Urticaria: A comprehensive review

Antia, Camila; Baquerizo, Katherine; Korman, Abraham M.; Bernstein, Jonathan A.; Alikhan, Ali

doi:10.1016/j.jaad.2018.01.020

Cited by 110 publications

(104 citation statements)

References 152 publications

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“…Wheals can occur in combination with angioedema in 40% and angioedema can be the only manifestation of urticaria in 20% of patients [1,5].…”

Section: Definitionmentioning

confidence: 99%

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Chronic Spontaneous Urticaria – Diagnosis and Management

Ladoyanni¹

2021

Urticaria - Diagnosis and Management

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Chronic urticaria can be subclassified into chronic spontaneous urticaria and chronic inducible urticaria. Up to 30% of cases are associated with functional immunoglobulin G antibodies to the high affinity immunoglobulin E receptor FcεRIα or to immunoglobulin A. Pathogenic activation of mast cells and basophils gives rise to release of pro-inflammatory mediators that lead to development of hives. CSU is a debilitating disease with a relapsing course. It affects 0.5–1% of the population at any given time. The duration of CSU is generally 1–5 years but can be longer in cases associated with angioedema and autoreactivity. CSU has detrimental effects on life quality with sleep-deprivation and psychiatric disorders being the most frequent. In a great number of patients an underlying cause or eliciting factor cannot be identified. Among the patients in which an aetiology is suspected, infections, medication, food and psychological factors are most commonly associated. A potential autoimmune cause has been reported in up to 50% of patients. Chronic inducible urticaria is characterised by its ability to be triggered consistently and reproducibly in response to a specific stimulus (pressure, temperature, vibration, water, heat, light). Antihistamines form the mainstay of therapy. In recalcitrant chronic urticaria, a variety of other drugs have been tried.

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“…Wheals can occur in combination with angioedema in 40% and angioedema can be the only manifestation of urticaria in 20% of patients [1,5].…”

Section: Definitionmentioning

confidence: 99%

“…Urticaria are classified into 2 major categories [2, 3, 5] -acute vs. chronicaccording to duration, and -spontaneous vs. inducible -according to aetiology [5]. Acute urticaria resolves in less than 6 weeks.…”

Section: Definitionmentioning

confidence: 99%

Chronic Spontaneous Urticaria – Diagnosis and Management

Ladoyanni¹

2021

Urticaria - Diagnosis and Management

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“…Recently, a meta-analysis found a strong evidence demonstrating this association (OR = 1.19, 95%CI: 1.15-2.52, P = 0.008) and highlighted that the rate of H. pylori infection, interestingly, was significantly high in patients with moderate and severe psoriasis (OR = 2.27; 95%CI: 1.42-3.63, I 2 = 27%) but not in patients with the milder disease (OR = 1.10; 95%CI: 0.79-1.54, I 2 = 0%)[ 66 ]. Another disease commonly associated with H. pylori infection is chronic urticaria, a clinical condition that presents with itchy, erythematous or swollen urticaria[ 67 , 68 ]. The studies reveal conflicting evidence regarding the cause-effect association of H. pylori with chronic urticaria.…”

Section: Extragastric Manifestationsmentioning

confidence: 99%

Helicobacter pylori infection: Beyond gastric manifestations

Santos

Brito

Silva

et al. 2020

WJG

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Helicobacter pylori ( H. pylori ) is a bacterium that infects more than a half of world’s population. Although it is mainly related to the development of gastroduodenal diseases, several studies have shown that such infection may also influence the development and severity of various extragastric diseases. According to the current evidence, whereas this bacterium is a risk factor for some of these manifestations, it might play a protective role in other pathological conditions. In that context, when considered the gastrointestinal tract, H. pylori positivity have been related to Inflammatory Bowel Disease, Gastroesophageal Reflux Disease, Non-Alcoholic Fatty Liver Disease, Hepatic Carcinoma, Cholelithiasis, and Cholecystitis. Moreover, lower serum levels of iron and vitamin B12 have been found in patients with H. pylori infection, leading to the emergence of anemias in a portion of them. With regards to neurological manifestations, a growing number of studies have associated that bacterium with multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, and Guillain-Barré syndrome. Interestingly, the risk of developing cardiovascular disorders, such as atherosclerosis, is also influenced by the infection. Besides that, the H. pylori -associated inflammation may also lead to increased insulin resistance, leading to a higher risk of diabetes mellitus among infected individuals. Finally, the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism. In this sense, this minireview aims to gather the main studies associating H. pylori infection with extragastric conditions, and also to explore the main mechanisms that may explain the role of H. pylori in those diseases.

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“…Angioedema is life-threatening if it occurs in the upper airways and can be very painful if it occurs in the gastrointestinal tract (70). Wheals and angioedema often coexist but may also present alone (71). Most of these conditions are mainly mediated by histamine and other pro-inflammatory mediators released by mast cells and basophils (72).…”

Section: Angioedemamentioning

confidence: 99%

Coagulation and Skin Autoimmunity

et al. 2019

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Several lines of evidence indicate that the immune system, inflammation, and coagulation are simultaneously activated in autoimmune and immune-mediated skin diseases. Pro-inflammatory cytokines such as interleukin-6 and tumor necrosis factor-alpha induce the expression of the main initiator of coagulation, i.e., tissue factor. The proteases of coagulation in turn act on protease-activated receptors inducing the expression of various pro-inflammatory cytokines triggering inflammation. The cross-talk among immune system, inflammation, and coagulation amplifies and maintains the activation of all three pathways. This review focuses on three skin disorders as chronic spontaneous urticaria (CSU), angioedema, and bullous pemphigoid (BP), in which the relationships among the three systems have been investigated or their clinical consequences are relevant. Markers of thrombin generation, fibrinolysis, and inflammation have been reported to be increased in the plasma during flares of CSU and angioedema, as well as in the active phase of BP, with the marker levels reverting to normal during remission. The coagulation activation seems to be important only at local level in CSU and angioedema while both at local and systemic levels in BP which is the only condition associated with an increased thrombotic risk. The prothrombotic state in autoimmune skin diseases raises the question of the indication of anticoagulant treatment, particularly in the presence of other cardiovascular risk factors.

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Urticaria: A comprehensive review

Cited by 110 publications

References 152 publications

Chronic Spontaneous Urticaria – Diagnosis and Management

Chronic Spontaneous Urticaria – Diagnosis and Management

Helicobacter pylori infection: Beyond gastric manifestations

Coagulation and Skin Autoimmunity

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