Urticarial Dermatitis: Clinical Characteristics of Itch and Therapeutic Response to Cyclosporine

Abstract

BackgroundUrticarial dermatitis, which is characterised by persistent wheals with eczematous papules and plaques, is frequently misdiagnosed and difficult to treat. Patients commonly experience intolerable pruritus which may greatly affect their quality of life.ObjectiveThe objective of this study is to characterize the clinical patterns of pruritus in patients with urticarial dermatitis and to determine the effectiveness of cyclosporine treatment.MethodsThis prospective study included 50 histopathologically confirmed patients with urticarial dermatitis. A face-to-face structured questionnaire was given to all patients, and they were treated with low-dose cyclosporine (1~3 mg/kg/d) for at least 2 weeks.ResultsThe majority of patients (80.0%) had moderate to severe pruritus. Most patients experienced exacerbation of the itch in the evening (74.0%), with the extremities (upper, 86.0%; lower, 94.0%) being the most commonly involved sites. Due to severe pruritus, patients complained about reduced social contact, quality of life and difficulties in falling asleep et al. Cyclosporine significantly reduced the mean itch score and extent of erythema, and improved interference with daily activities and sleep.ConclusionOur study highlights the detailed description and characteristics of pruritus in patients with urticarial dermatitis. And we recommend alternative and effective therapeutic option of low-dose cyclosporine.

A persistent dermal hypersensitivity reaction associated with Helicobacter pylori infection

“…Some success has been reported with the use of dapsone, hydroxyurea, azathioprine, cyclosporin, and mycophenolate mofetil. [8][9][10] In our case, after multiple courses of topical steroids, antihistamines, and permethrin had failed, we were able to control the eruption with oral prednisone while awaiting the results of further laboratory tests. Uncovering the etiologic trigger of a DHR is even more critical in light of the fact that many of the patients presenting with this eruption are elderly and often frail.…”