Atopic predisposition in cholinergic urticaria patients and its implications. (21st June 2016)

• Record Type: Journal Article
• Authors: Altrichter, S.; Koch, K.; Church, M.K.; Maurer, M.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 30:Number 12(2016:Dec.)
• Page Start: 2060
• Page End: 2065
• Publication Date: 2016-06-21
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.13765
• Languages: English
• ISSNs: 0926-9959

Abstract

Abstract: Background: Cholinergic urticaria (CholU) is a frequent chronic urticaria disorder with itchy weal and flare‐type skin reactions in response to physical exercise or passive warming. A higher frequency of atopy among CholU patients has been reported, but the significance of this observation is unclear. Objective: To assess the prevalence and relevance of atopy in CholU patients. Materials and Methods: Thirty CholU patients were assessed for atopic skin diathesis (atopic predisposition) by use of the Erlangen Atopy Score and divided into atopic and non‐atopic predisposed CholU individuals. Both groups were assessed for disease severity (CholUSI) and activity (CholUAS7), quality of life impairment [Dermatology Life Quality Index (DLQI) and CU‐Q2 OL], seasonal exacerbation, total and specific serum IgE and comorbidities. Results: CholU patients were found to exhibit high rates of atopic predisposition (57%), with higher prevalence and scores in female than in male patients. High Erlangen Atopy Scores were linked to high CholU severity, activity and impact on QoL. Atopic predisposed CholU patients show different seasonal exacerbation patterns, IgE specificity and comorbidity profiles as compared to non‐atopic CholU patients. Conclusion: Atopic predisposition and cholinergic urticaria appear to be linked more closely than previously thought, which suggests shared pathogenetic mechanisms. Atopic patients with cholinergic urticaria have more severe disease and poorer quality of life than those who do not. Thus, all cholinergic urticaria patients should be assessed for atopic predisposition.