N Silpa-archa1, K Kulthanan, S Pinkaew. 1. Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Abstract
BACKGROUND: Physical urticarias (PU) are an urticarial response to different specific physical stimuli. PU can occur concurrently with chronic spontaneous urticaria or another type of PU. OBJECTIVE: We aimed to study the prevalence, type, clinical data and natural course of each type of PU and other inducible urticarias and also the prognostic factors for remission of patients visiting a tertiary referral hospital. METHOD: We performed a retrospective study of 1200 chronic urticaria patients who visited our Urticaria Clinic during a period of 5 years. RESULTS: Of the 1200 chronic urticaria patients, 86 (7.2%) were diagnosed as PU and other inducible urticarias. The most common type of PU was symptomatic dermographism (n = 35, 40.7%) followed by cold urticaria (n = 20, 23.3%) and delayed pressure urticaria (n = 11, 12.8%), respectively. Twelve patients (13.9%) had associated chronic spontaneous urticaria. None of the cases had multiple types of PU. Erythrocyte sedimentary rate elevation was the most common abnormal laboratory result. Nevertheless, only 4.6% declared a related infection. For each type, the median time after onset before 50% remission showed that cholinergic urticaria took the shortest course (34 months) and delayed pressure urticaria took the longest period (110 months). After 1 year and 5 years from the onset of symptoms, 13% and 50% of PU patients were free of symptoms, respectively. CONCLUSION: This study emphasized the variety of PU, other inducible urticarias and natural courses based on tertiary hospital care. PU and other inducible urticarias have tendency to have a longer course than chronic spontaneous urticaria.
BACKGROUND: Physical urticarias (PU) are an urticarial response to different specific physical stimuli. PU can occur concurrently with chronic spontaneous urticaria or another type of PU. OBJECTIVE: We aimed to study the prevalence, type, clinical data and natural course of each type of PU and other inducible urticarias and also the prognostic factors for remission of patients visiting a tertiary referral hospital. METHOD: We performed a retrospective study of 1200 chronic urticariapatients who visited our Urticaria Clinic during a period of 5 years. RESULTS: Of the 1200 chronic urticariapatients, 86 (7.2%) were diagnosed as PU and other inducible urticarias. The most common type of PU was symptomatic dermographism (n = 35, 40.7%) followed by cold urticaria (n = 20, 23.3%) and delayed pressure urticaria (n = 11, 12.8%), respectively. Twelve patients (13.9%) had associated chronic spontaneous urticaria. None of the cases had multiple types of PU. Erythrocyte sedimentary rate elevation was the most common abnormal laboratory result. Nevertheless, only 4.6% declared a related infection. For each type, the median time after onset before 50% remission showed that cholinergic urticaria took the shortest course (34 months) and delayed pressure urticaria took the longest period (110 months). After 1 year and 5 years from the onset of symptoms, 13% and 50% of PUpatients were free of symptoms, respectively. CONCLUSION: This study emphasized the variety of PU, other inducible urticarias and natural courses based on tertiary hospital care. PU and other inducible urticarias have tendency to have a longer course than chronic spontaneous urticaria.