Triggers of Exacerbation in Chronic Urticaria and Recurrent Angioedema—Prevalence and Relevance

Grumach, Anete Sevciovic; Staubach‐Renz, Petra; Villa, Ricardo Cardona; Diez-Zuluaga, Susana; Reese, Imke; Lumry, William R.

doi:10.1016/j.jaip.2021.04.023

Cited by 14 publications

(15 citation statements)

References 101 publications

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“…1 Clearly, conventional urticaria and angioedema can also be linked to stress and this is where the boundaries with somatization are blurred. 32 Although there has been little that has been published about somatoform idiopathic anaphylaxis recently, it will still present to tertiary care allergy clinics. 29 Patients experience symptoms simulating anaphylaxis.…”

Section: Urticaria Angioedema Anaphylaxis and Somatizationmentioning

confidence: 99%

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Somatization in dermatology

Millington

Shobajo

Wall³

et al. 2022

Skin Health and Disease

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Medically unexplained dermatologic symptoms, such as pruritus, numbness and burning are known as somatization. These cutaneous symptoms can be very difficult to treat because of an absence of an objective explanation and they may not fit neatly into any known dermatological or psychiatric condition. These disorders are more commonly encountered in primary care and in dermatology, rather than in psychiatry. Certain skin disorders, for example, pruritus, could be a manifestation of somatization and others may predispose to somatic symptoms, for example, atopic dermatitis and psoriasis. Although there has been increasing research in the interconnection between psychiatry and dermatology, psychodermatology is a relatively new crossover discipline in clinical practice and recognition of psychodermatological conditions, such as cutaneous somatic disorders, can be difficult. Somatization may occur with or without the existence of a dermatological disease. When a dermatological disorder is present, somatization should be considered when the patient is worrying too much about their skin, spending too much time and energy on it and especially if the patient also complains of many non‐cutaneous symptoms. Purely cutaneous somatic conditions include for example, the genital pain syndromes or Gardner–Diamond syndrome, characterized by unexplained bruising, which usually affects women. Effective management tools may include mindfulness therapies, pharmacotherapy with selective serotonin reuptake inhibitors, tricyclic antidepressants and cognitive conduct therapy. Electroconvulsive therapy can also be considered in extremely rare cases for treatment of severe somatization on a background of mood disorders. This paper discusses somatization, its relationship to immunodermatoses and its relevance to clinical practice.

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Section: Urticaria Angioedema Anaphylaxis and Somatizationmentioning

confidence: 99%

“…Angioedema of the mouth or tongue with no clear physical cause may be linked to flashbacks of oral sexual abuse 1 . Clearly, conventional urticaria and angioedema can also be linked to stress and this is where the boundaries with somatization are blurred 32 …”

Section: Somatization and Psoriasismentioning

confidence: 99%

Somatization in dermatology

Millington

Shobajo

Wall³

et al. 2022

Skin Health and Disease

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“…Urticaria, may be precipitated by upper respiratory tract viral infections or the intake of non‐steroidal anti‐inflammatory drugs (NSAIDs), other medications or even foodstuffs. 27 Identification of such triggers may be helpful in patient education and management.…”

Section: Urticaria Definitionmentioning

confidence: 99%

“…Although urticaria is often thought to be due to type 1 hypersensitivity, (immunoglobulinE (IgE) mediated allergy), this is infrequently the case and very rarely without involvement of other body systems (cardio‐respiratory, gastrointestinal) and very rarely the case for chronic urticaria. Urticaria, may be precipitated by upper respiratory tract viral infections or the intake of non‐steroidal anti‐inflammatory drugs (NSAIDs), other medications or even foodstuffs 27 . Identification of such triggers may be helpful in patient education and management.…”

Section: Urticaria Definitionmentioning

confidence: 99%

Clinical review: The suggested management pathway for urticaria in primary care

Tanno

Angier

Clark

et al. 2022

Clinical & Translational All

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Background Urticaria is a common condition presenting both as acute and chronic disease within primary care. To those without specialist training it is poorly understood from the points of view of diagnosis and management. It causes a considerable disease burden to sufferers with marked impact on quality of life. Purpose of this review The recent publication of the EAACI/GA²LEN/EuroGuiDerm/APAAACI Guideline for the Definition, Classification, Diagnosis and Management of Urticaria guideline prompted us to take this excellent resource and re‐configure its findings and recommendations to a non‐specialist audience with particular reference to the needs of the primary care team.

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“…Several etiological factors have been associated with CU, including autoimmune diseases, allergens, pseudo-allergens, and infections, but it is challenging to identify the specific trigger in most patients ( 9 , 10 ). Autoimmune and inducible conditions may be more resistant to treatment and have a prolonged course ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Multicentric and Observational Study of Omalizumab for Chronic Spontaneous Urticaria in Real-Life in Colombia

et al. 2022

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BackgroundAlthough chronic urticaria (CU) is a common, cause of medical consulting both in general practitioners and allergist specialists worldwide, there is little information about its behavior and management in Latin America. Currently, national and international guidelines recommend using Omalizumab for cases refractory to management with antihistamines. Despite advances in the knowledge of Omalizumab for the management of CU, although there are few studies in underdeveloped countries, there are many studies evaluating the impact of Omalizumab treatment. There is not clinical information related with CSU-Omalizumab in patient settled in the Caribbean area. This research aims to evaluate the management of CU with Omalizumab in a real-life scenario in Colombia.MethodologyWe conducted an observational, descriptive, and retrospective study with patient recruitment between 2014 and 2017 of individuals diagnosed with Chronic Urticaria (CU) treating allergology specialists in five Colombian cities. We included patients with CU who failed to achieve disease control after treatment for 4 weeks with fourfold doses of second-generation H1-antihistamines, as recommended by the EAACI/GA2LEN/EDF/WAO guidelines and who received treatment with Omalizumab.ResultsWe included 123 patients, 73.1% (n = 90) were women. The mean age was 47.1 years (Standard Deviation, SD: 16.2). The median of the total months of disease evolution was 30 (IQR = 13–58). 81.3 % (n = 100) of patients were diagnosed with chronic spontaneous urticarial (CSU). 4.8% (n = 6) had inducible CU (CIndU), and 13.8% (n = 17) reported mixed urticaria (spontaneous CU with at least one inducible component). Regarding emotional factors, 34.9% (n = 43) of subjects indicated anxiety symptoms, 34.1% (n = 42) had exacerbations associated with stress, and 14.6% (n = 18) manifested episodes of sadness. The percentage of patients with CSU controlled according to medical criteria at 3 months with Omalizumab were 80% (n = 80/100) and at 6 months 87% (n = 87/100). The frequency of adverse events was 29.2% (n = 36), with headache being the most frequent adverse event.ConclusionsThis real-life study with Omalizumab at CU describes percentages of effectiveness and safety similar to those observed in pivotal and real-life studies conducted in other regions around the world.

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Triggers of Exacerbation in Chronic Urticaria and Recurrent Angioedema—Prevalence and Relevance

Cited by 14 publications

References 101 publications

Somatization in dermatology

Somatization in dermatology

Clinical review: The suggested management pathway for urticaria in primary care

Multicentric and Observational Study of Omalizumab for Chronic Spontaneous Urticaria in Real-Life in Colombia

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