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Zhang L, Peng C, Li J. Shedding light on dermographism: a narrative review. Int J Dermatol 2024; 63:999-1006. [PMID: 38419351 DOI: 10.1111/ijd.17102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
Dermographism is a common subtype of chronic urticaria. It generally manifests as a linear wheal after scratching or friction, with or without angioedema. The pathophysiology is not clear, but currently, we believe that the stimulation of the skin by mechanical stress leads to the activation of mast cells, which provoke the release of histamine and pro-inflammatory mediators, ultimately forming wheal along the stressed area. The gold standard for diagnosis is a medical history and provocation test or dermatographic test. As one of the subtypes of chronic urticaria, the Urticaria Control Test (UCT), Chronic Urticaria Quality of Life questionnaire (CU-Q2oL), and Dermatology Life Quality Index (DLQI) are also effective tools for evaluating disease control in dermographism patients. In addition to avoiding triggers, nonsedating H1 antihistamines are the first-line medications recommended by EAACI and other guidelines; for those who do not respond to standard doses, the recommended dosage can be increased up to 4 times. When necessary, the off-label use of omalizumab can be considered, and some drugs with potential therapeutic effects are still being explored. However, there is still a lack of biomarkers for predicting disease severity, efficacy, and prognosis. Here, we review what we know about dermographism and some points that need exploration in the future.
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Affiliation(s)
- Li Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Cong Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Chien WC, Tsai TF. Pressure and Skin: A Review of Disease Entities Driven or Influenced by Mechanical Pressure. Am J Clin Dermatol 2024; 25:261-280. [PMID: 38159214 DOI: 10.1007/s40257-023-00833-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
Skin perceives and reacts to external mechanical forces to create resistance against the external environment. Excessive or inappropriate stimuli of pressure may lead to cellular alterations of the skin and the development of both benign and malignant skin disorders. We conducted a comprehensive literature review to delve into the pressure-induced and aggravated skin disorders and their underlying pressure-related mechanisms. Dysregulated mechanical responses of the skin give rise to local inflammation, ischemia, necrosis, proliferation, hyperkeratosis, impaired regeneration, atrophy, or other injurious reactions, resulting in various disease entities. The use of personal devices, activities, occupations, weight bearing, and even unintentional object contact and postures are potential scenarios that account for the development of pressure-related skin disorders. The spectrum of these skin disorders may involve the epidermis (keratinocytes and melanocytes), hair follicles, eccrine glands, nail apparatuses, dermis (fibroblasts, mast cells, and vasculature), subcutis, and fascia. Clarifying the clinical context of each patient and recognizing how pressure at the cellular and tissue levels leads to skin lesions can enhance our comprehension of pressure-related skin disorders to attain better management.
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Affiliation(s)
- Wei-Chen Chien
- Department of Medical Education, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan.
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Zuberbier T, Peter J, Staubach P, Chularojanamontri L, Kulthanan K. Potential Therapeutic Approaches for Chronic Urticaria: Beyond H1-Antihistamines and Biologics. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2265-2273. [PMID: 37356753 DOI: 10.1016/j.jaip.2023.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023]
Abstract
Chronic urticaria is a disease that can significantly impact a patient's quality of life and ability to function. There are effective treatment options, such as nonsedating antihistamines or biologics, but some patients do not respond to these therapies, or the therapies are not available or affordable to all patients. This review aims to summarize potential treatment strategies for patients (1) who do not respond to antihistamines and (2) cannot readily access or do not respond to biologics. The review emphasizes the importance of sound clinical practice, including correct diagnosis of chronic urticaria phenotypes, treatment of associated comorbidities, and consideration of add-on pharmacological and nonpharmacological approaches. Although some treatments may lack high-quality evidence, they may still be justifiable in certain cases, provided that there is shared decision-making, regular reassessment, and early recognition of adverse events.
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Affiliation(s)
- Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany.
| | - Jonny Peter
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - Petra Staubach
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Yang X, Kong M, Wang H, Song Z, Chen Q. Symptomatic dermographism induced by oral minocycline: A report of four cases. J Dermatol 2023; 50:1063-1067. [PMID: 36938687 DOI: 10.1111/1346-8138.16779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 03/21/2023]
Abstract
Symptomatic dermographism (SD) is the most common form of chronic inducible urticarias. The etiology of this disease has rarely been reported in the literature. Minocycline is widely used in the treatment of acne, rosacea, and other inflammatory skin diseases. Herein we report four cases of SD onset during minocycline administration. These were young women in their 20s to 30s who were taking minocycline orally for acne vulgaris or rosacea. They all experienced the onset of SD 2-3 weeks after taking the drug, and then the complete disappearance of SD 1 month after stopping the drug. Minocycline was thought to be the culprit drug in these cases as other drugs were ruled out on clinical grounds. Our small series suggests that oral minocycline may induce SD, thus raising the awareness of this association in clinical practice. More research is needed to further confirm this association and reveal the underlying mechanism(s).
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Affiliation(s)
- Xianjie Yang
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Minmin Kong
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Huan Wang
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhiqiang Song
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Qiquan Chen
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China
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Khaliliya R, Confino-Cohen R, Lachover-Roth I, Meir-Shafrir K, Cohen-Engler A, Rosman Y. Chronic Urticaria in Elderly-New Insights. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1290-1294. [PMID: 36649801 DOI: 10.1016/j.jaip.2022.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/11/2022] [Accepted: 12/26/2022] [Indexed: 01/16/2023]
Abstract
BACKGROUND Many medical conditions have a unique profile in older adults. Chronic urticaria (CU) is a common disease, but data regarding elderly patients are limited. OBJECTIVE To describe the demographics, clinical characteristics, comorbidities, and outcome of elder patients with CU. METHODS This retrospective, single-center study included patients older than 65 years, diagnosed with CU in our clinic. Data for the entire cohort were retrieved from electronic medical records. RESULTS Of 1859 patients older than 65 years, 181 patients diagnosed with CU were included: 166 had chronic spontaneous urticaria (CSU) and 15 chronic inducible urticaria. Most patients with CSU were female (119, 72%). The mean age at diagnosis was 72 ± 5.9 years. Comorbidities included autoimmunity in 38 (22.9%), malignancy in 23 (13.8%), and atopy in 19 (11.5%). The time to referral to a specialist was 22.8 ± 53 months from the onset of symptoms. Specialist intervention improved patient outcomes. This was evident by reduced systemic steroid use (odds ratio [OR] = 0.145, [95% confidence interval (CI): 0.08-0.26], P < .001), all-cause hospitalization (OR = 0.09, [95% CI: 0.01-0.75], P = .01), emergency department visits (OR = 0.08, [95% CI: 0.08-0.35], P < .001), and primary physician visits (P < .001, Cramer's V = 0.528). CONCLUSIONS Older people with CU have unique characteristics, including high prevalence of autoimmunity and malignancy and lower prevalence of atopy. Raising awareness of CU in elderly and prompt referral to an allergy specialist may improve outcomes.
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Affiliation(s)
- Rasha Khaliliya
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Confino-Cohen
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idit Lachover-Roth
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Meir-Shafrir
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel
| | - Anat Cohen-Engler
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Rosman
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Ertaş R, Türk M, Yücel MB, Muñoz M, Ertaş ŞK, Atasoy M, Maurer M. Eating Increases and Exercise Decreases Disease Activity in Patients With Symptomatic Dermographism. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:932-940. [PMID: 36535522 DOI: 10.1016/j.jaip.2022.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/13/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Eating can increase disease activity in patients with symptomatic dermographism , the most common subtype of chronic inducible urticaria, but it is unclear how common this is. The effects of exercising on symptomatic dermographism disease activity have also not yet been determined. OBJECTIVE To assess the impact of exercise and nonspecific carbohydrate-rich food intake on the severity and intensity of symptomatic dermographism after exercise and nonspecific carbohydrate-rich food intake. METHODS We assessed disease activity by FricTest provocation testing in 75 symptomatic dermographism patients before and after eating, exercising, or both. We determined the rates of food-dependent (FD) symptomatic dermographism and food-exacerbated (FE) symptomatic dermographism. By comparing post- and pre-exercise FricTest scores, we identified complete responders: that is, patients with a negative FricTest response after exercising and partial responders. Finally, we evaluated whether exercise protects patients with FD-symptomatic dermographism or FE-symptomatic dermographism from eating-induced worsening of symptomatic dermographism. RESULTS Of 64 symptomatic dermographism patients, eight had FD-symptomatic dermographism (13%), 42 had FE-symptomatic dermographism (66%), and 14 patients showed no negative impact of eating on disease activity (21%). Physical exercise reduced FricTest skin provocation test responses in 83% of 58 patients. Exercising protected patients with FD/FE-symptomatic dermographism from worsening of symptomatic dermographism owing to eating in half of cases, with higher rates for exercise after eating (67%) compared with exercise before eating (35%). CONCLUSIONS Our study shows that eating often worsen symptomatic dermographism symptoms, and exercise often improves it. Our findings might aid patients in controlling symptoms better.
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Affiliation(s)
- Ragıp Ertaş
- Urticaria Center of Reference and Excellence, Chronic Skin Diseases Unit, Department of Dermatology, University of Health Sciences, Kayseri City Education and Research Hospital, Kayseri, Turkey.
| | - Murat Türk
- Clinic of Allergy and Immunology, University of Health Sciences, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Muhammed Burak Yücel
- Urticaria Center of Reference and Excellence, Chronic Skin Diseases Unit, Department of Dermatology, University of Health Sciences, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Melba Muñoz
- Urticaria Center of Reference and Excellence, Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Şule Ketenci Ertaş
- Department of Internal Medicine, Division of Rheumatology, Kayseri Acıbadem Hospital, Kayseri, Turkey
| | - Mustafa Atasoy
- Department of Dermatology, Biruni University, İstanbul, Turkey
| | - Marcus Maurer
- Urticaria Center of Reference and Excellence, Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
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Amjad MA, Hamid Z, Ochieng P, Li S. COVID-19 Vaccine Booster-Induced Dermatographism. Cureus 2022; 14:e26566. [PMID: 35936173 PMCID: PMC9351818 DOI: 10.7759/cureus.26566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/09/2022] Open
Abstract
The urgent requirement for a preventative vaccination became more pressing due to the severe repercussions that the SARS-CoV-2 (COVID-19) virus had on society and the economy. The deployment of the COVID-19 vaccination program had to be expedited. As with all vaccinations, adverse events have been recorded with the COVID-19 vaccine. Some patients may experience cutaneous reactions such as rashes, itching, hives, and swelling after receiving the COVID-19 vaccine, but it is unclear how common these events are or how frequently they recur. This article discusses an unusual case of a young man who got chronic severe dermatographism after receiving a booster shot of the Moderna vaccine (Moderna, Inc., Cambridge, Massachusetts).
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Rujitharanawong C, Tuchinda P, Chularojanamontri L, Nanchaipruek Y, Jantanapornchai N, Thamlikitkul V, Kulthanan K. Natural history and clinical course of patients with dermographism in a tropical country: a questionnaire-based survey. Asia Pac Allergy 2022; 12:e39. [DOI: 10.5415/apallergy.2022.12.e39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Chuda Rujitharanawong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Papapit Tuchinda
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yanisorn Nanchaipruek
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nuttagarn Jantanapornchai
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Visanu Thamlikitkul
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Liu L, Wang X, Wang W, Wang B, Li L. Symptomatic dermographism in Chinese population: an epidemiological study of hospital-based multicenter questionnaire survey. Curr Med Res Opin 2022; 38:131-137. [PMID: 34550851 DOI: 10.1080/03007995.2021.1984220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE There are few epidemiological studies on SD in China. This study aims to clarify the epidemic distribution characteristics of SD in China and provide ideas and clues for the prevention and treatment of the disease. METHODS The cross-sectional study was conducted in 2019 based on the hospital's epidemiological questionnaire. All enrolled patients completed a specific survey with 39 questions, related to demographic characteristics and the relative symptoms. Demographics, disease symptoms were characterized with descriptive statistics. The differences in the symptoms between different genders, disease courses, and regions were compared. RESULTS A total of 1800 patients were recruited, of which 615 patients were diagnosed with SD. Among 615 SD patients, the proportion of patients with chronic spontaneous urticaria was the highest, with 437 cases (71.1%). There is a female predominance (female/male ratio is 1.27:1), but there is no statistically significant difference between genders. The average disease course was 2.23 years. Among them, 429 patients had a course less than one year, accounting for about 2/3, and patients with a course more than one year accounted for less than 1/3. The clinical characteristics of patients with different course of disease were statistically different. The initial age is mainly concentrated in the 20-40 years old, accounting for 46.5% (286) of the total number. There are certain differences in incidence due to the different geographical conditions in north and south. Multiple types of urticaria may coexist in the same patient, and the number of patients with multiple urticaria is higher than the number of patients with simple SD. There are differences in the clinical manifestations of SD between north and south. CONCLUSIONS Environmental factors may affect the occurrence of SD, which may have a similar etiology to other types of urticaria and the cause of SD can be explored from more perspectives.
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Affiliation(s)
- Lijuan Liu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xin Wang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wenjuan Wang
- Hebei Province Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Bin Wang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Yücel MB, Ertas R, Türk M, Muñoz M, Atasoy M, Maurer M. Food-dependent and food-exacerbated symptomatic dermographism: New variants of symptomatic dermographism. J Allergy Clin Immunol 2021; 149:788-790. [PMID: 34375619 DOI: 10.1016/j.jaci.2021.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/30/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Symptomatic dermographism (SD) is the most common form of chronic inducible urticaria. The criterion standard for diagnosing SD and disease activity assessment in SD is provocation testing. As of now, if and what cofactors have an impact on provocation test results is unknown. OBJECTIVE We sought to determine whether the induction of signs and symptoms of SD is affected by the intake of food. METHODS We performed standardized skin provocation testing with a dermographometer (FricTest) before and after the intake of food. Patients were off antihistamine treatment for at least 3 days before testing. In total, 17 patients were tested after not having eaten for at least 4 hours (preprandial) on one volar forearm and 60 minutes after a carbohydrate-rich meal (postprandial) on the other. FricTest responses (wheals, itch) at trigger thresholds were assessed at 5 and 30 seconds as well as at 1, 2, 5, and 10 minutes. RESULTS We identified 7 patients with SD who showed faster onset of FricTest-induced whealing and/or lower trigger thresholds after the intake of food, that is, food-exacerbated SD. In 5 other patients, FricTest provocation testing resulted in a positive response only after the intake of food, but not before. Three of these 5 patients with food-dependent SD had comorbid chronic spontaneous urticaria and 1 had cholinergic urticaria. CONCLUSIONS We describe 2 previously unknown subtypes of SD, food-exacerbated SD and food-dependent SD. The prevalence and underlying pathomechanisms of food-exacerbated SD and food-dependent SD need to be investigated, and the impact of food intake on other forms of chronic inducible urticaria should be explored.
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Affiliation(s)
- Muhammed Burak Yücel
- Urticaria Center of Reference and Excellence (UCARE), Chronic Skin Diseases Unit, Department of Dermatology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Ragıp Ertas
- Urticaria Center of Reference and Excellence (UCARE), Chronic Skin Diseases Unit, Department of Dermatology, Kayseri City Education and Research Hospital, Kayseri, Turkey.
| | - Murat Türk
- Clinic of Allergy and Immunology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Melba Muñoz
- Urticaria Center of Reference and Excellence (UCARE), Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mustafa Atasoy
- Urticaria Center of Reference and Excellence (UCARE), Chronic Skin Diseases Unit, Department of Dermatology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Marcus Maurer
- Urticaria Center of Reference and Excellence (UCARE), Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Kulthanan K, Ungprasert P, Tuchinda P, Chularojanamontri L, Rujitharanawong C, Kiratiwongwan R, Jantanapornchai N, Hawro T, Maurer M. Symptomatic Dermographism: A Systematic Review of Treatment Options. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:3141-3161. [DOI: 10.1016/j.jaip.2020.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/04/2020] [Accepted: 05/16/2020] [Indexed: 11/29/2022]
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12
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Raynowska J, Graves JS. Dermatographism associated with ocrelizumab. Mult Scler Relat Disord 2020; 46:102505. [PMID: 32979732 DOI: 10.1016/j.msard.2020.102505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
Dermatographism is a disorder of unknown etiology that results in inducible hives from environmental stimuli. Here we report the first known case of dermatographism associated with ocrelizumab in a patient with relapsing remitting multiple sclerosis. The patient presented with pruritic linear raised rash approximately two weeks after her first infusion with ocrelizumab and was later diagnosed with dermatographism. This case highlights a potential rare adverse reaction to ocrelizumab and may provide insight into the biological underpinnings of dermatographism.
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Affiliation(s)
- Jenelle Raynowska
- Department of Neurosciences, University of California San Diego, San Diego, CA, United States.
| | - Jennifer S Graves
- Department of Neurosciences, University of California San Diego, San Diego, CA, United States.
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Chattopadhyay T, Mondal H, Mondal S, Das D, Biri S. Fabrication of a low-cost strap for holding precordial electrodes on the hirsute chest. J Family Med Prim Care 2020; 9:2359-2363. [PMID: 32754501 PMCID: PMC7380826 DOI: 10.4103/jfmpc.jfmpc_292_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/14/2020] [Accepted: 03/26/2020] [Indexed: 11/04/2022] Open
Abstract
Background: Aim: Materials and Methods: Results: Conclusion:
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14
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Brom‐Spierenburg AJ, Theelen MJP, Sloet van Oldruitenborgh‐Oosterbaan MM. Dermatographism in a horse, responsive to cetirizine treatment. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. J. Brom‐Spierenburg
- Department of Equine Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | - M. J. P. Theelen
- Department of Equine Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
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Can P, Etikan P, Kızıltaç U, Kızıltaç K, Singer R, Kocaturk E. Fric Test Revisited: A Suggestion for a New Scoring System and Its Correlation with Urticaria Control Test and Dermatology Life Quality Index. Int Arch Allergy Immunol 2018; 178:76-82. [DOI: 10.1159/000492970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/16/2018] [Indexed: 11/19/2022] Open
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16
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Brain-derived neurotrophic factor is increased in serum levels of patients with symptomatic dermographism. Postepy Dermatol Alergol 2017; 34:346-349. [PMID: 28951710 PMCID: PMC5560183 DOI: 10.5114/ada.2017.69315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/01/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction Symptomatic dermographism (SD) is the most common form of physical urticaria. However, the role of neuroimmune mechanisms in SD is unclear. Aim To investigate circulating levels of brain-derived neurotrophic factor (BDNF) in symptomatic dermographism. Material and methods Thirty-two patients suffering from SD and 33 healthy subjects were included in the study. Serum BDNF levels were determined by a human enzyme-linked immunoassay (ELISA) kit. The serum C-reactive protein concentration and eosinophil counts in peripheral blood were evaluated. Results The BDNF serum levels were detectable in both SD patients and healthy controls. The BDNF serum levels were significantly higher in patients with SD compared with healthy controls (p = 0.004). There was a positive but weak correlation between serum BDNF and CRP levels; it was not statistically significant (r = 0.211, p = 0.255). There was also a positive but weak correlation between serum BDNF and eosinophil counts; it was not statistically significant (r = 0.271, p = 0.141). Conclusions The present study shows that BDNF is increased in the serum levels of patients with SD, suggesting a role for BDNF in the pathophysiology of this disorder.
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Burbridge M. Dermographism: A Rare Cause of Intraoperative Hypotension and Urticaria. ACTA ACUST UNITED AC 2016; 7:41-3. [PMID: 27434310 DOI: 10.1213/xaa.0000000000000336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 54-year-old man with dermographism presented for spine surgery, and shortly after induction of anesthesia, he experienced severe hypotension and urticaria, resulting in cancellation of the case on suspicion of allergic reaction. For subsequent ventral hernia repair, a perioperative management strategy was devised, which resulted in an uneventful perioperative course. This case report is the first to demonstrate severe intraoperative hypotension and urticaria from dermographism. We discuss the strategy that made the subsequent surgery a success and provide guidance for practitioners who face a patient with a severe form of this chronic disease.
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Affiliation(s)
- Mark Burbridge
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
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Binmadi N, Almazrooa S. Dermographism in the Oral Cavity. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:421-4. [PMID: 27324161 PMCID: PMC4917076 DOI: 10.12659/ajcr.898247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/12/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Dermographism is a type of physical urticaria that can be induced by writing on the skin. It occurs in 2-5% of the population and is considered to be a normal physiological phenomenon. However, in a small subset of patients, it can be symptomatic and may affect the quality of life. The etiology of this disease remains unclear. CASE REPORT Herein, we present a case of dermographism in a 20-year-old male and discuss the involvement of the oral mucosa in this condition. CONCLUSIONS Although this condition is well known to occur in the skin, we believe this condition is rarely discussed among dentists. All healthcare providers, especially dentists, should know its potential to cause complications during dental procedures.
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Hawkey S, Abdul Ghaffar S. Glove-related hand urticaria: an increasing occupational problem among healthcare workers. Br J Dermatol 2016; 174:1137-40. [DOI: 10.1111/bjd.14318] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S. Hawkey
- Department of Dermatology; Ninewells Hospital & Medical School; University of Dundee; Dundee DD1 9S U.K
| | - S. Abdul Ghaffar
- Department of Dermatology; Ninewells Hospital & Medical School; University of Dundee; Dundee DD1 9S U.K
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Mehta A, Godse K, Agarwal S, Patil S. Feasibility and Utility of the Fric Test in Symptomatic Dermographism: A Pilot Study. Indian J Dermatol 2015; 60:638. [PMID: 26677310 PMCID: PMC4681236 DOI: 10.4103/0019-5154.169167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Aayushi Mehta
- DY Patil School of Medicine, Nerul, Navi Mumbai, India. E-mail:
| | - Kiran Godse
- DY Patil School of Medicine, Nerul, Navi Mumbai, India. E-mail:
| | - Shweta Agarwal
- DY Patil School of Medicine, Nerul, Navi Mumbai, India. E-mail:
| | - Sharmila Patil
- DY Patil School of Medicine, Nerul, Navi Mumbai, India. E-mail:
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Schoepke N, Młynek A, Weller K, Church MK, Maurer M. Symptomatic dermographism: an inadequately described disease. J Eur Acad Dermatol Venereol 2014; 29:708-12. [PMID: 25174372 DOI: 10.1111/jdv.12661] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 06/25/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Symptomatic dermographism is the most common form of physical urticaria with a prevalence of 2-5%. However, its clinical picture has rarely been described. OBJECTIVE To understand more of patients' views about the practical aspects of their condition, its cause and impact on quality of life. METHODS Ninety-one of 150 patients with symptomatic dermographism from our specialist urticaria clinic completed a 38-question questionnaire sent them by mail. RESULTS The mean duration of disease was 6¼ years. In most patients, the condition was continuous, but ~25% had prolonged symptom-free phases. Severity was evaluated as moderate in 45%, severe in 33% and very severe in 6% of respondents. Other responses included: symptoms worse in the evening in 81%; quality of life significantly impaired in 44%; normal life not possible 7%; stress induces acute episodes 44%; other urticarial forms coexist 21%; allergy coexist 48%. A family history was reported in 14%. Almost all patients were taking H1 -anti-histamines, 49% getting marked improvement and 23% becoming symptoms free. LIMITATIONS It is a survey only of patient opinions. CONCLUSIONS This questionnaire survey confirmed that symptomatic dermographism is a debilitating condition with profound effects on quality of life but its underlying cause and disease mechanisms remain obscure.
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Affiliation(s)
- N Schoepke
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin, Berlin, Germany
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Sheraz A, Simms MJ, White IR, White JML. Erythematous reactions on removal of Scanpor ®tape in patch testing are not necessarily caused by dermographism. Contact Dermatitis 2014; 71:62-4. [DOI: 10.1111/cod.12197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 12/02/2013] [Accepted: 12/11/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Adil Sheraz
- St John's Institute of Dermatology; St Thomas' Hospital; Westminster Bridge Road London SE1 7EH UK
| | - Mark J. Simms
- St John's Institute of Dermatology; St Thomas' Hospital; Westminster Bridge Road London SE1 7EH UK
| | - Ian R. White
- St John's Institute of Dermatology; St Thomas' Hospital; Westminster Bridge Road London SE1 7EH UK
| | - Jonathan M. L. White
- St John's Institute of Dermatology; St Thomas' Hospital; Westminster Bridge Road London SE1 7EH UK
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Mehrpoor G, Owlia MB, Soleimani H, Ayatollahi J. Adult-onset Still’s disease: a report of 28 cases and review of the literature. Mod Rheumatol 2014. [DOI: 10.3109/s10165-008-0104-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mlynek A, Vieira dos Santos R, Ardelean E, Weller K, Magerl M, Church MK, Maurer M. A novel, simple, validated and reproducible instrument for assessing provocation threshold levels in patients with symptomatic dermographism. Clin Exp Dermatol 2013; 38:360-6; quiz 366. [DOI: 10.1111/ced.12107] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2012] [Indexed: 11/27/2022]
Affiliation(s)
- A. Mlynek
- Department of Dermatology and Allergology; Allergie-Centrum-Charité; Charit\xE9 - Universitätsmedizin Berlin; Berlin; Germany
| | - R. Vieira dos Santos
- Department of Dermatology and Allergology; Allergie-Centrum-Charité; Charit\xE9 - Universitätsmedizin Berlin; Berlin; Germany
| | - E. Ardelean
- Department of Dermatology and Allergology; Allergie-Centrum-Charité; Charit\xE9 - Universitätsmedizin Berlin; Berlin; Germany
| | - K. Weller
- Department of Dermatology and Allergology; Allergie-Centrum-Charité; Charit\xE9 - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Magerl
- Department of Dermatology and Allergology; Allergie-Centrum-Charité; Charit\xE9 - Universitätsmedizin Berlin; Berlin; Germany
| | - M. K. Church
- Department of Dermatology and Allergology; Allergie-Centrum-Charité; Charit\xE9 - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Maurer
- Department of Dermatology and Allergology; Allergie-Centrum-Charité; Charit\xE9 - Universitätsmedizin Berlin; Berlin; Germany
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Abstract
The physical urticarias are a heterogeneous subgroup of chronic urticarias in which wheals can be reproducibly induced by different specific physical stimuli such as cold, heat, pressure, vibration, or sunlight. Physical urticarias comprise up to 25 % of chronic urticarias and occur more frequently in young adults. Symptoms, i.e. wheal and flare responses or angioedema, are usually limited to the skin areas exposed to the eliciting stimulus. However, generalised urticaria with variable extracutaneous manifestations can also occur. Some patients may also present with more than one physical urticaria. Skin lesions in physical urticaria result from mast cell activation and mediator release. The mechanisms by which physical stimuli activate skin mast cells are not fully understood. Because of this, trigger avoidance and symptomatic treatment are key therapeutic concepts for physical urticarias. Identification of the inducing physical trigger, including its individual thresholds, is necessary for an effective therapy. Here, we have summarized clinical features, diagnostic workup and therapy options for physical urticarias.
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Affiliation(s)
- Marina Abajian
- Department of Dermatology and Allergy, Allergie-Centrum-Charité/ECARF, Charité-Universitätsmedizin Berlin, Germany.
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Affiliation(s)
- Kiran V Godse
- Shree Skin Centre and Laboratory, 21/22, L market, Sector 8, Nerul, Navi Mumbai 400 706, India
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Herman-Kideckel SM, Cadesky K, Sussman D, Maclachlan S, Sussman G. Association of dermographic urticaria with the use of progesterone in cottonseed oil. Ann Allergy Asthma Immunol 2011; 106:439-40. [PMID: 21530878 DOI: 10.1016/j.anai.2011.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 01/01/2011] [Accepted: 01/11/2011] [Indexed: 11/17/2022]
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Silpa-archa N, Kulthanan K, Pinkaew S. Physical urticaria: prevalence, type and natural course in a tropical country. J Eur Acad Dermatol Venereol 2010; 25:1194-9. [PMID: 21175877 DOI: 10.1111/j.1468-3083.2010.03951.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Physical urticarias (PU) are an urticarial response to different specific physical stimuli. PU can occur concurrently with chronic spontaneous urticaria or another type of PU. OBJECTIVE We aimed to study the prevalence, type, clinical data and natural course of each type of PU and other inducible urticarias and also the prognostic factors for remission of patients visiting a tertiary referral hospital. METHOD We performed a retrospective study of 1200 chronic urticaria patients who visited our Urticaria Clinic during a period of 5 years. RESULTS Of the 1200 chronic urticaria patients, 86 (7.2%) were diagnosed as PU and other inducible urticarias. The most common type of PU was symptomatic dermographism (n = 35, 40.7%) followed by cold urticaria (n = 20, 23.3%) and delayed pressure urticaria (n = 11, 12.8%), respectively. Twelve patients (13.9%) had associated chronic spontaneous urticaria. None of the cases had multiple types of PU. Erythrocyte sedimentary rate elevation was the most common abnormal laboratory result. Nevertheless, only 4.6% declared a related infection. For each type, the median time after onset before 50% remission showed that cholinergic urticaria took the shortest course (34 months) and delayed pressure urticaria took the longest period (110 months). After 1 year and 5 years from the onset of symptoms, 13% and 50% of PU patients were free of symptoms, respectively. CONCLUSION This study emphasized the variety of PU, other inducible urticarias and natural courses based on tertiary hospital care. PU and other inducible urticarias have tendency to have a longer course than chronic spontaneous urticaria.
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Affiliation(s)
- N Silpa-archa
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Magerl M, Schmolke J, Metz M, Zuberbier T, Siebenhaar F, Maurer M. Prevention of signs and symptoms of dermographic urticaria by single-dose ebastine 20 mg. Clin Exp Dermatol 2009; 34:e137-40. [DOI: 10.1111/j.1365-2230.2008.03097.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Effects of smoke exposure and other lifestyle factors on pain response to electrical stimulation in women. Pain Res Manag 2008; 13:231-5. [PMID: 18592060 DOI: 10.1155/2008/240573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A relationship between smoking and development of pain syndromes has been suggested in the literature. The present study examined associations between smoke exposure and other related variables, and pain response to suprathreshold electrical stimulation. METHODS Subjects were prospectively recruited from a population referred to an electrodiagnostic clinic. Information about age, smoke exposure, caffeine and alcohol consumption was obtained, as well as documented objective signs of stress through physical assessment. One investigator applied two standardized 0.1 ms electrical stimulations (50 mA followed by 100 mA) to asymptomatic extremities at the beginning of each electrodiagnostic session, using consistent technique. Subjects used a visual analogue scale to indicate the level of pain felt after each stimulation. RESULTS Two hundred fifteen women were included. Current smokers and those currently exposed to second-hand smoke had significantly higher pain ratings (P=0.003 for 50 mA, P=0.005 for 100 mA) than those not currently exposed to smoke. Time since exposure was negatively associated with pain ratings. Those with objective signs of stress reported higher levels of pain, which was significant for the 100 mA stimulation (P=0.046). Linear regression modelling indicated that current smoke exposure and alcohol use were associated with higher pain ratings at both 50 mA and 100 mA, while stress was associated with higher pain ratings and older age was associated with lower pain ratings at 100 mA only. INTERPRETATION Exposure to cigarette smoke is significantly related to higher reported levels of pain experienced in response to electrical stimulation in this study population. Exposure to smoke can add 10 points to the 100-point visual analogue scale compared with subjects without exposure, with alcohol use adding another eight points. Reported pain decreases as length of time since previous exposure to smoke increases.
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Mehrpoor G, Owlia MB, Soleimani H, Ayatollahi J. Adult-onset Still's disease: a report of 28 cases and review of the literature. Mod Rheumatol 2008; 18:480-5. [PMID: 18754076 DOI: 10.1007/s10165-008-0104-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 04/16/2008] [Indexed: 12/16/2022]
Abstract
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is characterized by fever, skin rash, polyarthralgias or polyarthritis, sore throat, hepatosplenomegaly, lymphadenopathy, leukocytosis, liver enzyme elevation, and high serum level of ferritin. Several kinds of skin lesions have been reported in this condition. The aim of this study was to assess the clinical and laboratory aspects of 28 patients with AOSD in central Iran. According to the diagnostic criteria of AOSD, we identified 28 patients between 2002 and 2007. We intended to describe the clinical characteristics, treatment, and outcome of our patients with AOSD. Of 28 patients with AOSD, 21 (75%) were female, 7 (25%) were male. Fever (100%), sore throat (92%), Arthralgia (92%), dermatographism (92%), typical rash (85%) and arthritis (60%) were the most common findings. The mean values of laboratory findings were as follows; C-reactive protein (CRP) level of 14.4 mg/dl, erythrocyte sedimentation rate (ESR) of 91.5 mm/h, leukocyte count of 15744.4/microl. Abnormal levels of aspartate aminotransferase and alanine aminotransferase were observed in 25 (89%) patients. Twenty patients (71%) had high ferritin values (>500 ng/ml). The clinical characteristics were similar to previous series. A febrile polyarthritis was the most frequent presentation form. Dermatographism was frequently encountered phenomenon in our patients with AOSD. Being that dermatographism is a simple inducible skin reaction, along with its sensitivity in active disease, we suggest more controlled studies to validate accuracy and positive predictive value of it in convenient clinical setting in the diagnosis of AOSD and to consider including it in diagnostic criteria.
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Affiliation(s)
- Golbarg Mehrpoor
- Department of Internal Medicine, Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Safaeieh, Yazd, Iran.
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Abstract
PURPOSE OF REVIEW To illustrate features of allergy in mastocytosis. RECENT FINDINGS The rates of atopy in patients with mastocytosis have generally been found to be similar to those of the normal population, although the incidence of anaphylaxis is much higher in mastocytosis. Introduction of objective pathologic criteria by the WHO for the diagnosis of mastocytosis has greatly facilitated the workup of patients with suspected mastocytosis, and has led to identification of mast cell disease in a subset of patients with anaphylaxis. There is increasing evidence that an activating c-kit mutation (D816V) exists in a subset of patients with recurrent mast cell activation symptoms who have normal-appearing bone marrow biopsies in routine evaluations without skin lesions. The genetic deficiency of alpha tryptase has not been found to influence serum tryptase levels in patients with mastocytosis. SUMMARY Pathologic mast cell activation is a key finding in both allergic diseases and mastocytosis, albeit caused by entirely different mechanisms. Mastocytosis should be suspected in patients with recurrent anaphylaxis, who present with syncopal or near-syncopal episodes without associated hives or angioedema.
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Affiliation(s)
- Matthew Greenhawt
- Division of Allergy and Immunology, Department of Internal Medicine, University of Michigan, School of Medicine, Ann Arbor, Michigan 48109, USA
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Jauhar S, Staines K, McQueen M, Watson IB, Wray D, Felix DH. Dermographism and delayed pressure urticaria. ACTA ACUST UNITED AC 2007; 103:774-9. [PMID: 17331756 DOI: 10.1016/j.tripleo.2006.11.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2006] [Revised: 11/27/2006] [Accepted: 11/29/2006] [Indexed: 11/22/2022]
Abstract
There are few papers in the literature that describe pressure urticaria in the maxillofacial region. We present 2 cases and discuss the significance and principles of management. One case describes the diagnosis of pressure urticaria and the second describes the dental management of a patient with severe pressure urticaria.
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Affiliation(s)
- Sachin Jauhar
- Glasgow Dental Hospital and School, Glasgow, Scotland.
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