Document Detail


Urticaria and angioedema: a clinical spectrum.
MedLine Citation:
PMID:  8673682     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this review is to give the reader a global insight into the spectrum of urticaria, focusing on differential diagnosis and pathogenic mechanisms. This review will define the role of the mast cell, explore a possible autoimmune basis for urticaria, and examine the purported role of food allergy in chronic urticaria. Last, the work-up and treatment of urticaria will be discussed in the context of the histologic diagnosis. STUDY SELECTION: The relevant past medical literature will be reviewed in the context of new and novel research into the mechanisms of chronic urticaria. RESULTS: Urticaria can be classified histopathologically into the following three categories: (1) neutrophilic vasculitis, (2) polymorphous perivascular infiltrate, and (3) sparse perivascular lymphocytic infiltrate. Each of the above histologic patterns correlates with a distinct clinical entity and the work-up and treatment of urticaria will be related to each of the above histologic types. CONCLUSIONS: Urticaria and angioedema are frustrating problems for both physicians and their patients; however, the problem can best be approached by considering urticaria as a symptom that may be part of a larger clinical spectrum. The physical examination and medical history remain the two most important pieces of information. The allergist frequently overlooks the value of a skin biopsy as an aid in sorting out the pathophysiology of urticaria and the biopsy results may help to classify urticaria into subgroups which respond differently to treatment.
Authors:
E N Charlesworth
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology     Volume:  76     ISSN:  1081-1206     ISO Abbreviation:  Ann. Allergy Asthma Immunol.     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-08-12     Completed Date:  1996-08-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9503580     Medline TA:  Ann Allergy Asthma Immunol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  484-95; quiz 495-9     Citation Subset:  IM    
Affiliation:
Department of Allergy and Dermatology, Brenham Clinic Association, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioedema* / diagnosis,  etiology,  pathology,  therapy
Diagnosis, Differential
Humans
Urticaria* / diagnosis,  etiology,  immunology,  pathology,  therapy

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