A Clinician's View of Urticarial Dermatitis

Rietschel, Robert L.

doi:10.1001/archderm.142.7.932-a

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…29 The lesions last for days to weeks and are bilateral and symmetrically located on the trunk and proximal extremities. 29,30 The lesions sometimes have a targetoid appearance with peripheral scaling, and excoriated erythematous papules may coexist. Lesions are intensely pruritic, and pruritus is unrelieved by treatment with antihistamines and topical corticosteroids.…”

Section: Common Cutaneous Urticarial Syndromesmentioning

confidence: 99%

“…Lesions are intensely pruritic, and pruritus is unrelieved by treatment with antihistamines and topical corticosteroids. 29,30 The histologic picture is that of a predominantly dermal eczematous reaction with papillary dermal edema and superficial perivascular lymphocytic infiltration with eosinophils and minimal epidermal spongiosis (Fig 3, B). 29,31 The etiology remains elusive in most cases, but drugs are most likely implicated in many cases.…”

Section: Common Cutaneous Urticarial Syndromesmentioning

confidence: 99%

“…Additional features may include eczematous changes, vesicles, or targetoid lesions d PUPPP predominantly involves the trunk (abdomen) and proximal extremities d Spontaneous complete resolution occurs within weeks d A histologic examination reveals a nonspecific perivascular lymphohistiocytic infiltrate with some edema and eosinophils in the dermis; direct and indirect immunofluorescence studies are routinely negative PUPPP, also known as polymorphic eruption of pregnancy, is one of the most commonly diagnosed pruritic dermatoses of pregnancy, but it has a J AM ACAD DERMATOL VOLUME 62,NUMBER 4 confusing nomenclature because of the diversity of its cutaneous features. 57,58 The disease usually affects women during their first pregnancy, and the skin lesions classically appear in the third trimester (mean onset in the 35th week [range, [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]), and in extremely rare cases it first appears postpartum or earlier on in the pregnancy. 57,58 The etiology of PUPPP is still unknown; hormonal changes, connective tissue damage, and immunologic mechanisms are likely involved.…”

Section: Contact Dermatitis (Irritant or Allergic)mentioning

confidence: 99%

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Urticarial lesions: If not urticaria, what else? The differential diagnosis of urticaria

Peroni

Colato

Schena

et al. 2010

Journal of the American Academy of Dermatology

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Section: Common Cutaneous Urticarial Syndromesmentioning

confidence: 99%

Section: Common Cutaneous Urticarial Syndromesmentioning

confidence: 99%

Section: Contact Dermatitis (Irritant or Allergic)mentioning

confidence: 99%

See 1 more Smart Citation

Urticarial lesions: If not urticaria, what else? The differential diagnosis of urticaria

Peroni

Colato

Schena

et al. 2010

Journal of the American Academy of Dermatology

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“…Many clinicians still label cases as dermatitis, drug reaction or urticaria. Clinicians' failure to embrace the term could be due to the lack of specific clinical diagnostic criteria on the one side and the overlap occasionally found between UD and other skin conditions on the other. Different studies have found different female to male ratios in these patients, ranging from 0.26:1 to 2.4:1 …”

Section: Discussionmentioning

confidence: 99%

Retrospective chart review in a cohort of patients with urticarial dermatitis

Banan

Butler

2013

Aust J Dermatology

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Urticarial dermatitis is a poorly understood skin condition while it seems to be much more common than the paucity of reports suggest. It manifests with severely pruritic papules and plaques that resemble eczematous and urticarial lesions morphologically. The key clues to diagnosis are the urticarial appearance and overlap with an eczematous reaction. Here, we present a series of 19 cases (13 women and six men) with urticarial dermatitis clinically and histologically. The patients' average age was 58 and most of the cases were idiopathic. Trunk and proximal extremities were the most common sites involved followed by the distal extremities. Poor response to potent topical corticosteroids and antihistamines was usual and many patients required oral prednisone or other immunosuppressant agents or phototherapy.

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“…I agree with Dr Rietschel that those patients with primarily urticarial papules and plaques rarely have allergic contact dermatitis. 23 The term urticarial dermatitis used in Australia may include patients with similar dermatoses, as this condition also preferentially affects the elderly. 24 …”

Section: Practical Clinical Approach To the Elderly Patient With Prurmentioning

confidence: 99%

Pruritus in Elderly Patients—Eruptions of Senescence

Berger

Steinhoff²

2011

Seminars in Cutaneous Medicine and Surgery

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Geriatric patients are frequently afflicted by pruritic dermatoses. Most pruritic elderly patients present with a skin eruption. The high prevalence of pruritic inflammatory skin disorders in elderly patients is a consequence of three physiological changes that occur with aging: (1) the epidermal barrier repair is diminished; (2) the immune systems of elderly patients are activated and have defective Th1 function along with enhanced Th2 function (immunosenescense); and (3) neurodegenerative disorders may lead to pruritus by their central or peripheral effects. These consequences of aging may all afflict the same patient, explaining why elderly people often have multiple overlapping skin conditions. The following article outlines the pathogenesis of the most common forms of pruritic skin disease in elderly patients and the hallmarks that allow the dermatologist to establish an accurate diagnosis and also suggests a management strategy for each common type of pruritic skin disease in the elderly patient.

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A Clinician's View of Urticarial Dermatitis

Cited by 10 publications

References 6 publications

Urticarial lesions: If not urticaria, what else? The differential diagnosis of urticaria

Urticarial lesions: If not urticaria, what else? The differential diagnosis of urticaria

Retrospective chart review in a cohort of patients with urticarial dermatitis

Pruritus in Elderly Patients—Eruptions of Senescence

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