Sociodemographic and clinical characteristics, causal factors and evolution of a group of patients with chronic urticaria-angioedema
Keywords:
Urticaria, Angioneurotic edema, Socioeconomic factors, Infection, EpidemiologyAbstract
CONTEXT AND OBJECTIVE: Chronic urticariaangioedema is a common, multiple-cause complaint. The aim was to investigate the sociodemographic and clinical characteristics, causal and aggravating factors and evolution of urticaria-angioedema. DESIGN AND SETTING: This was a descriptive prospective study carried out at the Dermatology outpatient clinic of Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp). METHODS: A total of 125 patients with chronic urticaria-angioedema were evaluated to obtain sociodemographic data, anamnesis, dermatological and general clinical data and laboratory data, emphasizing causal and aggravating factors and complaint evolution. RESULTS: Chronic urticaria-angioedema occurred mainly in females (mean age: 35 years), but also in men (mean age: 32 years). White color and living in urban areas also predominated. There was no preferential time for symptoms to appear, and nighttime was the most commonly reported time for clinical worsening. Around half of the patients had urticaria associated with angioedema. There were no associated factors in most of the cases, and stress was the most commonly reported aggravating factor. The cause was ascertained in 37.6% of our cases. The mean duration of follow-up was 11.7 months. Around 60% of the patients evolved with the problem under control, 32% improved, 9% had no change in dermatological condition and only one patient worsened. CONCLUSIONS: Chronic urticaria-angioedema was more common among middle-aged women. It is a long-term disease, and its cause was explained in about one-third of the patients. Half of the patients presented disease control after treatment lasting an average of approximately one year.
Downloads
References
Cooper KD. Urticaria and angioedema: diagnosis and evalua- tion. J Am Acad Dermatol. 1991;25(1 Pt 2):166-74; discussion 174-6.
Soter NA. Acute and chronic urticaria and angioedema. J Am Acad Dermatol. 1991;25(1 Pt 2):146-54.
Soter NA. Urticaria and angioedema. In: Fitzpatrick TB, Freedberg IM, Wolf K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick’s dermatology in general medicine. New York: McGraw-Hill; 1999. p. 1409-25.
Tharp MD. Chronic urticaria: pathophysiology and treatment approaches. J Allergy Clin Immunol. 1996;98(6 Pt 3):S325-30.
Black AK, Champion RH. The urticaria. In: Champion RH, Burton JL, Burns DA, Breathnach SM, editors. Textbook of der- matology. Oxford: Oxford University Press; 1998. p. 2113-39.
Champion RH, Roberts SO, Carpenter RG, Roger JH. Urticaria and angio-oedema. A review of 554 patients. Br J Dermatol. 1969;81(8):588-97.
Mathews KP. Urticaria and angioedema. J Allergy Clin Immunol. 1983;72(1):1-14.
Hellgren L, Hersle K. Acute and chronic urticaria. A statistical investigation on clinical and laboratory data in 1.204 patients and matched healthy controls. Acta Allergol. 1964;19:406-20.
Miller DA, Freeman GL, Akers WA. Chronic urticaria. A clinical study of fifty patients. Am J Med. 1968;44(1):68-86.
Monroe EW, Jones HE. Urticaria. An updated review. Arch Dermatol. 1977;113(1):80-90.
Small P, Barrett D, Biskin N, Champlin E. Chronic urticaria
and angioedema. Clin Allergy. 1982;12(2):131-6.
Harris A, Twarog FJ, Geha RS. Chronic urticaria in child- hood: natural course and etiology. Ann Allergy. 1983;51 (2 Pt 1):161-5.
Greaves MW. Chronic urticaria. N Engl J Med. 1995;332(26):1767-72.
Sabroe RA, Greaves MW. The pathogenesis of chronic idiopathic urticaria. Arch Dermatol. 1997;133(8):1003-8.
Humphreys F, Hunter JA. The characteristics of urticaria in 390 patients. Br J Dermatol. 1998;138(4):635-8.
Sheldon JM, Mathews KP, Lovell RG. The vexing urticaria problem: present concepts of etiology and management. J Al- lergy. 1954;25(6):525-60.
Kozel MM, Mekkes JR, Bossuyt PM, Bos JD. The effectiveness of a history-based diagnostic approach in chronic urticaria and angioedema. Arch Dermatol. 1998;134(12):1575-80.
Sehgal VN, Rege VL. An interrogative study of 158 urticaria patients. Ann Allergy. 1973;31(6):279-83.
Charlesworth EN. Urticaria and angioedema: a clinical spectrum. Ann Allergy Asthma Immunol. 1996;76(6):484- 95; quiz 495-9.
Grattan CE, Sabroe RA, Greaves MW. Chronic urticaria. J Am Acad Dermatol. 2002;46(5):645-57; quiz 657-60.
Kozel MM, Sabroe RA. Chronic urticaria: aetiology, man- agement and current and future treatment options. Drugs. 2004;64(22):2515-36.
Martínez Pichardo R, Abdo Rodríguez A. Urticaria crónica: estudio de 300 pacientes. [Chronic urticaria: study of 300 patients]. Rev Cuba Med. 1987;26(12):1329-34.
Hide M, Francis DM, Grattan CE, Barr RM, Winkelmann RK, Greaves MW. The pathogenesis of chronic idiopathic urticaria: new evidence suggests an auto-immune basis and implications for treatment. Clin Exp Allergy. 1994;24(7):624-7.
Zuberbier T, Chantraine-Hess S, Hartmann K, Czarnetzki BM. Pseudoallergen-free diet in the treatment of chronic urticaria. A prospective study. Acta Derm Venereol. 1995;75(6):484-7.
Nizami RM, Baboo MT. Office management of patients with urticaria: an analysis of 215 patients. Ann Allergy. 1974;33(2):78-85.
Juhlin L. Recurrent urticaria: clinical investigation of 330 patients. Br J Dermatol. 1981;104(4):369-81.
Sibbald RG, Cheema AS, Lozinski A, Tarlo S. Chronic urticaria. Evaluation of the role of physical, immunologic, and other contributory factors. Int J Dermatol. 1991;30(6):381-6.
Hellgren L. The prevalence of urticaria in the total population. Acta Allergol. 1972;27(3):236-40.
Green GR, Koelsche GA, Kierland RR. Etiology and pathogen- esis of chronic urticaria. Ann Allergy. 1965;23:30-6.
Lindelöf B, Wahlgren CF. Chronic urticaria associated with internal malignancy. Int J Dermatol. 1990;29(5):384.
