Cholinergic urticaria patients of different age groups have distinct features

Asady, Aida; Ruft, Jessica; Ellrich, André; Hawro, Tomasz; Maurer, Marcus; Altrichter, Sabine

doi:10.1111/cea.13023

Cited by 29 publications

(23 citation statements)

References 31 publications

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“…The symptoms of CholU are induced by an increase in body temperature by passive warming such as physical exercise, hot baths or emotional stress 2 . Each patient has an individual stimulus threshold and symptoms can be triggered by minimal activity.…”

Section: Introductionmentioning

confidence: 99%

Omalizumab for cholinergic urticaria: 6 months prospective study and systematic review of the literature

Ghazanfar

Holm

Thomsen

2020

Dermatologic Therapy

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To examine the effectiveness of omalizumab on disease activity and quality of life in patients with cholinergic urticaria (CholU). Further, a systematic review of the literature was performed to identify all studies of use of omalizumab in CholU. A total of 23 patients (63.9%) were refractory to updosed non-sedating antihistamines and initiated omalizumab in the observation period. Among these, an improvement of 10.8 UAS7 points (4.6-17.0), P = .002, was seen at 6 months follow up. DLQI and disease bother score VAS also improved significantly from before initiating treatment with omalizumab to follow-up; 7.0 points (3.6-10.3), P < .001 and 3.1 points (1.5-4.8), P = .001, respectively. The overall mean drug survival time for omalizumab (discontinued due to any cause) was 30.6 months (22.2-39.0). A total of five patients (21.7%) reported suspected side effects (headache, muscle pain, fatigue and injection site reactions) during treatment with omalizumab until 6 months follow-up. The systematic literature review identified 58 additional antihistamine refractory patients with CholU treated with omalizumab. The available studies reported that omalizumab is effective in patients with CholU and improves their disease-related quality of life. Omalizumab is safe, reduces disease activity and improves disease-related quality of life in patients with CholU.

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Section: Introductionmentioning

confidence: 99%

Omalizumab for cholinergic urticaria: 6 months prospective study and systematic review of the literature

Ghazanfar

Holm

Thomsen

2020

Dermatologic Therapy

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“…Холинергическая крапивница характеризуется мелкопапулезной, нередко сливающейся сыпью, возникающей после физической нагрузки, реакцией на температуру, стрессом. Проявляется сильным зудом, купируется самостоятельно [7]. Эритромелалгия клинически проявляется признаками поражения кисти и/или стопы: жгучей болью, эритемой и местным повышением температуры на фоне физической нагрузки, эмоционального стресса, температурной реакции.…”

Section: Discussionunclassified

Gravitational Erythema: Case Study and Differential Diagnosis

Garipova

Gharabaghtsyan

Sorokina

et al. 2020

Vopr. sovr. pediatr.

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Обоснование. Гравитационная эритема-редкое патологическое состояние, которое характеризуется аномальной сосудистой реакцией на изменение венозного давления. Заболевание является доброкачественным, входит в круг дифференциальной диагностики васкулитов, васкулопатий, нейропатий и не требует лечения. В некоторых случаях может потребоваться применение компрессионного трикотажа. Описание клинического случая. Приведено описание случая гравитационной эритемы у пациента 13 лет. Заболевание характеризовалось появлением эритематозной мозаичной сыпи на коже нижних конечностей через 4-6 мин после перехода в положение стоя, максимально на уровне голеней, сопровождавшейся пятнами с синеватым оттенком, исчезающими при надавливании. Элементы сыпи носили зудящий характер, сопровождались появлением боли в дистальных отделах стоп. Элементы сыпи купировались при ходьбе, перемене положения конечности. Отмечен положительный компрессионный тест. Заключение. Дифференциальная диагностика гравитационной эритемы с другими клинически схожими состояниями сохраняет актуальность. Редкость диагностики гравитационной эритемы и низкая осведомленность врачей приводит к ошибочному диагнозу, неоднократному дорогостоящему обследованию и неэффективному лечению.

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“…Cholinergic urticaria (CholU) is one of the most common forms of inducible urticaria and is characterized by small itchy wheals that are induced by physical activity or passive warming [1][2][3]. There is a high reported prevalence (up to 4%) in the general population [4,5], with one publication mentioning a 20% prevalence in young adults [6], although the disease can also start later in life [7]. The severity/clinical spectrum of the disease might be broad, with some patients suffering from severe disease with frequent wheal formation and intolerable itch, which majorly reduces their quality of life [8,9].…”

Section: Introductionmentioning

confidence: 99%

Sensitization against skin resident fungi is associated with atopy in cholinergic urticaria patients

Altrichter

Schumacher

Alraboni

et al. 2020

Clin Transl Allergy

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Background: Cholinergic urticaria (CholU) is a common type of chronic inducible urticaria, characterized by small itchy wheals that appear upon physical exercise or passive warming. Malassezia globosa, a skin resident fungus, has been identified as an antigen that induces mast cell/basophil degranulation and wheal formation through specific IgE, in Japanese patients with atopic dermatitis and CholU. In this study we aimed in assessing the rate of IgE sensitizations against skin resident fungi in European CholU patients. Methods: We assessed serum IgE levels to Malassezia furfur, Candida albicans and Trichophyton mentagrophytes using routine lab testing and Malassezia globosa using a newly established ELISA. We correlated the results to wheal formation and other clinical features. Results: Four patients (of 30 tested) had elevated levels of IgE against Malassezia furfur and Candida albicans and two had elevated levels of IgE against Trichophyton mentagrophytes. Four sera (of 25 tested) had elevated levels of IgE to the Malassezia globosa antigen supMGL_1304. Sensitization to one skin fungus was highly correlated with sensitization to the other tested fungi. We saw highly significant correlations of sensitization to supMGL_1304 with wheal size in the autologous sweat skin test (r s = 0.7, P = 0.002, n = 19), the Erlangen atopy score (r s = 0.5, P = 0.03, n = 19), total IgE serum levels (r s = 0.5, P = 0.04, n = 19) and a positive screen for IgE against common airborne/inhalant allergens s (sx1; r s = 0.54, P = 0.02, n = 19). Conclusions: Sensitization to skin resident fungi including Malassezia globosa is uncommon in European CholU patients, but is associated with atopy and pronounced wheal formation upon dermal contact with their own sweat.

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Cholinergic urticaria patients of different age groups have distinct features

Abstract: There are two subtypes of CholU patients with different gender ratios, disease duration and comorbidities. These findings suggest that two distinct underlying pathogenetic pathways are relevant in these two subgroups of patients with CholU.

Cited by 29 publications

References 31 publications

Omalizumab for cholinergic urticaria: 6 months prospective study and systematic review of the literature

Omalizumab for cholinergic urticaria: 6 months prospective study and systematic review of the literature

Gravitational Erythema: Case Study and Differential Diagnosis

Sensitization against skin resident fungi is associated with atopy in cholinergic urticaria patients

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