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

Histamine release in cold urticaria was studied before and after therapy with cyproheptadine to determine whether any effect upon histamine release could be distinguished from end-organ receptor-site blockade. Patients were asymptomatic while taking cyproheptadine, their ice cube test reverted to normal, and only one of six patients had any swelling upon ice-water submersion of one hand for 5 min. Histamine-release curves were obtained following ice-water submersion before and after cyproheptadine therapy. All patients had significant histamine release and in five of six patients there was no evident difference in the magnitude of histamine release before or after therapy. A single patient did have diminished histamine release after therapy, but could not be restudied to be sure this was not a spurious result. Our data demonstrated that cyproheptadine is extremely effective in ameliorating the symptoms and signs of cold urticaria and that its principal effect is that of an H1 receptor antagonist, thereby blocking the effects of histamine. These data further suggest that a sufficient dose of any standard antihistamine should be similarly effective and that patients who do not tolerate cyproheptadine or do not appear to respond to it should be tried on other antihistamines of the H1 type.
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PMID:The role of cyproheptadine in the treatment of cold urticaria. 610 2

The prevalence of occupational asthma was studied in two snow crab-processing industries in operation since 1980. Before the 1982 season, all except 10 of the 313 employees were investigated by a questionnaire, prick skin tests with common allergens, crab n and crab-boiling water extracts, and spirometry. The diagnosis was confirmed in 46 (15.6%) workers (including 33 of 64 subjects with a history highly suggestive of occupational asthma in the previous seasons) by (1) specific inhalation challenges in 33 subjects (one immediate, nine dual, and 23 late asthmatic responses) and/or (2) a combination of monitoring of peak expiratory flow rates (n = 12) and significant changes in bronchial responsiveness to histamine (n = 16) as well as in spirometry (n = 18) after reappearance of symptoms on return to work. Positive skin tests to crab (p less than 0.001) and, to a lesser degree, smoking history (p = 0.03) but not atopy (p greater than 0.05) were related to the presence of occupational asthma. A high prevalence of rhinoconjunctivitis (35 of 46) and urticaria (16 of 46) was also documented in the affected individuals.
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PMID:Occupational asthma in snow crab-processing workers. 647 Mar 60

A case of localized heat urticaria is reported in a 51-year-old woman who within a few minutes of contact with warm water developed erythema and swelling sharply localized to the heated area. After a hot bath urticarial lesions appeared over large areas of her body, accompanied by a feeling of weakness, but no other systemic symptoms. After challenge with heat by immersing her left arm in water heated to 42 degrees C, a rapid decrease of her serum complement level of factor B was demonstrated, suggesting that activation of an alternative complement pathway plays a role in this form of urticaria. Biopsies for immunofluorescent study of complement and immunoglobulins were negative at 30 and 180 min after heat challenge. The dermal fibres and endothelial cells of dermal vessels were capable, in vitro, of complement binding before and after exposure to heat.
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PMID:Localized heat urticaria associated with a decrease in serum complement factor B (C3 proactivator). 655

A PABA ester-oxybenzone preparation is superior to PABA or sulisobenzone alone in protecting the skin from methoxsalen-induced ultraviolet A (UVA) phototoxicity after water substantivity challenge. Such a mixture would be useful as a UVA screen for uninvolved or actinically damaged skin in patients receiving psoralens and ultraviolet A (PUVA) therapy. An effective topical UVA screen also may protect against UVA-induced diseases like solar urticaria, polymorphic light eruptions, drug-induced phototoxicity or photoallergy, and possibly against the deep degenerative changes of solar elastosis.
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PMID:Topical protection against long-wave ultraviolet A. 660 70

Urticaria and angioedema may occur in skin and mucus membranes when mast cells are activated by various physical stimuli, including trauma, pressure, vibration, light, cold, heat, and (in rare cases) water. Experimental challenge of patients with cold-induced and cholinergic urticaria/angioedema in particular provides an in vivo model of mast cell activation in humans. This model synthesizes observations of the evolution of clinical manifestations, histologic analysis of tissue alterations, measurement of mediators released into the circulation, and assessment of leukocyte motility. The model in turn allows a characterization of mediators that exist preformed in mast cell granules or that are generated through interactions with other cell types. Release of these mediators produces a variety of biologic effects, including elaboration of certain enzymes and alterations in venular permeability, smooth muscle contraction, leukocyte motility, and the release of substances from other cell types.
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PMID:Physical urticaria/angioedema: an experimental model of mast cell activation in humans. 700 77

Thermography is a very instructive method of showing the interaction between direct changes in heat radiation of the surface of the skin and its relation to reflex processes. Short reflex arcs, such as the axon reflex, and long reflex arcs, such as the flush phenomenon provoked by visceral cutaneous reflexes, can be illustrated by thermography. Reflex changes in skin temperature by cooling the skin of patients with cold contact urticaria with the short-term development of large areas of warmed skin and also reflex changes in cholinergic urticaria after prior heating of such skin areas where the urticarial eruption follows are reflected in the picture of telethermography. Reflex arcs between extremities affect the arterial blood flow and show individual variation, as in the case of the cessation of permanent local vasoconstriction by indirect cooling. The thermographic illustration of convective heat transport to the skin surface can be obstructed by the cooling effect of sweat secretion, e.g., water vapor exudation and by changes in conductive heat transport in abnormal skin.
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PMID:Reflex heating of the skin and telethermography. 716 39

Two patients with urticaria evoked at the site of contact of skin with water have been studied. Protection of the skin from contact with water by prior application of petrolatum ointment prevented wealing, but removal of the stratum corneum enhanced wealing. Organic solvents did not themselves evoke wealing, but they enhanced the reaction to subsequent challenge by water. That the release of acetylcholine is an essential step in the pharmacogenesis of wealing in aquagenic urticaria is indicated by the suppressive effect of locally-applied scopolamine on water-evoked wealing. Aquagenic urticaria is also associated with elevated blood histamine levels and degranulation of mast cells in the water-challenged skin. The relationship of acetylcholine and histamine to each other and to contact of water with the skin remains uncertain.
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PMID:Aquagenic urticaria: evidence of cholinergic and histaminergic basis. 727 9

We described the sixteenth reported case of local heat urticaria, in a 59-yr-old woman with erythema and angioedema upon contact with hot water or outdoor heat exposure. Immersing her hand in 39 degrees to 40 degrees C heated water resulted in an erythematous, angioedematous response sharply demarcated by the line of immersion and was associated with immediate increases in histamine concentration (18 to 135 ng/ml) and high molecular weight neutrophil chemotactic activity (two to five times prechallenge levels) in venous blood draining the challenge site. We suggest that the local heat urticarial response in this woman was a form of physical urticaria associated with release of mast cell-derived mediators, akin to cold and cholinergic urticaria.
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PMID:Mediator release in local heat urticaria. 728 47

A 30-year-old woman with aquagenic urticaria developed hives every time she came in contact with a water source such as tap water, snow or sweat. The patient's condition was satisfactorily controlled with cyproheptadine hydrochloride. I believe the triggering event in these attacks may have been an osmotic stimulus.
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PMID:Aquagenic urticaria. 730 67

An 11-yr-old girl presented with a history of urticaria induced by warm or cool showers, exercise, and emotional stimuli. During evaluation she repeatedly developed generalized punctate urticaria, pruritus, palpitations, and headaches after warm baths or exercise, and she had a positive methacholine skin test. She developed similar lesions and pruritus after local application of sterile water, tap water, ethanol, normal saline, or 3% saline. The diagnosis of combined aquagenic and cholinergic urticaria was made and presented a unique opportunity to study and compare mediator release and clinical symptoms in both conditions. The patient was submerged in bath water at either 37 degree or 41 degree C to induce either aquagenic or cholinergic urticaria, respectively. Histamine was released into the systemic circulation in both conditions in a similar time course; however, systemic symptoms occurred only after the 41 degree C bath. After failure to induce tolerance to the 41 degree C bath water, hydroxyzine therapy was instituted. One week later she was rechallenged; few symptoms appeared, and a rise in serum histamine was not detected as had been shown in previous challenges. The data suggest that in our patient, hydroxyzine may have contributed to the inhibition of both histamine release and the appearance of symptoms during hot bath challenging.
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PMID:Evaluation of a patient with both aquagenic and cholinergic urticaria. 731 13


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