Sunil Narayan Tolat; Anil Gosavi; Vasudha Belgaumkar; Ravindranath Chavan; Nitika Deshmukh; Sweta Tharewal; Nupur Warke
Abstract
Schnitzler’s syndrome is an autoinflammatory disorder presenting with wheals, monoclonal gammopathy, and signs of inflammation. A 55-year-old woman presented with reddish, moderately itchy wheals with intermittent fever and arthralgia for two years. Multiple erythematous, edematous plaques were ...
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Schnitzler’s syndrome is an autoinflammatory disorder presenting with wheals, monoclonal gammopathy, and signs of inflammation. A 55-year-old woman presented with reddish, moderately itchy wheals with intermittent fever and arthralgia for two years. Multiple erythematous, edematous plaques were noted all over the body. Dermographism was present. A diagnosis of chronic urticaria was considered and treated with antihistamines. The patient returned six weeks later with partial symptomatic relief. She was then investigated for the cause of chronic urticaria, and the following differentials were considered: systemic lupus erythematosus (SLE), dermatomyositis, urticarial vasculitis, and auto-inflammatory diseases. The patient was febrile, and her blood investigations revealed leukocytosis and a raised erythrocyte sedimentation rate along with IgM gammaglobulinemia and an M band on serum electrophoresis. Skin biopsy revealed a neutrophilic infiltrate in the dermis. Thus, based on the Strasbourg diagnostic criteria, a final diagnosis of Schnitzler syndrome was made. Urticarial rash is one of the most common complaints encountered by dermatologists. Other extremely uncommon diseases like autoinflammatory disorders (for example, Schnitzler syndrome) can mimic chronic urticaria. The appearance of the rash and associated symptoms should be carefully considered to identify these missed cases. Auto-inflammatory syndromes are severely debilitating, with little awareness among healthcare professionals. Thus, they are often recognized with a diagnostic delay of many years. Early diagnosis of such rare diseases is imperative for effective treatment and to prevent devastating long-term complications.
Mohammad Shahidi Dadras; Sahar Dadkhahfar; Ayda Bahmanjahromi; Hannane Seifian; Fahimeh Abdollahimajd
Abstract
The coronavirus disease 2019 (COVID-19) has emerged as a worldwide pandemic. In addition to pulmonary symptoms, reports of the involvement of other organs such as the skin are being published. We present the cases of three COVID-19 patients who presented with cutaneous manifestations ...
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The coronavirus disease 2019 (COVID-19) has emerged as a worldwide pandemic. In addition to pulmonary symptoms, reports of the involvement of other organs such as the skin are being published. We present the cases of three COVID-19 patients who presented with cutaneous manifestations and review the previous reports. Purpura and petechiae, erythematous papules andmacules, and urticarial eruptions are signs seen in the presented cases. Although a growing number of cutaneous manifestations of COVID-19 have been reported, there is no doubt that further reports of both typical and atypical presentations are needed to confirm and understand skin involvement in COVID-19. Since COVID-19 manifests in various forms, dermatologists, as thefirst line of dealing with patients who come with skin rashes, should always be aware of the early diagnosis of this disease.
Firooz Alireza; Handjani Farhad; Lajevardi Vahideh; Mansouri Parvin; Nassiri-Kashani Mansour; Norouzi Yasaman
Abstract
Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria. Iranian Society of Dermatology developed ...
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Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria. Iranian Society of Dermatology developed a clinical practice guideline concerning diagnosis and treatment of urticaria that was published in 2015. The current guideline is an update to the previous one and includes findings related to this subject which has been published in the medical literature from 2015 to August 2018.
Siddalingappa Karjigi; Murthy Sambasiviah Chidambara; Herakal Kallappa; Deepika Madagondanahalli
Volume 20, Issue 2 , 2017, , Pages 50-53
Abstract
Background: Chronic urticaria (CU) is a common skin disorder that accounts for 15%-20% of dermatological cases. There is growing evidence that some cases of chronic idiopathic urticarial (CIU) are associated with various autoimmune diseases, including thyroid autoimmunity. This study aims to identify ...
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Background: Chronic urticaria (CU) is a common skin disorder that accounts for 15%-20% of dermatological cases. There is growing evidence that some cases of chronic idiopathic urticarial (CIU) are associated with various autoimmune diseases, including thyroid autoimmunity. This study aims to identify the thyroidprofile, including thyroid autoantibodies, in patients with CU.Methods: This case-control study included 100 patients with CU and 100 controls without urticaria. Males and females (age range: 20-40 years) who attended the Navodaya Medical College Hospital and Research centre were included. Participants underwent laboratory investigations that consisted of a complete blood count(CBC) thyroid autoantibodies, and other relevant investigations. Results: Patients in the CU group had a male to female ratio of 1:2.1 and a mean age of 31.2 years. The control group had a male to female ratio of 1:1 and a mean age of 35 years. Antimicrosomal antibodies (AMA) were present in 14 (14%) patients, 13 females and 1 male. There were no autoantibodies in any of the control group participants. Among these 14 patients, 5 (35.71%) had elevated serum thyroid stimulating hormone (TSH) and one had coexistent anti-thyroglobulin antibodies. Other associated diseases included diabetes mellitus, human immunodeficiency virus (HIV), and hepatitis B surface antigen (HBsAg) in onepatient each.Conclusion: Thyroid autoantibodies may play a role in persistent CU. Screening patients with persistent CU for thyroid functions, including thyroid autoantibodies, may help with proper management.
Firooz Alireza; Hallaji Zahra; Khatami Alireza; Lajevardi Vahideh; Mansouri Parvin; Pedram Mehryan; Zohreh Mozafari; Mansour Nassiri-Kashani; Reza Robati; Hassan Seirafi
Volume 18, Issue 3 , 2015, , Pages 81-96
Abstract
Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.One of the missions of the Iranian ...
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Urticaria is a common and challenging skin disorder. Diagnosis and treatment of urticaria is not limited to the field of dermatology. General physicians, allergologists and clinical immunologists are also commonly involved in the management of patients with urticaria.One of the missions of the Iranian Society of Dermatology is to develop strategies in order to provide the best possible management for patients suffering from dermatological conditions. To accomplish this mission, the Society assigned a committee to search and critically appraise the recent research evidence and available guidelines to develop a clinical practice guideline concerning diagnosis and treatment of urticaria.
Omidian Mohammad; Omidian Ehsan
Volume 12, Issue 3 , 2009, , Pages 90-92
Abstract
Background: The etiology of urticaria is recognized only in a minority of cases. Allergies to a wide variety of agents have been suspected, as well as hyper reactivity to food additives or drugs. Recently, autoimmune reaction to immunoglobulin E (IgE) and later to high-affinity IgE receptors on mast ...
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Background: The etiology of urticaria is recognized only in a minority of cases. Allergies to a wide variety of agents have been suspected, as well as hyper reactivity to food additives or drugs. Recently, autoimmune reaction to immunoglobulin E (IgE) and later to high-affinity IgE receptors on mast cells has been reported. The aim of this study was to show elevated serum IgE levels in the patients with chronic idiopathic urticaria (CIU) so that the underlying disease and the cause of CIU may be atopic condition or an occult disease with raised serum IgE. Method: Altogether, 57 patients (30 women and 27 men, with an age range from 14 to 75 years ; mean age of 35.86 years), who suffered from chronic urticaria with a duration of 3 months to 8 years were included in this study and serum IgE level was assessed. Result: Thirty three patients had elevated serum IgE levels. The range of IgE levels were 114-3280 U (geometric mean greater than 100 ku/l) and mean IgE level was 411.39 U. Conclusion: Although the causes of CIU are often not clear, at least one causes of CIU may be atopy or other diseases that may be hidden and show elevated serum IgE. The patients present with CIU along with elevated serum IgE, should be investigated for atopy or other diseases that may be associated with elevated serum IgE.
M Mirshams Shahshahani; S Alami Harandi; AH Ehsani
Volume 8, Issue 1 , 2004, , Pages 39-43
Abstract
Background: Urticaria is a common skin disease characterized by transient and itchy swelling. The spectrum of etiologic factors in urticaria is very wide and contains external factors such as drugs, foods and internal diseases such as infections, SLE, hormonal factors and even lymphoma. Objective: To ...
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Background: Urticaria is a common skin disease characterized by transient and itchy swelling. The spectrum of etiologic factors in urticaria is very wide and contains external factors such as drugs, foods and internal diseases such as infections, SLE, hormonal factors and even lymphoma. Objective: To determine different kinds of urticaria and different etiologic and prevocational factors in patients with urticaria. Patients and Methods: This descriptive study was carried on 120 patients with urticaria referred to Razi Hospital in Tehran in year 1376. They were evaluated in two groups: Acute and chronic urticaria, duration of 6 weeks was the limit between them. Results: About 30% of patients had acute urticaria and causes were determined in 58% of them. Upper respiratory tract infections, drugs and foods were the most common etiologic factors. In only 22% of patients with chronic urticaria, the causes were found, which included infections (Sinusitis, hepatitis B, intestinal parasitic infections), drugs (NSAIDs and Codeine) and food. Fifty percent of these patients had common urticaria, 22% of them were affected with one of the physical urticarias and in 22% of them a combination of two or more kinds of urticaria were founded. Conclusion: The most important factor in determining the cause and provocation of urticaria are taking detailed history and performing thorough clinical examination. Paraclinical studies had a little role in determining etiology of urticaria.
F Iraji; M Saghaei; H Mokhtari
Volume 4, Issue 1 , 2000, , Pages 31-35
Abstract
Background: Urticaria is very common and most of the current treatments are only partially successful. Objective: As the efficacy of acupuncture in the treatment of chronic urticaria has not been studied in Iran, we decided to do this study. Patients and Methods: In a randomized, controlled, double-blind ...
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Background: Urticaria is very common and most of the current treatments are only partially successful. Objective: As the efficacy of acupuncture in the treatment of chronic urticaria has not been studied in Iran, we decided to do this study. Patients and Methods: In a randomized, controlled, double-blind clinical trial, 40 patients with chronic urticaria referred to skin clinics of Isfahan University in 1378 were studied. The patients had idiopathic urticaria, resistant to conventional treatment, and had not received any medication in the last month. We randomly divided them in two equal groups. One group was treated with acupuncture and the other with placebo for 3 weeks. Data entry and analysis was performed by Systat and T-test was used for data analysis. Results: The mean numbers of the episodes of urticaria in 3 weeks were 4.81 times in the control group and 3.62 times in the acupuncture group (P=0.01). The mean duration of urticarial episodes in the third week was 5.08 hours in the control group and in received acupuncture group was 2.37 hours in the acupuncture group (P=0.03). Conclusion: Acupuncture induced remission of chronic urticaria in the majority of the patients. Its efficacy was greatest in the third week of treatment.
