Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lupus erythematosis is a nodular skin lesion that usually occurs on the inner surfaces of the extremities, and is 5-7 times more common in women than in men, particularly between 20-30 years of age. It is diagnosed by biopsy since the associated symptoms of malaise, fever, and arthralgia are variable. Known agents to induce lupus are streptococcal infection, sarcoidosis, tuberculosis, mycoses, medications particularly sulfa and oral contraceptive steroids, and a variety of other infections and allergies. A table is included in this review showing 8 cases of lupus erythematosus reported in the literature where oral contraceptive steroids were proved to be the etiologic factor, either by withdrawing and repeating pill prescription or by skin tests. The review ends with a list of other dermatological side effects of the pill, such as chloasma, acne, vaginal moniliasis, herpes, photosensitivity, and urticaria.
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PMID:[Etiologies of erythema nodosum (a little known etiology: estro-progestagens)]. 101 56

A new type of corneal dystrophy with various oculocutaneous symptoms and other signs is described. Snowflake dystrophy is characterized by hundreds of small, round, oval or cork-screw-like white opacities in the endothelium and Descemet's membrane. The length of the opacities is 5-20 mu and they form an even layer throughout the posterior membrane. 44% of the patients above the age of 70 years had also pseudoexfoliation of the lens capsule. Corneal endothelial pigmentation advance with the age but are not even in elderly patients necessarily present. A wide range of cutaneous disturbances of melanin metabolism was noted in 4/5 of the cases: intradermal nevi, lentigines, nevus spilus, melasma, vitiligo, early alopecia and early graying of the hair. Photosensitivity reactions like solar urticaria were noted in 5 cases. The skin was often wrinkled, dry and inelastic. Conjunctival wrinkling and Bitot's spots, ovarial cysts, frequently recurrent tonsillitis and several cholecystectomies suggest a generalized involvement of mucous membranes in this syndrome. Degenerative joint disease was constated in 2/5 of cases. The genetic analysis of 59 persons revealed an autosomal dominant mode of inheritance. The prevalence of the gene was high in the province of Satakunta in western Finland.
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PMID:Inherited corneal snowflake dystrophy with oculocutaneous pigmentation disturbances and other symptoms. 387 58

Pigmentary anomalies are among the least serious but most frequent skin changes resulting from oral contraceptive use. A pseudo "mask of pregnancy" called chloasma or melasma may be produced. It is a blotchy hyperpigmentation of the face which can be a disfiguring cosmetic and emotional problem. Melasma most often appears 1-4 months after taking the pill. Of 13 such patients closely studied, melasma of pregnancy had previously been present in 10. Only minimal improvement was noted in 7 even up to 4 years after stopping the drug. Histological examination of 10 biopsy specimens showed normal appearing epidermis with pigment in the basal cell layer of the skin. Of 199 patients taking oral contraceptives in one study, 24% had melasma; of 212 patients in a second study, 29% developed this problem. A history of temporary melasma during pregnancy is an important predictor. Reduced exposure to sunlight is recommended. Use of a hydroquinone cream as a bleaching agent results in only slight improvement. Changing the type of pill has had little effect but reducing the amount of progesterone may help. Other skin manifestations with oral contraceptives include: 1) acne vulgaris, which may be improved or aggravated; 2) alopecia or diffuse thinning of the entire scalp hair, which may be reversible; 3) treatment of aphthous stomatitis, which is controlled by estrogen therapy; and 4) erythema nodosum, which subsides when oral contraceptives are stopped. Urticarial reactions represent an allergic response to special drugs.
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PMID:Melasma and other skin manifestations or oral contraceptives. 562 Jun 4

Hormonal contraceptives can induce changes in the skin and its appendages. Many skin functions are regulated by sex hormones. Clinical use of synthetic sex hormones can effect these hormone-dependent functions. Some effects are due to individual overdose of hormonal contraceptives; others are due to allergic reactions to contraceptive components. Estrogenic potency rather than the kind of estrogen is the determining factor whereas the kind of gestagen used is more important than its potency. Nortestosterone derivatives can exhibit variable androgenic residual action whereas progesterone derivatives have a strongly anti-androgenic effect. The table lists various skin manifestations with their possible causative agent(s) and treatment prevention possibilities. Specially described are: 1) Chloasma where combined action of estrogens and gestagens seem to be responsible together with individual factors of hair color, pigmentation, and extent of light exposure. 2) Acne, seborrhea, and hirsutism resulting from androgenic effect of gestagens; 19-nortestosterone derivatives affect sebaceous glands, 17-hydroxyprogesterone derivatives act on hair follicles. The two have opposite effects. 3) Hair loss occurs during the initial months of contractive intake. It is caused by the gestagen action on the growth phase of the hair, is dose-dependent and self-limiting. Androgenic alopecia is induced by nortestosterone and depends on individual hair pattern. It starts, after several months of hormone intake. 4) Symptoms of individual hormone overdose, where metabolic factors can induce a variety of skin manifestations. Estrogens potentiate corticosteroid effects on the skin such as striae, telangiectasiae, and rosacea dermatitis. 5) "Allergies" or etiological unexplained reactions to contraceptives such as purpura, prurigo, urticaria, and eczema. Elimination testing is diagnostic for these. Real allergies to sex hormones are autoimmune reactions which can be diagnosed with skin tests or lymphocyte transformation tests.
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PMID:[Skin changes from taking hormonal contraceptives]. 724 55

The clinical presentation of certain dermatologic conditions differs between women and men; this may be especially true when women are perimenstrual or pregnant. Skin diseases that erupt or become aggravated during the perimenstrual period include autoimmune progesterone dermatitis and melasma. Dermatologic conditions that may be exacerbated perimenstrually include acne vulgaris, rosacea, lupus erythematosus, psoriasis, atopic eczema, lichen planus, dermatitis herpetiformis, erythema multiforme, and urticaria. The hormonal effects of increased cutaneous vascularity, seborrhea, and dermal edema during the perimenstrual period may account for the eruption of or increase in severity of these diseases. Clinical presentation, differential diagnoses, and treatment options for select cutaneous conditions are discussed.
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PMID:Clinician's Photo Guide To Recognizing and Treating Skin Diseases in Women: Part 1. Dermatoses Not Linked to Pregnancy. 974 12

Studies concerning the prevalence of skin diseases and the general dermatologic services in Ethiopia are limited. A total of 7760 patients with 9725 dermatological diseases were seen by a dermatovenereologist from September 1995 to August 1996 at Kazanchis Health center in Addis Ababa. Male to female ratio was 1.01:1.00. Three thousand eighteen (31.0%) of the total 9725 cases had prior evaluation by other health personnel, including doctors (but not dermatologists). Out of these cases, 2720 (90.1%) were misdiagnosed and mismanaged. This high percentage points to the need for further short-term dermatology training for non-dermatologists. Bacterial, fungal and viral infections were dominating, comprising 19.4%, 18.5% and 6.5% of cases respectively. Infestations (i.e., pediculosis and scabies together) represented 10% of cases. Eczemas contributed 18.1% of the total cases. Photoallergic dermatitis (4.5%), Pityriasis alba (4.4%), urticaria (2.2%), prurigo (2%), benign tumors (1.8%), lichen planus (1.6%) and melasma (1.5%) were also quite common.
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PMID:Skin diseases seen in Kazanchis health center. 1195

Fertility control by cyclic norethindrone (Norlutin), 17 alpha-ethinyl 19-nortestosterone, plus .06 mg 3-methoxy ethinyl estradiol (Ortho-Novum) was studied in 364 women over a period of 32 months for a total of 6062 cycles. No patient who followed the instructions became pregnant. 37 patients stopped the medication for various reasons. The interval between stopping medication and becoming pregnant averaged 1.6 months. 13 of these pregnancies occurred after 11-15 cycles of treatment. Children born to these mothers were normal with no virilization observed. Findings from all Papanicolaou smears and cervical biopsies were normal. The desirable effects of diminishing the menstrual flow, reducing dysmenorrhea and regulating the menstrual cycle, plus the all-important one of contraception, far outweighed minimal and infrequent undesirable side effects (in order of frequence: chloasma, hot flashes, headache, nausea, acne, abdominal pain, dizziness and urticaria). In only 4.8% of the total 6062 cycles was some complaint made.
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PMID:Long-term administration of norethindrone in fertility control. 1227 4

Oral contraceptives (OCs) can affect the skin through their hormonal effects or through iatrogenic effects associated with their toxicity in certain individuals. They may also be beneficial in certain androgen-dependent dermatoses. Toxic effects of OCs are rare but potentially serious; they should be diagnosed early and require permanent termination of OC use. The clinical manifestations are variable and not specific to the medication. The most frequently reported manifestations are allergic vascularities which may lead to serious renal complications, fixed pigmented erythema, urticaria, which may have other etiologic factors, and lichenoid eruptions. Combined OCs, because of their estrogen content, may cause sensitivity to light in susceptible women. Other dermatoses can be initiated or aggravated by OCs without direct relation to their hormonal effects. OCs are therefore contraindicated if there is a personal or family history of porphyries or a personal history of systemic lupus erythematosus, erythema nouex, herpes gestationis, or malignant melanoma. Hormonal-related dermatological effects caused by either progestins or estrogens have become less frequent as dose levels have declined. Chloasma, either melasma or a poorly defined spotty pigmentation, accounts for 2/3 of cases of OC-related dermatoses. It is more common in women of Mediterranean background. 80% of affected OC users have a history of "mask of pregnancy", but the condition is also found in nulliparas. Exposure to sunlight is a factor. Women with a history of chloasma of pregnancy and dark coloring should not use OCs. Seborrhea is directly related to the androgen effect of OCs and is less likely to occur with 17 OH progesterone derivatives than with 19 norsteroid derivatives. The role of androgens in acne is well known, but 2 other factors are necessary: an anomaly in keratinization and proliferation of corynebacterium acnes, a saprophyte of the follicles. OCs do not necessarily need to be suspended during well-conducted acne treatment. Alopecia is rare but difficult to diagnose because of its psychological aspects. Androgenic alopecia is aggravated by progestins derived from 19 norsteroids. True hirsutism caused by an androgen-producing ovarian pathology is not related to OC use. Estrogens are incriminated in the etiology of telangiectasies, permanent dilatations of the arterioles. Once developed the condition does not regress and requires treatment with sclerosing agents, electrocoagulation, or laser. The various dermatological risk factors should be ruled out before prescription of an OC. Classic contraceptive pills are not commonly used in treatment of common acne because the strongly estrogenic climate required for therapeutic utility carries the risk of hypertriglyceridemia, thrombophlebitis, and possibly carcinogenesis. The recent development of pills containing the antiandrogen cyproterone acetate instead of a progestin in combination with ethinyl estradiol reduces androgenic effects in women. This pill may be useful in cases of severe acne, severe seborrhea, androgenic alopecia, or excessive facial hair.
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PMID:[Cutaneous effects in hormonal contraception]. 1228 Dec 76

The incidence of cutaneous effects of oral contraceptives (OCs) is estimated at 2.7-5%. Secondary effects directly attributable to the hormonal action of OCs include melasma, acne and hyperseborrhea, alopecia, and cutaneous lesions of vascular origin. Melasma or chloasma accounts for about 2/3 of all cutaneous side effects of OCs. It appears from 1 month-3 years after the start of OC use, its frequency increasing with dose and duration of use. Pigmentation appears to accentuate the symptoms in brunettes rather than predisposing them to melasma. Exposure to the sun plays a certain role, but use of a low dose OC and effective sun protection are not enough to reverse the pigmentation. These melasmas regress more slowly than after pregnancy and many remain definitive. The influence of OCs on acne is variable, with some OCs provoking sebaceous hypersecretion and some improving acne enough to be used for treatment. For the therapeutic effect to be observed, the estrogen dose must be sufficient to offset the androgenic effect of the progestin. Combined pills containing the strong antiandrogen cyproterone acetate should control acne if other, less androgenic progestins fail. Alopecia is a very rare effect of OCs and its appearance may even reflect simple coincidence. Vascular complications of combined OCs are dependent on estrogens and may include such manifestations as telangiectasias, angiomas, and livedo reticularis. Some secondary cutaneous effects are probably not due to a hormonal influence. They are less well known than the direct hormonal effects, and publications concerning the often detail isolated observations that are difficult to interpret. Reactions of hypersensitivity or allergy to combined OCs may include urticaria and eczema. A history of OC use should be sought in all women presenting with erythema nodosum and the OCs should be discontinued. Pruritus and jaundice may be observed in 1 OC user in 100,000. They indicate a cholestatic hepatitis for which estrogens are responsible. Most patients developing the condition have already had pruritus or jaundice during pregnancy; such a history contraindicates OC use. Several dermatological and systemic disorders are aggravated by OC use. Hereditary angioedema, herpes gestationis, porphyries, and systemic lupus erythematosus are exacerbated by OC use. The role of OCs in malignant melanomas remains controversial.
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PMID:[Dermatological complications caused by oral contraceptives]. 1234 76

Topical corticosteroids are one of the oldest and most useful treatments for dermatologic conditions. There are many topical steroids available, and they differ in potency and formulation. Successful treatment depends on an accurate diagnosis and consideration of the steroid's delivery vehicle, potency, frequency of application, duration of treatment, and side effects. Although use of topical steroids is common, evidence of effectiveness exists only for select conditions, such as psoriasis, vitiligo, eczema, atopic dermatitis, phimosis, acute radiation dermatitis, and lichen sclerosus. Evidence is limited for use in melasma, chronic idiopathic urticaria, and alopecia areata.
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PMID:Choosing topical corticosteroids. 1917 66


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