Knowledge of the clinical course of chronic spontaneous urticaria (CSU) remains unclear. The purpose of our study was to investigate the clinical course of CSU in the Korean adult population. Each patient in the CSU group who was defined by disease codes between 2003 and 2007 was tracked whether he or she went into remission or not until 2013. Kaplan-Meier survival analysis was carried out to analyze remission, and log-rank tests were performed for between-group comparisons. Demographic differences between subjects who went into remission 1 year after the initial diagnosis and those who did not were analyzed using χ² tests. A total of 13,969 subjects were included in the CSU group. The 1-, 2-, 3-, 4-, and 5-year remission rates of CSU were 21.5%, 33.0%, 38.9%, 42.6%, and 44.6%, respectively. The proportion of subjects in the 65+ age group (P=0.050) and with male gender (P=0.002) was significantly higher among subjects who did not go into remission 1 year after the initial diagnosis. Our study indicates that CSU could have a more persistent course than previously reported.
Adult ; Diagnosis ; Humans ; Korea ; Male ; Urticaria

BACKGROUND: The majority of chronic urticaria cases are chronic idiopathic urticaria (CIU) with no specific identifiable etiology. The role of autoantibodies in such cases remains controversial. OBJECTIVE: This study determined the positivity rate of autologous serum tests in CIU patients. METHODS: This study was performed on 30 patients with CIU and 30 individuals without any systemic or dermatologic disease. After the volar parts of right and left forearms were cleansed, 0.05 ml serum physiologic and 0.05 ml autologous serum were injected intradermally on the right forearm 5 cm apart from each other, resulting in the formation of small papules; meanwhile, 0.05 ml histamine alone was injected to the left forearm. The test results were evaluated after 30 minutes as positive in positive cases. RESULTS: The autologous serum test produced significant and non-significant results in patients with CIU and controls, respectively. The positivity rates of the autologous serum test in the CIU and control groups were 53.3% and 26.6%, respectively. There was no relationship between autologous serum test positivity and sex in either group. In male patients with CIU, positive results ranged widely with age, while in female patients, positive results were mainly observed at younger ages with a narrow age range. CONCLUSION: The autologous serum test is a useful test in the diagnosis and treatment of CIU as well as the selection of immunotherapy, especially in patients refractory to classic therapy.
Autoantibodies ; Diagnosis* ; Female ; Forearm ; Histamine ; Humans ; Immunotherapy ; Male ; Urticaria*

We experienced a case of arteriovenous hemangioma showing Dariers sign on the forehead of a 43-year-old man. He presented with a single, 1 * 1.5cm sized, violaceous, asymptomatic nodule with a history of an intermittent wheal at the lesional site. This skin lesion showed Dariers sign clinically and proliferation of mast cells histopathologically with the punch biopsy specirnen suggesting urticaria pig- mentosa. Howerer, we could diagnose it as a arteriovenous hemangioma on complete excision, as the specimen showed arteriovenous proliferation with increased mast cells in a perivascular pattern. This case showed confusing clinical signs and showed the importance of complete excision for the diagnosis of a small skin tumor especially when a vascular proliferating tumor is suspected.
Adult ; Biopsy ; Diagnosis ; Forehead ; Hemangioma* ; Humans ; Mast Cells ; Skin ; Urticaria

Chronic urticaria (CU) is defined by the presence of urticaria that has been continuously or intermittently for a period of 6 weeks or longer. The prevalence of CU in the general population has been estimated to range from 0.5% to 5%. Correct diagnosis and proper management for CU is essential to improve the quality of care. To date, several practical guidelines have been available for practitioners. In this article, we reviewed and summarized the epidemiology, pathogenesis, diagnosis, and management based on case reports and studies of CU from Korea and the other part of world, and recently published guidelines. Although there are many controversies, this report for CU would provide a clinical guidance for healthcare professionals in Korea.
Delivery of Health Care ; Diagnosis ; Epidemiology ; Korea ; Prevalence ; Urticaria*

BACKGROUND: Although urticaria is a common disorder that affects as many as 20% of all people at some time during their lifetime, the etiology of urticaria is still unknown in most cases. OBJECTIVE: We attempted to analyze the clinical characteristics of chronic urticaria according to etiological aspects. METHODS: The study was carried out on 230 patients with chronic urticaria, who visited our clinic with urticaria between March 2003 and February 2006. The diagnosis was made by detailed questionnaire and limited laboratory and provocation tests. RESULTS: Of the 230 patients with chronic urticaria, 138 (60.0%) presented with idiopathic urticaria, 53 (23.1%) autoimmune urticaria, 33 (14.4%) physical urticaria and 6 (2.5%) another type. Chronic idiopathic urticaria was combined with physical components in 97 cases (42.2%), and cholinergic component was the most common form. Chronic idiopathic urticaria and autoimmune urticaria showed a higher score than physical urticaria in the severity of disease, but there was no significant difference in the duration of urticaria. CONCLUSION: Our data shows the clinical-etiological aspects and classification of chronic urticaria. Although the symptom severity of chronic idiopathic urticaria and autoimmune urticaria is higher than that of physical urticaria, our data is limited to predict the treatment response rate or the prognostic variables of chronic urticaria owing to the short follow-up period. Further studies will be needed to identify the natural course of chronic urticaria.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Surveys and Questionnaires ; Urticaria*

Most guidelines for chronic urticaria (CU) in infants and children are based on limited pediatric evidence. Current evidence used to guide treatment in children is extrapolated from data focusing on older age groups. CU in children is a different and complex condition than that in adults. Furthermore, there is little published information regarding urticaria in Korean children. The aim of the present article is to review recent research on chronic childhood urticaria and improve the current understanding of its pathogenesis and management. The classification and definition of urticaria in adults also applies to children. CU is defined as a daily occurrence of spontaneous wheals, angioedema, or both for >6 weeks. The precise pathophysiology of CU is unknown and the rates of successful identification of a cause in children with CU vary from 20%-50%. There is no established laboratory test to evaluate the presence of urticaria. The natural course of childhood CU is undetermined, with limited reports discussing long-term outcomes. Second-generation H1 antihistamines are the cornerstone of management, while limited therapeutic drugs are available for adults.
Adult ; Angioedema ; Child* ; Classification ; Diagnosis* ; Histamine Antagonists ; Humans ; Infant ; Urticaria*

Bronchioloalveolar carcinoma is a subtype of the lung adenocarcinoma. Early stage bronchioloalveolar carcinoma is usually asymptomatic, especially in the peripheral lung. Rarely, urticaria has been described occurring with lung cancer, usually small-cell lung cancer, but no case has been reported of the bronchioloalveolar carcinoma yet. We report here a unique and initial urticaria on a patient, lasting for 6 months, who finally was diagnosed as early stage bronchioloalveolar carcinoma (T1aN0M0). After treatment of surgery, the symptom of urticaria disappeared and did not recur. Therefore, we consider that utricaria is a possibly clinical manifestation in early stage bronchioloalveolar carcinoma.
Adenocarcinoma, Bronchiolo-Alveolar ; diagnosis ; pathology ; Female ; Humans ; Middle Aged ; Urticaria ; diagnosis ; pathology

Adult ; Female ; Humans ; Lymphadenitis ; complications ; diagnosis ; pathology ; Positron-Emission Tomography ; Urticaria ; etiology ; Vitiligo ; etiology

BACKGROUND: Allergic skin diseases such as atopic dermatitis and urticaria are known to be mediated by IgE. It is important to confirm a causative allergen for diagnosis and treatment. The multiple allergosorbent test (MAST) is a simple method for simultaneously measuring total and allergen-specific IgE. OBJECTIVE: The purpose of this study was to analyze results from the MAST, which measures total and specific IgE, and to compare the different results. METHODS: We reviewed the MAST results of 270 allergic disease patients tested between June 2007 and May 2012. RESULTS: There were statistical differences in total IgE production and in positive sensitization to specific allergens between the disease groups. The level of total IgE and positive rates of specific IgE were highest in atopic dermatitis patients, followed by urticaria, allergic contact dermatitis, and pruritus patients. Atopic dermatitis patients had significantly more allergens than those with other diseases. There were no statistical differences in total IgE level, rates of positive sensitization to specific allergens, and the number of causative allergens between the patients with acute and chronic urticaria. CONCLUSION: Each disease showed a different IgE pattern. Atopic dermatitis showed the highest level of serum IgE. There were no differences in IgE levels between acute and chronic urticaria patients. We identified an increase in IgE level in allergic contact dermatitis patients. Further study is needed to determine whether these patterns could be useful in diagnosis and choice of treatment methods.
Allergens ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Diagnosis ; Humans ; Immunoglobulin E ; Immunoglobulins ; Pruritus ; Skin Diseases* ; Urticaria

PURPOSE: Recent studies indirectly suggest a possible link between food allergy (FA) and asthma. Most of them have evaluated the occurrence of FA in asthmatic children, especially in the first year of life, using questionnaire-based studies or specific IgE (sIgE) assay. The aim of this study was to evaluate the prevalence and clinical impact of IgE-mediated FA in school children with asthma using a double-blind placebo-controlled food challenge (DBPCFC). METHODS: The study group consisted of school children with atopic asthma who were admitted to the Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, for the evaluation of food hypersensitivity. The diagnosis of FA was established using questionnaires, sIgE analysis, and the DBPCFC. Asthma severity and asthma control state were also assessed. RESULTS: A relationship between consumed food and complaints was reported in 180 children (49.7%). Seventy children (19.3%) were sensitized to food allergens. IgE-mediated FA was confirmed in 24 children (6.6%), while 11 children (3%) demonstrated respiratory symptoms. Food-induced asthma exacerbations were observed in 9 patients (2.5%). Statistically significant differences in the prevalence of atopic dermatitis (P<0.002), urticaria (P<0.03), digestive symptoms (P<0.03), rhinitis (P<0.02), sIgE level (P<0.001), positive family history of atopy (P<0.001) and FA in history (P<0.001) were found between asthmatic children with FA and those without. Children with food-induced asthma exacerbations demonstrated significantly greater severity, poorer controls, and worse morbidity compared to those without. CONCLUSIONS: Although food-induced respiratory reactions in children with asthma were rare, they were classified as severe and associated with worse morbidity, greater severity, and poorer control. As the most commonly observed symptoms were coughing and rhinitis, which can be easily misdiagnosed, a proper diagnosis is essential for improving the management of both clinical conditions.
Allergens ; Asthma* ; Child* ; Cough ; Dermatitis, Atopic ; Diagnosis ; Food Hypersensitivity* ; Gastroenterology ; Humans ; Immunoglobulin E ; Prevalence* ; Rhinitis ; Urticaria