Chronic idiopathic urticaria antibiotics

Urticarial vasculitis is a rare clinicopathologic entity that is characterized by chronic or recurrent episodes of urticarial lesions. Skin findings of this disease can be difficult to distinguish visually from those of chronic idiopathic urticaria but are unique in that individual lesions persist for ≥24 hours and can leave behind dusky hyperpigmentation. This disease is most often idiopathic but has been linked to certain drugs, infections, autoimmune connective disease, myelodysplastic disorders, and malignancies...

The patient is a 64-year-old Caucasian woman with idiopathic chronic urticaria who presented to her primary care physician's office with mucoid otitis media. Medical history was significant for hypertension, hyperlipidaemia, allergic rhinitis, pre-diabetes, gastro-oesophageal reflux, paroxysmal atrial fibrillation, chronic kidney disease, diverticulosis with prior diverticulitis and history of recurrent infections. Her chronic urticaria was initially treated with antibiotics, antihistamines and oral steroids, but later she developed refractory urticaria requiring dapsone with modest improvement...

Urticaria, also known as hives, may affect up to 20% of the population at some time in their lives. Urticaria is characterized by extreme pruritus and described as erythematous, raised, circumscribed lesions with central pallor that blanch with pressure. The pathogenesis of urticaria involves mast cell activation, with subsequent release of histamine and other vasoactive mediators, leading to increased vascular permeability of postcapillary venules and development of edema, erythema, and pruritus. Urticaria is closely associated with angioedema in 40% of individuals; ∼10% of patients experience angioedema without urticaria...

BACKGROUND: Subjects with drug hypersensitivity are sometimes simultaneously reactive to several drugs. This nosological entity is defined as multiple drug hypersensivity (MDH). Urticaria and angioedema are the commonest clinical manifestations of hypersensitivity drug reactions (HDR). These clinical signs are also pathognomonic of chronic idiopathic urticaria (CIU), whose pathogenetic mechanisms are still largely unknown. The diagnostic algorithm of CIU includes autologous serum skin test (ASST) and autologous plasma skin test (APST), which demonstrated a high positive and negative predictive value, in multiple nonsteroidal anti-inflammatory drugs (NSAIDs) intolerance...

Previous observations have shown that the syndrome of thyroid autoimmunity and idiopathic urticaria and angioedema (ICUA) can be associated with a marked worsening of reactive airway disease. Possibly, mediators released in this syndrome may contribute to acute bronchospasm and associated respiratory symptoms in some patients. In this study, two patients presenting with overlapping clinical presentations of the syndrome of thyroid immunity and ICUA are described in whom a diagnosis of anaphylaxis to food and antibiotics, respectively, was initially suspected but ruled out by testing and challenges...

Acute and chronic sinusitis are major clinical problems faced by physicians in several disciplines. Although there is a much studied relationship between sinusitis and asthma, as well as a well-known association of sinusitis and Wegener's granulomatosis, there is scant evidence suggesting an association of angioedema with sinusitis. Angioedema can be extremely disfiguring, and is potentially lethal due to compromised airways. It is also a frustrating diagnostic dilemma for patients and physicians. A diagnosis is found in fewer than 25% of chronic urticaria patients and much less for angioedema...

To study the frequency and clinical aspects of cold urticaria in Central Europe, patient data from a university dermatology clinic and a private dermatology office between 1984-94 were analysed and the patients re-examined if possible. The incidence of cold urticaria was found to be 0.05%. Of the 56 patients with cold urticaria (31 women, 25 men), 49 had idiopathic cold urticaria. The mean age was 41.0 +/- 15.6 year, the mean duration of disease 7.9 +/- 5.8 years. Atopy was found in 46.5% of patients, and 23...