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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent case reports have suggested that H2-antihistamines used alone may be effective in the treatment of acute urticaria, a common complaint of patients presenting to the emergency department. This contradicts accepted doctrine on the treatment of acute urticaria. Based on theories of H1- and H2-receptor interaction at the cellular level, it has been stated that H2-blockade before H1-blockade may exacerbate symptoms. The purpose of our study was to compare diphenhydramine, an H1-blocker, with cimetidine, an H2-blocker, in a randomized, prospective, double-blind clinical trial. Ninety-three patients presenting to the ED with clinical evidence of acute urticaria were treated with either 50 mg diphenhydramine IM or 300 mg cimetidine IM. Patients' signs and symptoms were quantitated on a numeric scale before receiving medications and 30 minutes after treatment. Parameters measured included degree of itching, intensity and extent of wheals, degree of sedation, and perception of overall improvement. Each medication provided significant relief of itching and wheal intensity (P less than .0001). Sedation was caused by both diphenhydramine (P less than .0001) and cimetidine (P less than .0006). However, the degree of sedation caused by diphenhydramine was significantly greater than that caused by cimetidine (P = .0001). The perception of overall improvement was greater with cimetidine, with 87% of patients reporting improvement, whereas 76% of diphenhydramine-treated patients reported improvement. Our results indicate that cimetidine is efficacious as the initial treatment of acute urticaria and has less tendency toward sedation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of cimetidine and diphenhydramine in the treatment of acute urticaria. 240 34

In the present experiments the role of unmyelinated sensory fibres in the mechanism of cutaneous inflammatory reactions under normal and pathological conditions has been studied in man and animals. Dye leakage responses to histamine, serotonin, compound 48/80, bradykinin and substance P were significantly reduced, while neurogenic inflammation was completely abolished in rats treated neonatally with capsaicin, as studied quantitatively by the Evans blue technique. Neurogenic inflammation could also be elicited by mustard oil in normally innervated human skin, but not in skin areas affected by herpes zoster or in a patient suffering from congenital analgesia. Repeated topical treatment of the skin with capsaicin (local desensitization) abolished the neurogenic inflammatory response for several days. Chemical pain sensitivity was strongly reduced, and thresholds for warmth and heat pain sensations were significantly elevated. Local capsaicin desensitization of the skin prevented whealing, flare and itch in patients with acquired cold and heat urticaria. The findings indicate that peptide-containing sensory nerves are involved in the mediation of chemogenic and heat pain, and possibly itch, and are responsible for initiation of the neurogenic inflammatory response. The results also provide direct evidence of the involvement of these particular sensory nerves in the modulation of the permeability-increasing effects of putative mediators of acute inflammatory reactions. It is concluded that, through modulation of cutaneous vascular reactions, peptidergic sensory nerves may play a hitherto unrecognized role in the pathomechanism of certain diseases of human skin.
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PMID:The modulation of cutaneous inflammatory reactions by peptide-containing sensory nerves. 241 73

A case of localized heat urticaria in a 70-year-old woman is reported. Increased plasma levels of prostaglandin D2 and blood histamine after heat challenge indicate a role for mast cell degranulation in the pathophysiology of the syndrome. Treatment with astemizole increased the temperature threshold to wealing, but not to itch or erythema. The patient was partially desensitized by repeated exposure to heat and this was further improved by indomethacin. After treatment there was no increase in plasma prostaglandin D2 on challenge. No evidence was found for the activation of the alternative complement pathway.
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PMID:Release of prostaglandin D2 and histamine in a case of localized heat urticaria, and effect of treatments. 243 16

A total of 65 patients with food allergy which manifested primarily by disorders of the gastrointestinal tract, bronchi and skin were placed under observation. The patients were administered sodium chromoglycate (nalcrom) per os in a dose of 200 mg 4 times a day for 2-3 weeks, in part of cases up to 3 months and even up to 1-1.5 year. The skin manifestations of allergy (pruritus, urticaria, Quincke's edema, and eczematous rash), abdominal pain, diarrhea, vomiting, bronchospasm, rhinitis, and conjunctivitis disappeared. At the same time the majority of the patients demonstrated the reduction of the intensity of skin responses to the administration of different food antigens, the decrease of the antibody titer in blood serum in response to food antigens, and of the IgE content in blood. The side effects (nausea, heartburn, intensification of skin itch and abdominal pain) were noted in 4 cases.
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PMID:[Treatment of patients with food allergy using Nalcrom]. 249 73

The presenting features of 236 thyrotoxic patients seen in the thyroid clinic were reviewed. 18.65% of these patterns had one or more dermatological complaints at presentation. There was no specific difference in this group of patients when compared with the general hyperthyroid population with regard to age, race, sex, duration of hyperthyroidism or biochemical indices of thyrotoxicosis. The two major complaints were itching and alopecia. The prevalence of pruritus at 6.4% in our series was identical to that of other workers, but we had a much lower occurrence of alopecia at 2.6%. The diagnosis of thyrotoxicosis was delayed in two patients in whom the only major complaint was pruritus. These symptoms cleared quickly when these patients became euthyroid. However there were other patients who noted hair loss with anti-thyroid medications. The incidence of vitiligo, eczema, onycholysis in our series was much lower those quoted in the Western literature The occurrence of pretibial myoxoedema in our series is similar to that of other workers from this region. The other miscellaneous manifestations include urticaria, xanthelasma and systemic lupus erythematosis. In conclusion we feel the cutaneous manifestations of hyperthyroidism are common in our patients.
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PMID:The prevalence of skin manifestations in thyrotoxicosis--a retrospective study. 252 42

The aim of this study was to approach on a psychical point of view 27 patients suffering from chronic idiopathic urticaria (14), pruritus sine materia (6), alopecia areata (3), pathomimia (4), in order to examine the possibility that psychic disorders could act as triggering or aggravating the dermatological affection. Psychical assessment was evaluated by colloquy and by the administration of some psychodiagnostic tests: EPI, MMPI, Zung. The role of psychogenic factors in skin diseases is emphasized and the results obtained from the use of antidepressant and minor tranquilizer drugs are discussed.
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PMID:[Preliminary approach to the mental component in dermatologic patients]. 257 43

The efficacy of nifedipine, a calcium channel antagonist, in the treatment of chronic idiopathic urticaria, was evaluated in a double-blinded, placebo-controlled, crossover trial. Ten patients with chronic urticaria refractory to maximally tolerated doses of H1 and H2 antihistamines and in whom extensive evaluation failed to identify a cause for their urticaria were entered into the study. Patients continued with their prestudy antihistamine regimens. A study drug dosage was titrated in each patient and maintained throughout the trial. Patients were treated with placebo or nifedipine for 4 weeks and then crossed over to the other medication for 4 weeks. One patient withdrew because of unrelated medical illness, two patients withdrew after crossover to placebo because of intolerable urticaria, and seven patients completed the study. A beneficial effect of nifedipine was clearly demonstrated. Hive count, hive index, and itch index were all significantly improved at the end of 4 weeks of nifedipine treatment (p = 0.023, 0.003, and 0.003, respectively) but not placebo treatment (p = 0.194, 0.664, and 0.944, respectively). Additionally, end point hive index and itch index scores with nifedipine compared to corresponding placebo scores were significantly improved (p = 0.010 and 0.008, respectively). Nifedipine was well tolerated. Thus, when nifedipine is used as an adjunct to antihistamines, it appears to be a safe, efficacious drug for the treatment of chronic idiopathic urticaria.
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PMID:Therapy of chronic idiopathic urticaria with nifedipine: demonstration of beneficial effect in a double-blinded, placebo-controlled, crossover trial. 265 8

A controlled trial of 4-weeks oral photochemotherapy (PUVA) on 14 patients with severe symptomatic dermatographism produced a clinically useful reduction in itching in five patients. In four of these patients itching had relapsed to pre-treatment levels within 3 months of finishing the PUVA course. A comparison of the weal and flare responses on exposed and covered (control) skin using a calibrated dermographometer showed no significant change in skin reactivity, even in the patients who experienced symptomatic relief. While PUVA may temporarily reduce itching in some patients with symptomatic dermographism, its use cannot generally be justified for treating this type of physical urticaria.
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PMID:The effect of psoralen photochemotherapy (PUVA) on symptomatic dermographism. 268 Jan 76

A total of 754 patients were treated intravenously with sulbactam/ampicillin, in a clinical trial to determine the efficacy and safety of the drug. The majority of patients were treated with 3 g/day by intravenous infusion for 4 to 14 days. Clinical response was evaluated in 689 of 754 patients. In the treatment of respiratory and urinary tract infections, efficacy was 82.5% and 77.1%, respectively. Overall, sulbactam/ampicillin was effective in 80.4% of all evaluable patients. Of 175 patients who failed to respond to prior antibiotic therapy, 135 patients (77.1%) were effectively treated with sulbactam/ampicillin. The overall bacteriological eradication rate was 91.8% against Gram-positive organisms, 75.9% against Gram-negative organisms, and 90% against anaerobes. In addition, 166 of 221 strains that were beta-lactamase producers were eradicated after treatment with sulbactam/ampicillin. Side effects such as rash, fever, itching, urticaria, and diarrhea occurred in only 2.65%, 20 of 754 cases. Laboratory abnormalities were similar to those reported for other beta-lactam antibiotics, including increases in levels of SGOT (4.9%), SGPT (5.7%), and eosinophilia (3.4%) counts. The study showed that sulbactam/ampicillin has a broad spectrum of antibacterial activity against both Gram-positive and Gram-negative organisms as well as anaerobes. There was a high degree of safety. Thus, sulbactam/ampicillin is effective and safe as a treatment for medical, surgical, urological, and gynecological infections.
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PMID:Clinical evaluation of sulbactam/ampicillin in Japan. 268 16

Histamine poisoning results from the consumption of foods, typically certain types of fish and cheeses, that contain unusually high levels of histamine. Spoiled fish of the families, Scombridae and Scomberesocidae (e.g. tuna, mackerel, bonito), are commonly implicated in incidents of histamine poisoning, which leads to the common usage of the term, "scombroid fish poisoning", to describe this illness. However, certain non-scombroid fish, most notably mahi-mahi, bluefish, and sardines, when spoiled are also commonly implicated in histamine poisoning. Also, on rare occasions, cheeses especially Swiss cheese, can be implicated in histamine poisoning. The symptoms of histamine poisoning generally resemble the symptoms encountered with IgE-mediated food allergies. The symptoms include nausea, vomiting, diarrhea, an oral burning sensation or peppery taste, hives, itching, red rash, and hypotension. The onset of the symptoms usually occurs within a few minutes after ingestion of the implicated food, and the duration of symptoms ranges from a few hours to 24 h. Antihistamines can be used effectively to treat this intoxication. Histamine is formed in foods by certain bacteria that are able to decarboxylate the amino acid, histidine. However, foods containing unusually high levels of histamine may not appear to be outwardly spoiled. Foods with histamine concentrations exceeding 50 mg per 100 g of food are generally considered to be hazardous. Histamine formation in fish can be prevented by proper handling and refrigerated storage while the control of histamine formation in cheese seems dependent on insuring that histamine-producing bacteria are not present in significant numbers in the raw milk.
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PMID:Histamine poisoning (scombroid fish poisoning): an allergy-like intoxication. 268 58


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