Skin Health Center
Urticaria 2, Advanced Topics
Order Skin Rescue Starter Pack
Other Skin Topics
Alpha Nutrition
Abstracts
Prevalence of IgE antibodies specific for food allergens in patients with chronic urticaria of unexplained etiology.
- Author
Kaeser P; Revelly ML; Frei PC
Division of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Allergy, 49: 8, 1994 Sep, 626-9
We investigated whether some cases of chronic urticaria of unexplained cause might be related to food allergy which had remained undetected during routine examination. This investigation was undertaken as the consequence of the availability of a new in vitro assay for specific IgE with increased sensitivity. The following three groups of subjects were studied: 1) a control group of 60 nonatopic subjects, 2) 60 patients with allergy to perennial aeroallergens without skin involvement, and 3) 60 patients suffering from chronic urticaria with no evidence of any triggering factor despite careful clinical investigation. Specific IgE against 19 food allergens frequently involved in urticaria were investigated in all subjects with the new CAP System (Pharmacia). Positive results (CAP > 0.70 kU/l) for one or more food allergens were found in none of the nonatopic controls, in six of the subjects with respiratory allergy, and in 16 of the urticaria patients. The use of an in vitro test with an increased sensitivity allowed us to detect a significant prevalence of IgE specific for food allergens in patients with chronic urticaria of unknown origin. This suggests that, in several of those patients, chronic urticaria might be triggered by a food allergy undetected by the usual methods.
Food-induced contact urticaria syndrome (CUS) in atopic dermatitis: reproducibility of repeated and duplicate testing with a skin provocation test, the skin application food test (SAFT).
- Author
Oranje AP; Van Gysel D; Mulder PG; Dieges PH
Sub-division of Paediatric Dermatology, University Hospital Rotterdam/Sophia & Dijkzigt, Belgium.
Contact Dermatitis, 31: 5, 1994 Nov, 314-8
IgE-mediated contact urticaria syndrome (CUS) is one of the manifestations of allergy in childhood atopic dermatitis (AD). Allergens such as foods and animal products penetrate the skin easily. They can then cause urticarial reactions in sensitized individuals. A provocation test system for foods, called the skin application food test (SAFT), has been developed. Over more than 5 years, a group of 175 patients with AD was built-up and investigated in a prospective follow-up study with SAFT. SAFT was more frequently positive in AD children aged 0-2 years than in older children. In several children of this population (Group 1), we repeated SAFT within a period of 1 year. In another unrelated group of children (Group 2-1), we compared the results of 'original' SAFT and SAFT using square chambers (Van der Bend) or Silver patches. In the 3rd group (Group 2-2) we compared 'original' SAFT with SAFT using big Finn Chambers. The agreement between the tests was high: in Group 1, we observed 88 to 93% concordant scores, and in Group 2, the scores were 96% to 100%. Statistically, the kappa coefficient ranged from 0.71-0.87 in Group 1, and from 0.83-1.00 in Group 2. SAFT is therefore highly reproducible. Agreement was at least > or = 88% between the scores (the lowest kappa value observed was at least 0.71).
Mechanisms in adverse reactions to food. The skin.
- Author
Sampson HA
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Allergy, 50: 20 Suppl, 1995, 46-51
Ingested food antigens rapidly cross the gastrointestinal barrier and reach pro-inflammatory cells in the skin. Food allergy provokes urticaria/angioedema by classical, Type I, IgE-mediated hypersensitivity. Food-induced atopic dermatitis is the result of non-classical, IgE-directed hypersensitivity involving resident mast cells, Langerhans cells, CD4+, TH2 lymphocytes and monocytes. A form of gluten sensitivity provokes a characteristic eczematous-like rash and enteropathy (Dermatitis herpetiformis).
Pirenzepine treatment in urticaria-angioedema syndrome caused by adverse reactions to foods.
- Author
-
Ciprandi G; Perasso A; Marenco G; Santucci R; Buffa P; Cheli R; Canonica GW
- Address
-
Semeiotica Medica R & Allergy Centre, Genoa, Italy.
- Source
-
Allergol Immunopathol (Madr), 1989 Jul-Aug, 17:4, 189-92
- Abstract
-
An increased gastroenteric mucosal permeability is generally considered a pathophysiological mechanism in the urticaria-angioedema syndrome caused by adverse reactions to foods. Since pirenzepine, an antimuscarinic receptor drug, exerts a cytoprotective activity on digestive mucosa, the authors evaluated the clinical efficacy of pirenzepine and terfenadine (antihistamine), alone or associated, in the treatment of patients with urticaria-angioedema syndrome due to food allergy. Furthermore, additional endoscopy and biopsy studies were performed in order to provide experimental evidence about the cytoprotective activity of this treatment. The results of the present investigation confirm the clinical efficacy, with improvement of histological parameters, of pirenzepine treatment in adverse reactions to foods, as previously demonstrated by our group, and suggest further investigations on the functional mucosal impairment hypothesized in this pathological condition.
Contribution to the etiopathogenesis of urticaria in children.
- Author
-
Moreno MV; González de la Cuesta C; Oehling A
- Address
-
Department of Allergology, Faculty of Medicine, University of Navarra, Pamplona, Spain.
- Source
-
Allergol Immunopathol (Madr), 1988 Jul-Aug, 16:4, 225-30
- Abstract
-
For hundreds of years urticaria has been an intriguing problem for researchers. Together with angioedema it constitutes a common condition that affects 20% of the general population. The etiologic diagnosis is obtained in a variable percentage of cases, according to the different studies published. The clinical course and the association with angioedema are also variables in the different works. It was the diversity of results that led us to undertake the present study. We selected 161 histories of children who came to our department of allergology; these children whose ages ranged from 1-12 years were diagnosed of urticaria and/or angio edema. The number of males was slightly higher than females and the most affected age group was that between 7-12 years. The acute and acute intermittent forms predominated especially in atopic children, highly associated with angioedema; chronic urticaria was less frequent. Within the etiologic factors, food allergy played an important role, followed by drug allergy. It was not possible to reach an etiologic diagnosis in 39.13% of cases.
Urticaria and angioedema: a clinical spectrum.
- Author
-
Charlesworth EN
- Address
-
Department of Allergy and Dermatology, Brenham Clinic Association, Texas, USA.
- Source
-
Ann Allergy Asthma Immunol, 1996 Jun, 76:6, 484-95; quiz 495-9
- Abstract
-
OBJECTIVE: The objective of this review is to give the reader a global insight into the spectrum of urticaria, focusing on differential diagnosis and pathogenic mechanisms. This review will define the role of the mast cell, explore a possible autoimmune basis for urticaria, and examine the purported role of food allergy in chronic urticaria. Last, the work-up and treatment of urticaria will be discussed in the context of the histologic diagnosis. STUDY SELECTION: The relevant past medical literature will be reviewed in the context of new and novel research into the mechanisms of chronic urticaria. RESULTS: Urticaria can be classified histopathologically into the following three categories: (1) neutrophilic vasculitis, (2) polymorphous perivascular infiltrate, and (3) sparse perivascular lymphocytic infiltrate. Each of the above histologic patterns correlates with a distinct clinical entity and the work-up and treatment of urticaria will be related to each of the above histologic types. CONCLUSIONS: Urticaria and angioedema are frustrating problems for both physicians and their patients; however, the problem can best be approached by considering urticaria as a symptom that may be part of a larger clinical spectrum. The physical examination and medical history remain the two most important pieces of information. The allergist frequently overlooks the value of a skin biopsy as an aid in sorting out the pathophysiology of urticaria and the biopsy results may help to classify urticaria into subgroups which respond differently to treatment.
Cell-mediated immune responses to artificial food additives in chronic urticaria.
- Author
-
Warrington RJ; Sauder PJ; McPhillips S
- Source
-
Clin Allergy, 1986 Nov, 16:6, 527-33
- Abstract
-
In some cases of chronic urticaria it is suspected that food additives such as tartrazine and sodium benzoate or salicylates may play a role in the pathogenesis of the condition. Since, at times, chronic urticaria may appear histologically similar to a mild cell-mediated immune response, the release of the T cell-derived lymphokine leucocyte inhibitory factor (LIF), in response to incubation with these additives and with acetylsalicylic acid (ASA), was measured in vitro using cells from normal controls, from patients with chronic urticaria with or without clinically associated additive sensitivity and from patients with asthma with or without associated ASA sensitivity. It was found that significant production of LIF occurred in response to tartrazine and sodium benzoate in those individuals with chronic additive induced urticaria. In addition, tartrazine caused LIF release from mononuclear cells of ASA-sensitive asthmatics. These results may indicate a possible role for additive-induced cell-mediated immune responses in the pathogenesis of some cases of chronic urticaria and suggest a potential diagnostic test for this condition.
Food-induced contact urticaria syndrome (CUS) in atopic dermatitis: reproducibility of repeated and duplicate testing with a skin provocation test, the skin application food test (SAFT).
- Author
-
Oranje AP; Van Gysel D; Mulder PG; Dieges PH
- Address
-
Sub-division of Paediatric Dermatology, University Hospital Rotterdam/Sophia & Dijkzigt, Belgium.
- Source
-
Contact Dermatitis, 1994 Nov, 31:5, 314-8
- Abstract
-
IgE-mediated contact urticaria syndrome (CUS) is one of the manifestations of allergy in childhood atopic dermatitis (AD). Allergens such as foods and animal products penetrate the skin easily. They can then cause urticarial reactions in sensitized individuals. A provocation test system for foods, called the skin application food test (SAFT), has been developed. Over more than 5 years, a group of 175 patients with AD was built-up and investigated in a prospective follow-up study with SAFT. SAFT was more frequently positive in AD children aged 0-2 years than in older children. In several children of this population (Group 1), we repeated SAFT within a period of 1 year. In another unrelated group of children (Group 2-1), we compared the results of 'original' SAFT and SAFT using square chambers (Van der Bend) or Silver patches. In the 3rd group (Group 2-2) we compared 'original' SAFT with SAFT using big Finn Chambers. The agreement between the tests was high: in Group 1, we observed 88 to 93% concordant scores, and in Group 2, the scores were 96% to 100%. Statistically, the kappa coefficient ranged from 0.71-0.87 in Group 1, and from 0.83-1.00 in Group 2. SAFT is therefore highly reproducible. Agreement was at least > or = 88% between the scores (the lowest kappa value observed was at least 0.71).