Urticaria

ISBN-13: 9783642703157 / Angielski / Miękka / 2011 / 189 str.

Beate M. Czarnetzki

Opis

Urticaria is a vexing problem, to the patient who teachers who have stimulated my interest and helped suffers from the annoying pruritus and the fear oflife me to understand the basic and clinical aspects of mast threatening reactions, to the physician who faces the cell-related problems is long. I would like to specifi challenge to find the cause of the eruption and to cally mention J.N. Fink during medical school train control the symptomatology, and to the scientist who ing in Milwaukee, J.R. Pomeranz and R.W. Belcher is asked to explain the process that elicits tissue during dermatology residency in Cleveland, L.M. swelling at the cellular and molecular levels. Lichtenstein and P. Norman during a research fellow The last thorough treatise on urticaria was the ship at the Department of Clinical Immunology and superb monograph by R. P. Warin and R.H. Champion, Allergy at Johns Hopkins University in Baltimore, and published more than a decade ago. Since then, there E. Macher at the University Clinics in Miinster where have been major advances in the field. This holds much of what I have learned in the past could be particularly for the clinical aspects of anaphylactoid broadened through further basic research and clinical reactions, the urticarial vasculitis syndrome, and the experience."

Spis treści

1 History of Urticaria.- 1.1 Introduction.- 1.2 Nomenclature.- 1.3 Pathogenetic Theories.- 1.4 The Physical Urticarias.- 1.5 Urticaria Pigmentosa.- 1.6 Angio(neurotic)edema.- 1.7 Treatment.- 2 Basic Mechanisms.- 2.1 The Wheal.- 2.2 The Mast Cell.- 2.2.1 Morphological Aspects.- 2.2.2 Mast Cell Heterogeneity.- 2.2.3 Mast Cell Receptors.- 2.2.4 Mast Cell Triggering.- 2.2.5 Modulation of Mast Cell Release.- 2.2.6 Mast Cell Granules.- 2.3 Mediators.- 2.3.1 Histamine.- 2.3.2 5-Hydroxytryptamine (Serotonin).- 2.3.3 Kinins.- 2.3.4 Slow-Reacting Substances (Leukotrienes C4, D4, E4).- 2.3.5 Platelet Activating Factor.- 2.3.6 Prostaglandins.- 2.3.7 Complement.- 2.3.8 Chemotactic Factors.- 2.3.9 Heparin.- 2.3.10 Enzymes and Enzyme Inhibitors.- 2.4 Overview of Pathogenetic Aspects.- 3 Acute and Chronic Urticaria.- 3.1 Definition.- 3.2 Classification.- 3.3 Epidemiology.- 3.3.1 Incidence.- 3.3.2 Age.- 3.3.3 Sex.- 3.3.4 Types of Urticaria.- 3.3.5 Atopy.- 3.4 Clinical Aspects.- 3.4.1 Cutaneous Lesions.- 3.4.2 Noncutaneous Symptomatology.- 3.4.3 Anaphylaxis.- 3.4.4 Serum Sickness.- 3.4.5 Course and Prognosis.- 3.5 Histopathology.- 3.6 Laboratory Findings.- 3.6.1 Leukocytes.- 3.6.2 Immunoglobulins.- 3.6.3 Complement and Protease Inhibitors.- 3.7 Specific Causes of Reactions.- 3.7.1 General Aspect of Drug Reactions.- 3.7.2 Penicillin.- 3.7.3 Sulfonamides and Antibiotics Other Than Penicillin.- 3.7.4 Various Other Drugs.- 3.7.5 Implants.- 3.7.6 Vaccines.- 3.7.7 Blood Products and Substitutes.- 3.7.8 Seminal Plasma.- 3.7.9 Contrast Media.- 3.7.10 Food.- 3.7.11 Infections.- 3.7.12 Inhalants.- 3.7.13 Hormones and Endocrine Disorders.- 3.7.14 Internal Disease.- 3.7.15 Neurological and Psychic Factors.- 3.8 Diagnosis and Differential Diagnosis.- 3.8.1 General Considerations.- 3.8.2 Specific Diseases.- 4 Angioedema.- 4.1 General Aspects and Epidemiology.- 4.2 Classification.- 4.3 Clinical Aspects.- 4.3.1 Cutaneous Symptoms.- 4.3.2 Extracutaneous Symptoms.- 4.4 Associated Diseases.- 4.5 Course and Prognosis.- 4.6 Histology and Ultrastructure.- 4.7 Pathogenesis.- 4.7.1 Biochemical Defects in Hereditary Angioedema.- 4.7.2 Pathogenesis of Acquired Angioedema.- 4.8 Laboratory Findings.- 4.9 Genetics.- 4.10 Diagnosis.- 4.11 Differential Diagnosis.- 5 The Physical Urticarias.- 5.1 General Aspects.- 5.2 Epidemiology and Clinical Aspects.- 5.3 Pathogenesis.- 5.3.1 Passive Transfer.- 5.3.2 Mediators.- 5.3.3 Unifying Pathogenetic Scheme.- 5.4 Dermographic Urticaria (Urticaria Factitia).- 5.4.1 Clinical Aspects and Epidemiology.- 5.4.2 Cutaneous Symptoms.- 5.4.3 Systemic Manifestations and Laboratory Findings.- 5.4.4 Morphological Changes.- 5.4.5 Special Types of Dermographic Urticaria.- 5.4.6 Other Diseases Associated with Dermographic Urticaria.- 5.4.7 Diagnosis.- 5.4.8 Differential Diagnosis.- 5.4.9 Prognosis.- 5.4.10 Pathogenesis.- 5.5 Vibratory Angioedema.- 5.6 Pressure Urticaria.- 5.6.1 Epidemiology.- 5.6.2 Clinical Features.- 5.6.3 Laboratory Findings.- 5.6.4 Associated Diseases.- 5.6.5 Histological Findings.- 5.6.6 Diagnosis.- 5.6.7 Pathomechanisms.- 5.7 Cold Urticaria.- 5.7.1 General Aspects.- 5.7.2 Clinical Features.- 5.7.3 Histological Findings.- 5.7.4 Laboratory Findings.- 5.7.5 Associated Diseases.- 5.7.6 Diagnosis.- 5.7.7 Differential Diagnosis.- 5.7.8 Prognosis.- 5.7.9 Pathogenesis.- 5.7.10 Special Types of Cold Urticaria.- 5.8 Cholinergic Urticaria.- 5.8.1 Epidemiology.- 5.8.2 Local Symptoms.- 5.8.3 Systemic Symptoms.- 5.8.4 Laboratory Findings.- 5.8.5 Histology.- 5.8.6 Associated Diseases.- 5.8.7 Diagnosis.- 5.8.8 Differential Diagnosis.- 5.8.9 Pathogenesis.- 5.8.10 Variant Types of Cholinergic Urticaria and Related Diseases.- 5.9 Solar Urticaria.- 5.9.1 General Aspects and Epidemiology.- 5.9.2 Cutaneous Reactions.- 5.9.3 Systemic Symptoms.- 5.9.4 Laboratory Findings.- 5.9.5 Histology.- 5.9.6 Underlying and Associated Diseases.- 5.9.7 Diagnosis.- 5.9.8 Differential Diagnosis.- 5.9.9 Prognosis.- 5.9.10 Pathogenesis.- 5.10 Heat Contact Urticaria.- 5.10.1 General Aspects.- 5.10.2 Local Reactions.- 5.10.3 Systemic Symptoms.- 5.10.4 Laboratory Findings.- 5.10.5 Associated Diseases.- 5.10.6 Histological Findings.- 5.10.7 Diagnosis.- 5.10.8 Differential Diagnosis.- 5.10.9 Prognosis.- 5.10.10 Pathogenesis.- 5.11 Aquagenic Urticaria.- 5.11.1 General Aspects.- 5.11.2 Clinical Findings.- 5.11.3 Diagnosis and Differential Diagnosis.- 5.11.4 Pathogenesis.- 6 Contact Urticaria.- 6.1 General Aspects and Classification.- 6.2 Clinical Manifestations.- 6.2.1 Local Appearance, Time Course, and Histology.- 6.2.2 Systemic Symptoms.- 6.3 Immunologically Mediated Contact Urticaria.- 6.4 Contact Urticaria due to Histamine Liberators.- 6.5 Venom-Induced Contact Urticaria.- 6.6 Contact Urticaria due to Unknown Mechanisms.- 6.7 Pathomechanisms of Contact Urticaria.- 6.7.1 Mechanism of Release.- 6.7.2 Mediators Involved in Contact Urticaria.- 6.7.3 Local Factors Important for Development of Contact Urticaria.- 6.8 Diagnosis of Contact Urticaria.- 6.8.1 Clinical Diagnosis.- 6.8.2 Diagnostic Skin Tests.- 6.8.3 Further Diagnostic Tests.- 7 Anaphylactoid Reactions.- 7.1 Definition.- 7.2 Classification.- 7.3 Epidemiological Aspects.- 7.4 Agents Eliciting Anaphylactoid Reactions.- 7.4.1 Analgesics.- 7.4.2 Preservatives and Colorings.- 7.4.3 Radiocontrast Media.- 7.4.4 Plasma Expanders.- 7.4.5 Anesthetics.- 7.5 Clinical Features.- 7.5.1 Symptomatology.- 7.5.2 Kinetics of the Reaction.- 7.5.3 Laboratory Findings.- 7.5.4 Prognosis.- 7.6 Diagnosis.- 7.6.1 Patient History.- 7.6.2 Skin Tests.- 7.6.3 Sequential Tests for Vascular Response.- 7.6.4 Oral Provocation Tests.- 7.6.5 In Vitro Tests for Lymphocyte Transformation.- 7.7 Pathogenesis.- 7.7.1 Immunoglobulins, Mast Cells, Mast Cell Mediators.- 7.7.2 Arachidonate Metabolism.- 7.7.3 Involvement of the Complement Pathway.- 7.7.4 Other Theories.- 7.8 Pathogenetic Aspects of Intolerance Reactions to Special Reagents.- 7.8.1 Contrast Media.- 7.8.2 Volume Expanders.- 7.8.3 Drugs for Anesthesia.- 8 Urticarial Vasculitis Syndrome.- 8.1 General Aspects.- 8.2 Epidemiology.- 8.3 Clinical Aspects.- 8.3.1 Cutaneous Manifestations.- 8.3.2 Systemic Manifestations.- 8.4 Histopathology.- 8.5 Immunopathology.- 8.6 Laboratory Findings.- 8.6.1 Erythrocyte Sedimentation Rate.- 8.6.2 Immunoglobulins.- 8.6.3 Complement System.- 8.6.4 Immune Complexes.- 8.7 Diagnosis.- 8.8 Differential Diagnosis.- 8.9 Prognosis.- 8.10 Pathogenesis.- 8.10.1 Immune Complexes.- 8.10.2 Mediators.- 8.10.3 Relationship to the Arthus Reaction.- 8.10.4 Other Pathogenic Factors.- 9 Mastocytosis (Urticaria Pigmentosa).- 9.1 Introduction.- 9.2 Cutaneous Mastocytosis.- 9.3 Systemic Mastocytosis.- 9.4 Symptomatology.- 9.5 Histology.- 9.6 Laboratory Findings.- 9.7 Diagnosis.- 9.8 Pathogenesis.- 9.9 Prognosis.- 10 Diagnosis.- 10.1 Introduction.- 10.2 History.- 10.2.1 Clinical Appearance and Symptoms.- 10.2.2 Potentially Provoking or Associated Factors.- 10.2.3 Physical Examination.- 10.3 Laboratory Procedures.- 10.3.1 Screening Tests.- 10.3.2 Specific Diagnostic Laboratory Tests.- 10.3.3 Laboratory Tests for Diagnosis of IgE-Dependent Allergy (RAST and RIST).- 10.3.4 In Vivo Provocation Tests.- 10.3.5 Tests for Physical Urticarias.- 10.3.6 Oral Challenge Tests.- 10.4 Diagnosis by Avoidance.- 10.4.1 Social Habits and Environmental Factors.- 10.4.2 Drugs.- 10.4.3 Diet.- 10.5 Diagnosis by Therapy.- 11 Therapy.- 11.1 Basic Therapeutic Considerations.- 11.2 Specific Therapeutic Modalities.- 11.2.1 Antihistamines.- 11.2.2 Beta-Adrenergic Agonists.- 11.2.3 Corticosteroids.- 11.2.4 Inhibitors of Mast Cell Secretion.- 11.2.5 Kallikrein Inhibitors.- 11.2.6 Mast Cell Mediator Depletion.- 11.2.7 Miscellaneous Therapeutic Agents.- 11.2.8 Hyposensitization.- 11.3 Treatment of Acute and Chronic Urticaria.- 11.3.1 Acute Urticaria.- 11.3.2 Anaphylaxis.- 11.3.3 Chronic Urticaria.- 11.4 The Physical Urticarias.- 11.4.1 Dermographic Urticaria.- 11.4.2 Cholinergic Urticaria.- 11.4.3 Cold Urticaria.- 11.4.4 Solar Urticaria.- 11.4.5 Heat Contact Urticaria.- 11.4.6 Pressure Urticaria.- 11.5 Mastocytosis.- 11.6 Urticarial Vasculitis Syndrome.- 11.7 Hereditary Angioedema.- 11.7.1 Danazol.- 11.7.2 Plasmin Inhibitors.- 11.7.3 Replacement Therapy with Fresh Frozen Plasma and C1INH.- 11.7.4 Practical Clinical Guidelines.- References.