Recurrent urticaria: clinical investigation of 330 patients

Juhlin, Lennart

doi:10.1111/j.1365-2133.1981.tb15306.x

Cited by 350 publications

(197 citation statements)

References 16 publications

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“…An alternative pathogenic mechanism hypothesized (Lessof, 1991) is a reduction of the intestinal barrier against chemical compounds, such as histamine, contained in some foods that may trigger pseudoallergic reactions. In fact, many patients suffering from CIU attribute their symptoms to food intolerance (Julin, 1981;Sayag et al, 1988;Bischoff & Manns, 1998).…”

Section: Discussionmentioning

confidence: 99%

“…Chronic idiopathic urticaria (CIU) is de®ned as repeated episodes or even continuous urticaria of unknown origin (Champion, 1988;Kaplan, 1988) and without any evidence if IgE mediated reaction (Warin, 1976). About 30 ± 40% of patients with chronic urticaria attribute their symptoms to food intolerance (Julin, 1981;Sayag et al, 1988), even if the affected person is seldom able to exactly identify the causative food. The possible pathogenic role of pseudoallergic reactions to food has been repeatedly discussed.…”

Section: Introductionmentioning

confidence: 99%

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Histamine plasma levels and elimination diet in chronic idiopathic urticaria

Guida

Martino

et al. 2000

Eur J Clin Nutr

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Objective: The aim of this study was to evaluate the effects of an oligoantigenic and histamine-free diet on patients affected with chronic idiopathic urticaria (CIU). Design: Ten patients with chronic idiopathic urticaria were prescribed an oligoantigenic and histamine-free diet for 21 days, followed by serial and controlled reintroduction of foods during a further 70 days. Modi®cation in clinical illness as well as histamine plasma levels, post-heparin plasma diamine oxidase (DAO) and intestinal permeability were evaluated. Results: The oligoantigenic and histamine-free diet induced a signi®cant improvement of symptoms (P`0.05). Moreover, CIU patients on free diet showed higher histamine plasma levels (P`0.05 vs post-diet and vs controls) that fell to control levels during the oligoantigenic and histamine-free diet. Post-heparin plasma diamine oxidase values were slightly reduced and were unchanged during the diet as well as intestinal permeability, which was always normal in all patients. Conclusions: These data suggest that histamine plays a major role in chronic idiopathic urticaria. The ®nding of normal intestinal permeability suggests that a morphological damage of intestinal mucosa should be excluded in these patients. However, the presence of low levels of post-heparin plasma diamine oxidase may indicate a subclinical impairment of small bowel enterocyte function that could induce a higher sensitivity to histaminerich or histamine-producing food. Descriptors: chronic idiopathic urticaria; diet; histamine; diamine oxidase; intestinal permeability

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Histamine plasma levels and elimination diet in chronic idiopathic urticaria

Guida

Martino

et al. 2000

Eur J Clin Nutr

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“…In our patients, urticaria was more common in males and the Saudi nationals outnumbered other nationalities. Previous studies showed either no sexual or racial predilection 7,14 or females predominated over males. 15 Urticaria was found to affect all age groups and the highest incidence was among young adults as in other studies.…”

Section: Prevalence and Incidencementioning

confidence: 99%

“…The physical urticarias can be identified from the history and their diagnosis can easily be confirmed by specific and simple clinical tests. 8,25 Urticaria had been reported with a wide variety of pathologic and systemic disorders; 14,15,20,21 however, its association with internal diseases was thought to be uncommon. 26 In this study, a miscellaneous group of underlying systemic causes was identified and included the urticarias associated with pregnancy, systemic lupus erythematosus, diabetes, thyrotoxicosis, malignancy and hereditary angioedema.…”

Section: Etiological Factorsmentioning

confidence: 99%

Experience in Urticaria with Patients Attending a Dermatological Clinic in a Referral Center in the Eastern Province of Saudi Arabia

Uthman

El-Nuhdi

1995

Annals of Saudi Medicine

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Urticaria is a common cutaneous vascular reaction pattern caused by diverse and multiple factors. However, an etiologic factor can be established in less than 20% of chronic cases. In this study, 274 patients with urticaria were evaluated in the dermatology clinic of King Fahd Hospital of the University (KFHU) between 1989 and 1992. Saudi nationals predominated; 188 patients were males (68.6%) and 86 were females (31.4%) and the peak incidence of urticaria was in young adults. The incidence of urticaria was 3.79% of dermatological cases. The success rate for identification of etiological factors was 41% in acute urticaria and 14% in chronic urticaria. The etiological categories discovered included allergies, physical factors, infections and miscellaneous systemic factors. In conclusion, causative factors remained elusive in the majority of cases. The identification and removal of the possible causative factors is the most important aspect of management in urticaria. A detailed history and physical examination are in order; however, extensive laboratory investigations are unnecessary. Ann Saudi Med 1995;15(1):10-13. MAE Uthman, M El-Nuhd, Experience in Urticaria with Patients Attending a Dermatological Clinic in a Referral Center in the Eastern Province of Saudi Arabia. 1995; 15(1): 10-13Urticaria is a common cutaneous eruption characterized by evanescent, pruritic and slightly erythematous plaques or papules. The incidence of urticaria has been estimated to vary from 10% to 25% in the general population.1 Urticaria is a vascular reaction pattern which can be caused by multiple and diverse factors. These factors activate mast cells as well as other cells (e.g., eosinophils, basophils, neutrophils, endothelial cells and platelets) with the release of their vasoactive and chemotactic mediators of inflammation. 2,3 Histamine is the best known mediator of increased vascular permeability and itching in urticaria; however, serum factors, kinins, fibrin degradation products, leukotriens and various enzymes have also been recognized to play a pathogenic role in urticaria. 3,4 Therefore, the pathogenetic mechanism involved in urticaria can be classified as either immunological or nonimmunological reactions. 5,6 In clinical practice, an urticarial eruption can easily be diagnosed; however, finding the etiological factor(s) involved can be difficult and impossible in the majority of cases.7 To the best of our knowledge, reports of urticaria from the Middle East and in particular from Saudi Arabia are unavailable. This study was undertaken to highlight the prevalence of urticaria and to evaluate its etiological factors involved in patients referred to our dermatology clinic. Patients and MethodsWe interviewed and reviewed all patients with urticaria seen consecutively at the dermatology clinic of King Fahd Hospital of the University (KFHU) in Al-Khobar from 1989 to 1992. The number of patients forming the basis of our statistical analysis was 274 and the case records of 34 patients were excluded for either an incorrect or a ...

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“…Patients with urticaria may have symptoms of pruritus, wheals (edematous, erythematous central clearing papules or plaques) and swelling of mucous membrane when it co-exists with angioneurotic edema (Kaplan, 2002). Other psychological symptoms may include depression and anxiety and; severity of pruritus appears to increase as depression worsens (Juhlin, 1981;Finlay, 2000). Generally, patients with skin disorders tend to avoid social company in order to prevent public ridicule and rejection.…”

Section: Introductionmentioning

confidence: 99%

Anxiety State and ITS Psychosocial Consequences among Acne Vulgaris and Chronic Urticaria Patients in Abuja

Ukonu¹,

Ibekwe²,

Ezechukwu³

2015

IJPS

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BACKGROUND/OBJECTIVE: the skin defines the essence of beauty and overall perceived attention within a social context. As such, there is a relationship between skin diseases and the extent of provoked emotional psychological disturbances and social concern that the sufferers do have. This study therefore seeks to ascertain levels of anxiety and their psychosocial consequences among sufferers of acne vulgaris and chronic urticaria in dermatological outpatient in Abuja-Nigeria. MATERIALS/METHODS: this study was a prospective, cross sectional study carried out on consecutive consented dermatological outpatients who had acne vulgaris (N = 62) and chronic urticaria (N = 31) over a period of nine months (June 2013-February 2014) and 50 apparently healthy control matched for age and sex were recruited into the study. Diagnosis of acne vulgaris and chronic urticaria were clinically made. Questions on State Trait Anxiety Index STAI (Y-1) form were used to determine their present feelings and level of perceived anxiety within the society as a result of acne vulgaris and chronic urticaria. Total STAI score greater than 54 suggests severe level of anxiety and univariate analysis of variance was used to determine relationship between anxiety and its social consequences. Data was keyed into and analysed with SPSS 20.RESULTS: ratio of male: female for subjects is 1:1.9 and 1:1.3 for controls while mean age in years ± Standard Deviation (SD) for subjects and controls were 29.02 ± (9.2) and 28.42 ± (8.3) respectively. There was sex and age match between subjects and controls. Also, there was observable moderate to severe anxiety among those that had acne vulgaris and chronic urticaria as compared to apparently healthy controls. Low self-esteem, inferiority complex, lack of self-confidence, and social withdrawal, were among the common social reactions noticeable among the subject group. Mean STAI score ± s.e (standard error) of subjects was significantly higher than that of the controls 49.7 ± 0.788 and 33.9 ± 1.255 respectively at t-test = 11.2 and p = 0.0001. CONCLUSION: acne vulgaris and chronic urticaria was highly associated with moderate to severe anxiety with attending social reactions when compared to apparently healthy controls.

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Recurrent urticaria: clinical investigation of 330 patients

Cited by 350 publications

References 16 publications

Histamine plasma levels and elimination diet in chronic idiopathic urticaria

Histamine plasma levels and elimination diet in chronic idiopathic urticaria

Experience in Urticaria with Patients Attending a Dermatological Clinic in a Referral Center in the Eastern Province of Saudi Arabia

Anxiety State and ITS Psychosocial Consequences among Acne Vulgaris and Chronic Urticaria Patients in Abuja

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