Retrospective Analysis of Drug-Induced Urticaria and Angioedema: A Survey of 2287 Patients

Abstract

Urticaria and angioedema (UA) represent a syndrome that is frequently encountered in children and adults. However, although they are often associated (in up to 50% of some patient populations), these two clinical entities should not be considered synonymous because they have distinct clinical and histopathological characteristics. The frequency of UA in drug-induced pathologies is quite high Here we report a retrospective survey of 2287 patients, observed between 1988 and 1997 presenting one or more episodes of drug-induced UA. In 1,973 patients (86.2%) [639 (32.4%) males and 1,334 (67.6%) females] a specific drug responsible for UA was identified. Particularly over the last two years the frequency of drug-induced UA has tended to increase, being more prevalent in females and the majority of cases (576: 23.1%) occuring during the third decade of life. The most frequently involved drugs are anti-inflammatory (particularly acetylsalicylic acid) and antimicrobial agents (mainly beta-lactams).

Advanced phenotyping in hypersensitivity drug reactions to NSAIDs

“…A precise definition of these entities is given below. Although many studies have focused on the model of asthma and/or rhinitis with nasal polyposis, the overall frequency of urticaria and angioedema in NSAID hypersensitivity is higher, and is in fact the most frequent phenotype in HDR to this class of drugs . In a recent study, a group of 659 patients with NSAID hypersensitivity reactions was evaluated .…”

Natural evolution in patients with nonsteroidal anti‐inflammatory drug‐induced urticaria/angioedema

“…Concerning the number of episodes, patients reported a median of 3 (IR: 2-5) after NSAIDs intake, six (15.78%) reported one episode; six (15.78%) reported two episodes; 10 (26.31%) reported three episodes; six (15.78%) reported four episodes; eight (21.05%) reported five episodes; and two (5.26%) reported six episodes (for detailed information see Table S1). The median time interval between the first and the last reactions was 60 months (IR: 21-126), and the median time interval between the last reaction induced by NSAID and the diagnosis (V1) was 6 months (IR: [3][4][5][6] All 38 patients were followed up at V2 ( Figure 1). The median time interval between V1 and V2 was 60 months (IR: 48-81).…”

“…NIUA is the most frequent entity in DHRs to NSAIDs in both adults and children . NIUA patients do not have chronic spontaneous urticaria (CSU) and develop skin symptoms exclusively, up to 24 hours after NSAIDs intake.…”

“…The latter two groups are immunologically mediated reactions induced by a single drug/drug group (selective hypersensitivity). 3,4 NIUA is the most frequent entity in DHRs to NSAIDs in both adults [5][6][7] and children. 8 NIUA patients do not have chronic spontaneous urticaria (CSU) and develop skin symptoms exclusively, up to 24 hours after NSAIDs intake.…”

Lacrimal gland prolapse in blepharochalasis

“…8 The surgical management of blepharochalsis includes blepharoplasty for redundant upper lid skin, a relatively simple procedure commonly performed by plastic surgeons and ophthalmologists. It is usual to wait until the condition is quiescent before performing the surgery.…”