Acute and Chronic Urticaria: Evaluation and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 6683

Special Issue Editor


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Guest Editor
Department of Internal Diseases with Division of Allergology, Institute of Medical Sciences, University of Opole, Opole, Poland
Interests: urticaria; angioedema; allergic diseases; asthma
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Special Issue Information

Dear Colleagues,

Urticaria is a disorder that still causes many problems in allergological and dermatological practice. In the pathophysiology of urticaria, various abnormalities should be taken into account. The symptoms of urticaria undoubtedly cause distress for the patients and have a detrimental influence on patients’ quality of life, even leading to the manifestation of emotional disturbances. Pruritus often disturbs the sleep cycle. Previous analyses demonstrated that urticaria patients are affected by psychiatric comorbidities. Recurrent angioedema, often coexisting with wheals, is an important problem in daily practice and emergency medicine and is one of the most important symptoms of urticaria.

Urticaria therapy has seen recent progress, connected not only with the effectiveness of antihistamines in increased doses and with the use of anti-IgE treatment but also with novel therapies. Assessing the response to treatment in CSU patients is absolutely essential for improving the quality of care. Nowadays, we have several tools to assess disease activity, impact, and control.

Additionally, the issue of urticaria in children and during pregnancy and lactation, along with comorbidities, is still not deeply explored.

In this Special Issue, we will focus on innovations and advancements in urticaria pathogenesis and management; we hope to provide more information that will be useful in future research as well as in daily practice.

Prof. Zenon Brzoza
Guest Editor

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Keywords

  • Urticaria
  • Angioedema
  • Pathogenesis
  • Diagnostics
  • Treatment
  • Novelty
  • Comorbidity

Published Papers (3 papers)

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Research

9 pages, 1029 KiB  
Article
Variations of Thiol–Disulfide Homeostasis Parameters after Treatment with H1-Antihistamines in Patients with Chronic Spontaneous Urticaria
by Clara Matei, Simona Roxana Georgescu, Ilinca Nicolae, Corina Daniela Ene, Cristina Iulia Mitran, Madalina Irina Mitran and Mircea Tampa
J. Clin. Med. 2021, 10(13), 2980; https://doi.org/10.3390/jcm10132980 - 2 Jul 2021
Cited by 4 | Viewed by 1671
Abstract
Background. The pathogenesis of chronic spontaneous urticaria involves metabolic, immunological, and psychological factors. The thiol–disulfide exchange reactions could be a mechanism to counteract oxidative stress in patients with chronic spontaneous urticaria. Objective: The assessment of thiol–disulfide homeostasis parameters (TDHPs) according to disease severity [...] Read more.
Background. The pathogenesis of chronic spontaneous urticaria involves metabolic, immunological, and psychological factors. The thiol–disulfide exchange reactions could be a mechanism to counteract oxidative stress in patients with chronic spontaneous urticaria. Objective: The assessment of thiol–disulfide homeostasis parameters (TDHPs) according to disease severity and the influence of H1-antihistamine therapy in patients with chronic spontaneous urticaria. Material and method. We have included 30 patients with chronic spontaneous urticaria in the study and we have determined the levels of native thiol, total thiol, disulfides as well as the disulfide/native thiol ratio, disulfide/total thiol ratio and the native thiol/total thiol ratio, before and after therapy with H1-antihistamines. Results. The results of the study showed altered levels of TDHPs and their normalization after treatment with H1-antihistamines in patients with chronic spontaneous urticaria. We determined a statistically significant increase in the serum levels of total thiol, native thiol, and native thiol/total thiol ratio and a significant reduction in the levels of disulfides, disulfide/native thiol ratio and disulfide/total thiol ratio after treatment with H1-antihistamines. The normalization of the serum levels of TDHPs has been associated with the relief of symptoms and reduction or resolution of pruritus and urticarial plaques. Conclusion. These results suggest the involvement of thiol–disulfide homeostasis in the defense against the harmful effects of reactive oxygen species in patients with chronic spontaneous urticaria and the potential role of TDHPs in monitoring H1-antihistamine therapy. To the best of our knowledge, this is the first study investigating TDHPs in patients with chronic spontaneous urticaria before and after treatment. Full article
(This article belongs to the Special Issue Acute and Chronic Urticaria: Evaluation and Treatment)
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5 pages, 217 KiB  
Article
Angioedema Coexisting Chronic Spontaneous Urticaria Negatively Influences Patients’ Sense of Coherence, What Results in Susceptibility to Anxiety Symptoms Occurrence
by Karina Badura-Brzoza and Zenon Brzoza
J. Clin. Med. 2021, 10(13), 2852; https://doi.org/10.3390/jcm10132852 - 28 Jun 2021
Cited by 2 | Viewed by 1461
Abstract
Background: Angioedema coexisting chronic spontaneous urticaria (CSU) is proved to result in patient anxiety occurrence, but the mechanisms and susceptibility patterns are unknown. Sense of coherence (SOC) is one of methods of coping with stress and is defined as a person’s general orientation [...] Read more.
Background: Angioedema coexisting chronic spontaneous urticaria (CSU) is proved to result in patient anxiety occurrence, but the mechanisms and susceptibility patterns are unknown. Sense of coherence (SOC) is one of methods of coping with stress and is defined as a person’s general orientation toward life. We decided to assess SOC disturbances in CSU patients in the context of possible angioedema association. Methods: The study comprised 71 CSU subjects. To analyze disease activity, the Urticaria Activity Score seven-day assessment questionnaire (UAS7) was used. For anxiety assessment, the STAI questionnaire was used. The SOC-29 questionnaire, consisting of questions related to comprehensibility (SOC-C), manageability (SOC-M), and meaningfulness (SOC-Mf), was used to analyze SOC parameters (SOC-T). Results: In patients with coexisting angioedema, we observed statistically significantly lower values of SOC-Mf and SOC-T in comparison to the wheals only group. In the angioedema group, we noticed significant negative correlations between SOC-M and SOC-Mf, as well as SOC-T values and anxiety. In the wheals only group, we proved statistically significant correlations between SOC-Mf and SOC-T and anxiety assessed as a state. Conclusions: It is necessary to identify CSU patients manifesting angioedema as they are more likely to have impaired SOC. Lower SOC in this specific group of patients can be related to anxiety symptoms occurrence and should probably be an indication for psychological support. Full article
(This article belongs to the Special Issue Acute and Chronic Urticaria: Evaluation and Treatment)
9 pages, 811 KiB  
Article
Chronic Spontaneous Urticaria and Type 1 Diabetes Mellitus—Does Quality of Life Impairment Always Reflect Health Danger?
by Zenon Brzoza, Katarzyna Nabrdalik, Lukasz Moos, Hanna Kwiendacz, Karina Badura-Brzoza, Hanna Jarolim, Katarzyna Kapeluszna and Janusz Gumprecht
J. Clin. Med. 2020, 9(8), 2505; https://doi.org/10.3390/jcm9082505 - 4 Aug 2020
Cited by 5 | Viewed by 2886
Abstract
Background and aims: Chronic spontaneous urticaria (CSU) and diabetes mellitus type 1 (T1DM) may compromise the quality of life (QoL). We decided to compare the QoL of T1DM patients to those suffering from CSU. Materials and methods: Sixty-six patients with well-controlled T1DM (male [...] Read more.
Background and aims: Chronic spontaneous urticaria (CSU) and diabetes mellitus type 1 (T1DM) may compromise the quality of life (QoL). We decided to compare the QoL of T1DM patients to those suffering from CSU. Materials and methods: Sixty-six patients with well-controlled T1DM (male 52%) in the mean age of (SD) 36.3 (11.09) years and 51 patients with CSU (male 33%) in the mean age of (SD) 35.8 (8.53) years were enrolled in this observational study. All the participants completed a Short-Form 36 (SF-36) QoL. Results: The QoL related to social functioning was significantly worse among CSU patients. There were differences related to gender found in the group of patients with T1DM—where men tended to declare a better quality of life than women (p = 0.015)—especially in the area of energy/fatigue and pain. It appeared that due to physical and emotional problems occurring in married patients, the QoL is lower in T1DM group in comparison to the CSU one. Conclusions: The patients with CSU presented significantly worse social functioning compared to the ones with T1DM. This fact proves the QoL impairment level is not always related to the level of health danger. The differences in the QoL related to gender and marital status found among T1DM patients point to the necessity for further exploration in a larger group of patients. Due to the fact that optimal disease management should ensure patient’s good emotional well-being, there is a need for additional psychological and social care for patients from those two groups. Full article
(This article belongs to the Special Issue Acute and Chronic Urticaria: Evaluation and Treatment)
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