were not significantly different, while both LCR sites and pressure lesions contained significantly more infiltrating cells than did normal skin injected with saline diluent. The differential counts in LCR and DPU were mostly mononuclear cells. Infiltrates in the DPU and LCR were mostly perivascular. No histopathologic changes were seen at skin sites challenged with pressure in the control patients with CU without clinical manifestations of DPU. We conclude that lesions seen in DPU are morphologically similar to classic LCR.

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Clinical, pharmacological and immunological aspects of delayed pressure urticaria

Cited by 48 publications

References 16 publications

Urticária de pressão tardia com manifestações sistêmicas: relato de caso

Urticária de pressão tardia com manifestações sistêmicas: relato de caso

Pharmacology of the Skin II

Delayed Pressure Urticaria Histologically Resembles Cutaneous Late-Phase Reactions

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