Skin reaction patterns in cholinergic urticaria.

Cholinergic urticaria Clinical picture Skin reactions Sweating Wheal

Journal

Allergology international : official journal of the Japanese Society of Allergology
ISSN: 1440-1592
Titre abrégé: Allergol Int
Pays: England
ID NLM: 9616296

Informations de publication

Date de publication:
03 Sep 2024
Historique:
received: 08 03 2024
revised: 14 07 2024
accepted: 19 07 2024
medline: 5 9 2024
pubmed: 5 9 2024
entrez: 5 9 2024
Statut: aheadofprint

Résumé

Skin reaction patterns vary across patients with cholinergic urticaria (CholU), but their definition, prevalence, and clinical significance remain ill characterized. Patients with CholU underwent pulse-controlled ergometry provocation testing to analyze skin reaction patterns and their correlation with location, onset, severity, sweating behaviour, clinical features, disease control, and quality of life (QoL) impairment. Based on the size, color, spacing, and shape of wheals as well as their surrounding skin responses, we identified six distinct types of CholU skin reactions, which differed in prevalence, from 83% (Type I) to 11% (Type VI) of patients affected. Almost all patients (94%) had ≥1 type of skin reaction pattern. Sweating was reduced in the majority of CholU patients and most prominently reduced in patients with Type VI skin signs (very small, round, red, widely spaced wheals with surrounding anemic halo), which emerged exclusively on the extremities. Type V skin signs (large, irregular, anemic, widely spaced wheals with moderate size erythema) were associated with the most severe clinical presentation and poorest QoL. Our analysis showed that most patients have more than one type of skin reaction patterns and that different skin signs are linked to distinct features. Future studies should determine any links between treatment response and types of skin signs in CholU.

Sections du résumé

BACKGROUND BACKGROUND
Skin reaction patterns vary across patients with cholinergic urticaria (CholU), but their definition, prevalence, and clinical significance remain ill characterized.
METHODS METHODS
Patients with CholU underwent pulse-controlled ergometry provocation testing to analyze skin reaction patterns and their correlation with location, onset, severity, sweating behaviour, clinical features, disease control, and quality of life (QoL) impairment.
RESULTS RESULTS
Based on the size, color, spacing, and shape of wheals as well as their surrounding skin responses, we identified six distinct types of CholU skin reactions, which differed in prevalence, from 83% (Type I) to 11% (Type VI) of patients affected. Almost all patients (94%) had ≥1 type of skin reaction pattern. Sweating was reduced in the majority of CholU patients and most prominently reduced in patients with Type VI skin signs (very small, round, red, widely spaced wheals with surrounding anemic halo), which emerged exclusively on the extremities. Type V skin signs (large, irregular, anemic, widely spaced wheals with moderate size erythema) were associated with the most severe clinical presentation and poorest QoL.
CONCLUSIONS CONCLUSIONS
Our analysis showed that most patients have more than one type of skin reaction patterns and that different skin signs are linked to distinct features. Future studies should determine any links between treatment response and types of skin signs in CholU.

Identifiants

DOI: 10.1016/j.alit.2024.07.008 PMID: 39232919
pubmed: 39232919
pii: S1323-8930(24)00085-6
doi: 10.1016/j.alit.2024.07.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Japanese Society of Allergology. Published by Elsevier B.V. All rights reserved.

Auteurs

Ilona Shurmelova (I)

Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria.

Agata Baldyga (A)

Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Eva Grekowitz (E)

Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Susanne Kimeswenger (S)

Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria; Johannes Kepler University, Center for Medical Research (ZMF), Linz, Austria.

Wolfram Hoetzenecker (W)

Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria; Johannes Kepler University, Center for Medical Research (ZMF), Linz, Austria.

Marcus Maurer (M)

Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany. Electronic address: marcus.maurer@charite.de.

Sabine Altrichter (S)

Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria; Johannes Kepler University, Center for Medical Research (ZMF), Linz, Austria; Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany. Electronic address: sabine.altrichter@kepleruniklinikum.at.

Classifications MeSH