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)

Rubino and Zanna (5) have responded to our comments (1) on their report (4) on the association of personality disorders with psoriasis and have presented data comparing the personality characteristics of psoriasis patients with those in urticaria patients. The problems that remain with their methodology are that dental controls may not be equivalent to dermatologic conditions, and in the urticaria study, no data on premorbid functioning were provided to differentiate state vs trait phenomena, and they did not control for duration of illness.
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PMID:Personality disorders in psoriasis. 900 73

Eosinophil cationic protein (ECP) is a cationic protein derived from eosinophil granulocytes, and has been studied mainly in atopic diseases and considered as a useful marker of disease activity in atopic dermatitis. We measured the serum ECP levels in patients with various skin diseases (n = 875) and in normal healthy controls (n = 79), and evaluated the correlation between ECP level and blood eosinophil number, or ECP and IgE levels. Serum ECP levels were significantly higher in patients with drug eruption (15.8 +/- 1.7 micrograms/l), psoriasis (15.1 +/- 6.0 micrograms/l), acute urticaria (13.9 +/- 1.4 micrograms/l) than in healthy controls (4.5 +/- 0.3 micrograms/l) (P < 0.05) and also significantly elevated in patients with elevated eosinophil numbers (15.2 +/- 1.0 micrograms/l) compared to those in patients with normal eosinophil numbers (8.8 +/- 0.3 micrograms/l) (P < 0.001). Serum ECP level and eosinophil number in peripheral blood were also correlated in patients with psoriasis (gamma = 0.82, P < 0.01), drug eruption (gamma = 0.31, P < 0.01) and acute urticaria (gamma = 0.20, P < 0.05). However, no correlation between ECP and IgE levels in all of the patients was found. Among the patients with chronic urticaria, ECP levels showed an increasing trend in patients with angioedema, cold urticaria and dermographic urticaria as compared with those in healthy controls. Our results suggest that, even though the role of ECP released from activated eosinophils is still unknown, its measurement might be of help to understand the pathogenesis of some skin disorders.
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PMID:Eosinophil cationic protein (ECP) level and its correlation with eosinophil number or IgE level of peripheral blood in patients with various skin diseases. 927 89

Mast cells are involved in atopic disorders, often exacerbated by stress, and are located perivascularly close to sympathetic and sensory nerve endings. Mast cells are activated by electrical nerve stimulation and millimolar concentrations of neuropeptides, such as substance P (SP). Moreover, acute psychological stress induces CRH-dependent mast cell degranulation. Intradermal administration of rat/human CRH (0.1-10 microM) in the rat induced mast cell degranulation and increased capillary permeability in a dose-dependent fashion. The effect of CRH on Evans blue extravasation was stronger than equimolar concentrations of the mast cell secretagogue compound 48/80 or SP. The free acid analog of CRH, which does not interact with its receptors (CRHR), had no biological activity. Moreover, systemic administration of antalarmin, a nonpeptide CRHR1 antagonist, prevented vascular permeability only by CRH and not by compound 48/80 or SP. CRHR1 was also identified in cultured leukemic human mast cells using RT-PCR. The stimulatory effect of CRH, like that of compound 48/80 on skin vasodilation, could not be elicited in the mast cell deficient W/Wv mice but was present in their +/+ controls, as well as in C57BL/6J mice; histamine could still induce vasodilation in the W/Wv mice. Treatment of rats neonatally with capsaicin had no effect on either Evans blue extravasation or mast cell degranulation, indicating that the effect of exogenous CRH in the skin was not secondary to or dependent on the release of neuropeptides from sensory nerve endings. The effect of CRH on Evans blue extravasation and mast cell degranulation was inhibited by the mast cell stabilizer disodium cromoglycate (cromolyn), but not by the antisecretory molecule somatostatin. To investigate which vasodilatory molecules might be involved in the increase in vascular permeability, the CRH injection site was pretreated with the H1-receptor antagonist diphenhydramine, which largely inhibited the CRH effect, suggesting that histamine was involved in the CRH-induced vasodilation. The possibility that nitric oxide might also be involved was tested using pretreatment with a nitric oxide synthase inhibitor that, however, increased the effect of CRH. These findings indicate that CRH activates skin mast cells at least via a CRHR1-dependent mechanism leading to vasodilation and increased vascular permeability. The present results have implications for the pathophysiology and possible therapy of skin disorders, such as atopic dermatitis, eczema, psoriasis, and urticaria, which are exacerbated or precipitated by stress.
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PMID:Corticotropin-releasing hormone induces skin mast cell degranulation and increased vascular permeability, a possible explanation for its proinflammatory effects. 942 40

Having observed altered itch and flare reactions after histamine application in patients with atopic eczema, we tried to determine these reactions in patients with urticaria and psoriasis. We investigated 16 healthy non-atopic subjects, 16 atopics in an eczema-free interval, 16 with acute atopic eczema, 16 with urticaria and 16 with psoriasis. Histamine was iontophoretically applied. The resulting sensations were rated on a visual analogue scale. Flare areas were measured 6 min after stimulation. Itch ratings of urticaria and psoriasis patients did not differ significantly from controls, whereas both atopic groups, regardless of acute or symptom-free state, reported significantly reduced intensity of itching. Flares were significantly diminished in all subjects with acute skin disease (psoriasis, urticaria and atopic eczema), regardless of diagnosis. However, flares were "normal" in symptom-free atopics and were not significantly different from controls. In conclusion, all "acute" patients showed a diminished axon-reflex function, possibly due to a downregulation of C-fiber responsiveness to histamine or an increased turnover rate of inflammatory mediators. Both atopic groups reported weaker itching, suggesting altered central nervous processing of itch.
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PMID:Histamine and cutaneous nociception: histamine-induced responses in patients with atopic eczema, psoriasis and urticaria. 953 90

A total of 149 elderly men and women with pruritic skin problems were selected for study at the dermatological clinic in the Department of Medicine, Rajavithi General Hospital, Bangkok, Thailand, from 26 November 1996 to 10 January 1997. There were 62 men (41.6%) and 87 women (58.4%). The average age was seventy years. Among these elderly patients, pruritic skin disease was the most common problem, found in about 41%. Xerosis (senile pruritus) was the most common problem at 38.9%. Other pruritic skin diseases found were inflammatory eczema (22.8%), lichen simplex chronicus (12.1%), skin infections (11.4%), psoriasis vulgaris (6.7%), urticaria (4.7%), drug rash (2%), insect bite (0.7%), and anogenital pruritus (0.7%). Xerosis usually occurred with increased bathing frequency and use of strong soaps and detergents. The causes of inflammatory eczema were seborrheic dermatitis, allergic contact dermatitis, dyshidrosis, and stasis dermatitis. Statistical analysis of xerosis and inflammatory eczema by gender showed no difference, but there was more inflammatory eczema among females.
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PMID:Pruritic skin diseases in the elderly. 957 76

Terbinafine is an allylamine antifungal agent widely used to treat dermatophyte onychomycosis and dermatomycoses. We report 10 severe cutaneous adverse reactions associated with terbinafine therapy which required discontinuation of the antifungal agent: erythema multiforme (five patients), erythroderma (one), severe urticaria (one), pityriasis rosea (one) and worsening of pre-existing psoriasis (two patients). The spectrum of cutaneous adverse effects associated with terbinafine therapy is reviewed. Patients should be counselled about discontinuing terbinafine at the onset of a cutaneous eruption and about seeking medical advice about further management.
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PMID:Cutaneous adverse effects associated with terbinafine therapy: 10 case reports and a review of the literature. 999 Apr 1

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

A computer-assisted telephone interview survey was carried out in the City of Maryborough to determine the prevalence and sources of advice for self-reported skin conditions. Of the 443 adults contacted, 416 (94%) agreed to participate in the study. One hundred and fourteen people (27%) reported having one or more skin conditions over the past 2 weeks, which included eczema/dermatitis 25.5% (range, 18.1-32.8%; 95% CI), warts 16.1% (9.8-22.4%), acne 16.2% (9.6-22.7%), cold sores 13.1% (7.3-18.9%) and tinea 11.2% (5.9-16.5%). Medical practitioners were the most common source of advice for 49% of skin conditions, followed by family and friends or self-prescribed (25%). Advice from a pharmacist was sought for 19% of skin conditions. Logistic regression analysis showed that those people who reported a moderate to severe inflammatory skin condition, such as dermatitis, urticaria or psoriasis, were most likely to seek advice from their medical practitioner. The type and severity of skin condition were factors which determined where a person sought advice on diagnosis and management.
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PMID:Maryborough skin health survey: prevalence and sources of advice for skin conditions. 983 19

Itching reflects a distinct quality of cutaneous nociception elicited by chemical or other stimuli to neuronal receptors at the superficial layers of the skin and muco-cutaneous orifices. Although recent experimental studies of the conduction and perception of itch have yielded deeper insight into the physiology of this sensory quality, little is known about the neuromechanisms involved in pruritus accompanying many inflammatory skin diseases, in particular, in atopic eczema. Previous case-control studies of our research group with patients suffering from atopic eczema (AE) revealed significantly diminished itch perception after iontophoretic application of different doses of histamine as well as substance P (i.c. injected). Further experiments using acetylcholine (ACh, i.c.) clearly demonstrated that ACh elicits pruritus instead of pain in patients with AE. The first part of the present review deals with the results of our most recent case-control studies on histamine-induced itch perception in atopics devoid of eczema as well as in patients with urticaria or psoriasis compared to atopics with or without manifest eczema. We demonstrated that both focal itch and perifocal alloknesis (i.e., itch elicited by a slight mechanical, otherwise non-itching stimulus) were significantly reduced in eczema-free atopics yet were normal in non-atopics suffering from urticaria or psoriasis. In further studies using ACh i.c. injected into the uninvolved skin of patients with AE, lichen ruber, psoriasis, type IV contact eczema, or non-specific nummular eczema (n = 10/each group), all the atopics and 6/10 psoriatics felt itch instead of burning pain, but none of the others did. Different doses of vasoactive intestinal peptide (VIP) i.c. applied to the controls and the atopics with or without eczema did not markedly increase the intensity of nociceptive sensations. However, ACh induced pain in the controls, pure pruritus in the atopics with acute eczema, and a 'mixture' of pain and itch in the atopics just free from eczema. Obviously, the quality of sensations evoked by ACh and VIP depends on the inflammatory or non-inflammatory state of the atopic skin. In a placebo-controlled, double blind study on histamine-induced focal itch and alloknesis with healthy subjects (n = 15) using naltrexone (opioid receptor antagonist) and cetirizine (H1-blocking agent), naltrexone was found to significantly reduce both itching and alloknesis. Cetirizine reduced focal itch but failed to influence the alloknesis phenomenon. The wheal and flare reaction was suppressed only by cetirizine. These different effects point to a mainly CNS-based activity of naltrexone but a peripheral level effect of cetirizine. Due to long-lasting experience with group sport as a supporting adjuvant for inpatients with AE, we evaluated, by clinical, psychometric, and physiological studies, the therapeutic efficacy of controlled physical exercise in addition to otherwise equal anti-eczematous therapy for both voluntary participants and non-participants in sports by performing several case-control studies, one followed-up to 6 months after the patients' discharge from the hospital. Regular moderate exercises neither deteriorated nor impeded the recovery from AE, ameliorated the participants' scratch controlling ability and significantly their depressed emotional mood. The non-participants failed to achieve these aims. Sweating-induced itch was inhibited in almost all participants if simple skin care (clearing by warm shower, ointment) and short-term rest were used by informed patients. In conclusion, there are several indications that itching is elicited in individuals inclined to cutaneous atopy, regardless of their eczematous or just eczema-free state, by a different physiological pathway from that in non-atopic individuals. Therefore, antipruritic agents influencing the centrally altered nociception of atopics are needed and may be expected in near future. (ABSTRACT TRUNCATED)
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PMID:Recent studies of cutaneous nociception in atopic and non-atopic subjects. 1009 77

Chronic forms of urticaria are common, often adversely impacting on quality of life. No formal studies have assessed the extent and nature of disability in different types of urticaria. The Dermatology Life Quality Index (DLQI) is a simple and validated 10-item questionnaire designed to measure and compare disability in different skin conditions. In this study, we aimed to assess the disability in different urticarial groups using the DLQI, allowing comparison with previously published DLQI scores in common skin diseases. The DLQI was administered to 170 consecutive patients attending a specialist urticaria clinic over a 4-month period. Consistent with previous studies using the DLQI, mean scores were not influenced by gender or age. Patients with chronic idiopathic urticaria without a concurrent physical urticaria (n = 47) suffered moderate quality of life impairment (mean +/- SD DLQI 25 +/- 24%). In comparison, patients with chronic idiopathic urticaria with concurrent delayed pressure urticaria (DPU) (n = 26) suffered significantly higher quality of life impairment (mean +/- SD DLQI 43 +/- 23%, 95% confidence interval for difference 7-29%). Disability in this group was greatest in the dimensions of work/study, symptoms/feelings and leisure. Subjects with another form of physical urticaria, cholinergic urticaria, also endured high levels of disability (n = 9, mean +/- SD DLQI 50 +/- 34%). From our urticaria study group, we have shown that subjects with DPU and cholinergic urticaria endure the most quality of life impairment. The mean DLQI scores demonstrated in these groups are comparable with those previously seen in severe atopic dermatitis out-patients (60%) and higher than those seen in out-patients with psoriasis (29.7%), acne (24.3%) and vitiligo (16.1%).
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PMID:The extent and nature of disability in different urticarial conditions. 1023 18


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