Background: Symptomatic dermographism (SD) is the most common form of chronic inducible urticaria. The criterion standard for diagnosing SD and disease activity assessment in SD is provocation testing. As of now, if and what cofactors have an impact on provocation test results is unknown.
Objective: We sought to determine whether the induction of signs and symptoms of SD is affected by the intake of food.
Methods: We performed standardized skin provocation testing with a dermographometer (FricTest) before and after the intake of food. Patients were off antihistamine treatment for at least 3 days before testing. In total, 17 patients were tested after not having eaten for at least 4 hours (preprandial) on one volar forearm and 60 minutes after a carbohydrate-rich meal (postprandial) on the other. FricTest responses (wheals, itch) at trigger thresholds were assessed at 5 and 30 seconds as well as at 1, 2, 5, and 10 minutes.
Results: We identified 7 patients with SD who showed faster onset of FricTest-induced whealing and/or lower trigger thresholds after the intake of food, that is, food-exacerbated SD. In 5 other patients, FricTest provocation testing resulted in a positive response only after the intake of food, but not before. Three of these 5 patients with food-dependent SD had comorbid chronic spontaneous urticaria and 1 had cholinergic urticaria.
Conclusions: We describe 2 previously unknown subtypes of SD, food-exacerbated SD and food-dependent SD. The prevalence and underlying pathomechanisms of food-exacerbated SD and food-dependent SD need to be investigated, and the impact of food intake on other forms of chronic inducible urticaria should be explored.
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http://dx.doi.org/10.1016/j.jaci.2021.07.030 | DOI Listing |
Clin Transl Allergy
November 2024
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Allergy Asthma Proc
November 2024
Chronic Skin Diseases Unit, Department of Dermatology, Urticaria Center of Reference and Excellence, Kayseri City Education and Research Hospital, University of Health Sciences, Kayseri, Turkey.
Symptomatic dermographism (SD) is the most common form of chronic inducible urticaria. SD disease activity increases with food intake in adult patients. Whether this is also so in children with SD is currently unknown.
View Article and Find Full Text PDFFront Allergy
October 2024
Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
Introduction: The latest international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for urticaria recommends limited laboratory testing for chronic spontaneous urticaria (CSU) and selective testing for only certain chronic inducible urticaria (CIndU) subtypes, though the rationale for these recommendations is poorly explained. This study aimed to improve the understanding of CIndU subtypes by comprehensively comparing their demographic, clinical, and laboratory characteristics with those of the better-characterized CSU.
Methods: We conducted a retrospective analysis of 567 patients (median age 41 years, 67% female) diagnosed with CSU, symptomatic dermographism (SD), cold urticaria (ColdU), cholinergic urticaria (CholU), and delayed pressure urticaria (DPU).
Arch Dermatol Res
October 2024
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Sector12, Chandigarh, 160012, India.
Clin Pediatr (Phila)
September 2024
Department of Dermatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
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