Worsening of chronic spontaneous urticaria after intake of hot pepper.

BACKGROUND

Patients with chronic spontaneous urticaria (CSU) have been reported to experience increased disease activity in response to the oral intake of hot pepper (Capsicum spp.). As of now, it is unclear how common this is.

OBJECTIVE

We assessed patients with CSU for the prevalence of disease worsening after the intake of hot pepper and characterized its effects on their urticaria.

METHODS

A questionnaire-based survey study in adult patients with CSU and a history of hot pepper consumption was carried out at a reference center for urticaria in Turkey. CSU patients who had co-existing chronic inducible urticaria were excluded from the study.

RESULTS

Of the eighty-five patients with CSU included in this study, 46% (39 of 85) reported worsening of their urticaria after consuming hot pepper. Demographic features, duration of CSU and control status of urticaria were not different between patients who experienced worsening of their urticaria after the intake of hot pepper and those who did not. In affected patients, worsening of their symptoms started 1.2 ± 1.2 hours after the intake of hot pepper and lasted for 3.3 ± 6.8 hours. Symptoms disappeared significantly faster in patients who took antihistamines after worsening of their urticaria with hot pepper (0.7 ± 0.6 vs. 5.8 ± 8.8 hours; p = 0.003).

CONCLUSIONS

Worsening of urticaria is common and relevant in patients with CSU in Turkey. Further studies are needed to explore if this is also the case in other geographical regions and to identify and characterize the underlying mechanisms.