Severe dermographism after topical therapy with diphenylcyclopropenone for alopecia universalis

We describe here a 19-year-old Japanese man with an 11-year history of alopecia universalis, who, after the 1st application of a 0.003% diphenylcyclopropenone (DPCP) solution to the whole scalp, developed acute contact dermatitis at the test site, together with widespread severe dermographism. Every 3 weeks, persistence of the severe urticarial reaction and efficacy of treatment were monitored by constant pressure stimuli in a series of pressure tests, and subsequently evaluated by laser Doppler flowmetry (LDF). Although, on pressure tests, the urticarial response was found to significantly improve after starting treatment, erythematous responses continued to appear for nearly 3 months. The persistent course of these side-effects in our patient strongly suggests that precautions must currently be taken in the therapeutic use of potent sensitizers such as DPCP.     

The effect of psoralen photochemotherapy (PUVA) on symptomatic dermographism

A controlled trial of 4-weeks oral photochemotherapy (PUVA) on 14 patients with severe symptomatic dermatographism produced a clinically useful reduction in itching in five patients. In four of these patients itching had relapsed to pre-treatment levels within 3 months of finishing the PUVA course. A comparison of the weal and flare responses on exposed and covered (control) skin using a calibrated dermographometer showed no significant change in skin reactivity, even in the patients who experienced symptomatic relief. While PUVA may temporarily reduce itching in some patients with symptomatic dermographism, its use cannot generally be justified for treating this type of physical urticaria.     

Calcium antagonist in the treatment of symptomatic dermographism. Low-dose and high-dose studies with nifedipine

The effect of nifedipine on subjective symptoms and objective dermographometer induced whealing was assessed independently in two double-blind cross-over trials in which active drug or placebo were taken for 2 weeks. The lower dose study used nifedipine 5 mg 3 times daily and gave rise to symptomatic improvement as assessed by diary card and visual analogue scale in 5 of 11 patients. This was not statistically significant and was not accompanied by a reduction in dermographometer-induced wheal and flare responses except at highest pressures. In a separate study 7 patients were treated with nifedipine 10 mg 3 times daily. No change in whealing occurred, 3 patients' symptoms became worse and only 1 showed symptomatic improvement on nifedipine. Side effects were frequent at this dose. The reasons for the unfavourable response despite in vitro evidence for inhibition of mast cell degranulation by this drug are discussed.     

奥马珠单抗治疗27例人工荨麻疹回顾分析

【摘要】 目的 通过分析真实世界奥马珠单抗治疗人工荨麻疹的数据,评估奥马珠单抗治疗人工荨麻疹的临床疗效和安全性。方法 回顾分析北京大学第一医院皮肤科门诊2018年2月到2021年5月完成16周奥马珠单抗治疗的人工荨麻疹病例资料,比较治疗前后关键摩擦阈值（CFT）和激发试验瘙痒评分、荨麻疹控制评分（UCT）、皮肤病生活质量指数（DLQI）、慢性荨麻疹生活质量问卷（CU-Q2oL）,记录治疗期间患者报告的不良事件。治疗前后组内数据比较采用Wilcoxon符号秩和检验。结果 纳入27例完成16周奥马珠单抗治疗的人工荨麻疹患者。27例患者基线期CFT均为4,UCT为7.0（5.0,8.0）分,DLQI为9.0（6.0,10.0）分,CU-Q2oL为63.0（50.0,72.0）分。在治疗第4周,9例（33.3%）患者CFT由4降为0,27例患者UCT评分上升至14.0（12.0,16.0）分（Z = 4.548,P＜0.05）,DLQI下降至2.0（0.0,2.0）分（Z = 4.513,P＜0.05）,CU-Q2oL下降至32.0（25.0,41.0）分（Z = 4.433,P＜0.05）。治疗第16周,UCT升至15.0（14.0,16.0）分,DLQI降至0.0（0.0,1.0）分,CU-Q2oL降至25.0（23.0,30.0）分。治疗期间无药物相关严重不良事件报告。结论 奥马珠单抗可有效改善人工荨麻疹的症状,提高患者生活质量,且具有良好的安全性。     

Quantified determination of dermographism in patients with atopic eczema

The usual method of checking dermatographism (D), which is typically white in atopic eczema (AE), allows only a qualitative rating. To allow reproducible quantification of D we have developed an easily used instrument, called a Dermographometer. This can be fitted with one to three blunt tapered metal bars of different weights applying a constant stretching pressure over the whole skin areas to be examined or different pressures at isolated points. We used this device to study D in 27 patients with AE and in 20 healthy controls. Of the 27 patients, 21 had white D, 2, red D, and 4, none at each pressure applied. In 18 of the controls D was red. In addition, the two groups differed significantly in the time to onset and the duration of the D elicited, which was much longer in patients with AE. Simultaneous and constant application of distinct grades of pressure for quantitative dermatographometry is a method that can reliably be used for the study of inter- and intraindividual variation in vascular reactivity in the course of various dermatoses, especially.     

皿治林治疗慢性荨麻疹的临床研究

目的评价皿治林（咪畔斯汀）治疗慢性荨麻疹的有效性及安全性。方法采用临床随机对照试验方法对127例慢性荨麻疹患者应用皿治林10mg治疗，每日1次口服，第8天、第15天随访1次，共2次。结果治疗前后评分比较差异均有显著性，且优于对照组（P均〈0．05），临床观察期间未发现明显毒副作用。结论使用皿治林治疗慢性荨麻疹是安全有效的。     

咪唑斯汀治疗143例慢性荨麻疹临床观察

目的 :评价咪唑斯汀 (Mizolastine ,皿治林 )治疗慢性荨麻疹的疗效和安全性。方法 :服用咪唑斯汀 1 0mg,每日 1次 ,连服 2周。结果 :1 43例慢性荨麻疹病人治疗 1周临床总有效率为 3 2 8% ,2周临床总有效率 77 6% ,明显高于 1周的疗效。治疗 1周和 2周后病人的瘙痒、风团大小、风团数量和症状均明显低于治疗前 ,治疗第 7天 ,总积分由治疗前的 7 1 4± 0 1 2下降为 3 62± 0 2 0 ,与治疗前比较差异有显著性 (P <0 0 0 1 )。治疗第 1 4天时 ,总积分进一步下降为 1 62± 0 1 7,与治疗前比较差异有显著性(P <0 0 0 1 )。半数以上病人在服药第 1天症状和体征开始缓解。经 3天治疗绝大多数患者症状和体征出现了改善 ,不良反应发生率 2 0 9% ,不良反应为困倦和乏力。结论 :咪唑斯汀治疗慢性荨麻疗效显著 ,安全性高。     

咪唑斯汀、雷尼替丁和潘生丁联合治疗慢性荨麻疹157例疗效观察

目的观察咪唑斯汀、雷尼替丁和潘生丁联合应用治疗157例慢性荨麻疹的疗效。方法278例慢性荨麻疹患者被随机分为咪唑斯汀组（12l例）和联合治疗组（157例），分别给予咪唑斯汀10mg，每日1次，或眯唑斯汀10mg，每日1次，加雷尼替丁300mg，每日2次和潘生丁50mg，每日3次，连用4周。结果联合治疗组显效率和总有效率分别为79．0％和91．7％，咪唑斯汀单用组显效率和总有效率分别为51．2％和74．4％，两组比较差异有非常显著性（P〈0．001）。不良反应嗜睡和口干的发生率咪唑斯汀分别为7．4％和9．9％，联合治疗组分别为8．9％和10．8％，经统计学检验两者差异无显著性（P〉0．05）。结论本文提示三种药联合应用是治疗慢性荨麻疹安全和有效的方法。     

对遗传过敏性皮炎的乙酸胆硷、组胺皮试和皮肤划痕反应的评价

在不同性质的炎症性皮肤病以乙酰胆碱、组胺皮试和皮肤划痕试验,提示在遗传过敏性皮炎(AD)的皮损和外表正常皮肤处的异常反应表现突出,虽非特异,但对诊断有参考价值.皮试的异常反应,除继发于炎症性改变外,通过对不同AD亚型和在不同部位试验的分析比较,发现与遗传过敏性素质有关.     

食物特异性IgG抗体与慢性自发性荨麻疹表型的相关性研究

目的探讨食物特异性IgG(sIgG)与慢性自发性荨麻疹(CSU)表型的相关性。方法连续收集2014年4月至2015年3月于中国医科大学附属第一医院等5家三级甲等医院皮肤科门诊就诊的活动期CSU、皮肤划痕症(SD)、急性荨麻疹(AU)患者和健康对照血清, 酶联免疫吸附法检测90种食物抗原sIgG抗体和总IgE抗体, 免疫印迹法检测20种变应原sIgE抗体, 化学微粒子发光法检测甲状腺过氧化物酶IgG抗体和甲状腺球蛋白IgG抗体。两组间和多组间正态分布计量数据的比较分别采用t检验和单因素方差分析, 两组间非正态分布计量数据的比较采用Mann-WhitneyU检验, 率的比较采用χ2检验和Fisher精确检验。结果纳入CSU患者248例, SD患者22例, AU患者15例, 健康对照13例。以sIgG ≥ 100 IU/ml(2+及以上)为阳性标准, CSU组、SD组和AU组的食物sIgG阳性率(176/248, 70.97%;15/22, 68.18%;11/15)略高于健康对照组(7/13), 但4组差异无统计学意义(χ2 = 1.80, P = 0.615)。248例CSU患者中, s...     

寒冷性荨麻疹患者血清组胺释放活性检测

目的：探讨原发性获得性寒冷性荨麻疹（PACU）患者血清组胺释放活性及其意义。方法：通过分离人皮肤肥大细胞,进行肥大细胞体外组胺释放试验,测定组胺释放率。将患者血清用Microcon YM-100超滤膜,分成＞100ku和＜100ku两部分,以及56℃加热去补体等处理后,比较不同条件下血清组胺释放活性。结果：15例PACU患者全血清组的组胺释放率明显高于正常对照组（P＜0．01）;＞100ku组与全血清组比较,无统计学差异（P＞0．05）;＜100ku组和去补体组与全血清组比较,差异均有显著性（P均＜0．01）。PACU患者全血清组和＞100ku组分别有10例组胺释放率＞15％,阳性率为66．67％：＜100ku组无1例阳性;去补体组有2例阳性,阳性率为13．33％。结论：部分PACU患者血清中存在组胺释放活性,这种活性物质的分子质量＞100ku,且依赖补体的参与。     

台州市531例慢性荨麻疹过敏原检测

目的:筛选台州市531例慢性荨麻疹患者过敏原。方法:采用免疫印迹法对531例慢性荨麻疹患者进行过敏原测定。结果:吸入性过敏原阳性率为25.24%(134例),其中尘螨阳性率22.41%(119例);食人性过敏原阳性率为29.0%(154例),其中蟹抗体阳性率13.75%(73例)。结论:本地区常见过敏原为尘螨。