EAACI/GA2LEN/EDF/WAO荨麻疹指南:定义、分类和诊断

EAACI/GA2LEN/EDF/WAO荨麻疹指南经2008年第三次国际荨麻疹共识会议讨论达成,由EAACI,GA2LEN,EDF和WAO联合倡议。其涵盖了荨麻疹的定义和分类,并涉及到了近几年在寻找病因、诱发因素及发病有关的分子和细胞机制中取得的最新进展。此外,还概括了不同亚型荨麻疹的诊断方法。     

中国荨麻疹诊疗指南（2014版）

本指南在2007版［１］基础上,结合近年来国内外研究进展,主要由中华医学会皮肤性病学分会免疫学组成员反复讨论和修改而成,供国内同行参考……     

荨麻疹：欧洲2009年指南和2006年指南的比较

2009年10月欧洲变态反应和临床免疫学院皮肤病学组（EAACI）、全球变态反应和哮喘欧洲协作网（GA2LEN）、欧洲皮肤病论坛（EDF）、世界变态反应组织（WAO）联合发布了新版的荨麻疹指南（以下简称新指南）。新指南和这四个组织2006年联合发布的荨麻疹指南（以下简称旧指南）相比,内容上有了很多更新,及时解读这些更新,对我国荨麻疹的研究和临床诊疗将产生很大的影响。     

【开放获取】中国荨麻疹诊疗指南（2022版）

【摘要】 荨麻疹是一种以风团和瘙痒为主要表现的常见皮肤病,部分病例存在病情迁延反复、临床疗效不佳等特点。本指南以2018版中国荨麻疹诊疗指南为基础,结合近年来国内外荨麻疹的最新研究进展,经中华医学会皮肤性病学分会荨麻疹研究中心数十位专家共同讨论后制定而成,适用于中国成人及儿童荨麻疹患者。除对荨麻疹的定义、发病机制等内容进行补充和更新外,还采用问答形式对荨麻疹分类、诊断及治疗等临床实践中重点关注的内容进行细致说明,以期为荨麻疹的诊疗提供更为全面、科学和权威的参考依据。     

荨麻疹诊疗指南(2007版）

本指南在中华医学会皮肤性病学分会主任委员张学军的主持下．经过国内皮肤科多位专家反复讨论和修改，现成文如下．供国内同行参考j参加本指南制定的专家为（按姓氏汉语拼音排列）：毕志刚、范卫新（最后执笔）、顾军、郝飞、王宝玺．徐金华、姚志荣、张建中、张学军、郑志忠、朱大勋．[第一段]     

梅毒治疗中伴发急性荨麻疹2例

我们采用长效青霉素治疗Ⅱ期梅毒病人 ,其中 2例于治疗 7至 10天后出现急性荨麻疹 ,二者均无荨麻疹及青霉素过敏史 ,现报道如下 :例 1　女 ,38岁 ,家庭妇女。Ⅱ期早发梅毒。予苄星青霉素 2 40万Ｕ分两臀肌注 ,每周一次。前三天予强的松 5ｍｇ ,一日四次口服。治疗 7天后 ,患者全身原皮疹大部分消退 ,全身突起大小不等 ,形状不规则的鲜红色风团 ,瘙痒难忍。无恶心、呕吐、心慌、气急等症。予口服赛特赞片等抗过敏治疗三天后 ,风团完全消退。例 2　女 ,43岁 ,教师。Ⅰ、Ⅱ期早发梅毒。治疗方法同例 1。治疗第 10天 ,原皮疹消退 ,全身突起大片…     

转移因子治疗荨麻疹200例

转移因子治疗荨麻疹２００例杨惠玲（南昌市皮肤病院）徐昌德（南昌市化工技校，３３０００１）一、病例资料：２００例患者男８７例，女１１３例，年龄为１３～５３岁，平均３１．１５岁。病程为３月～２年，平均１３．６５月。所有患者均有典型的荨麻疹临床表现，个别病...     

慢性荨麻疹的治疗

慢性荨麻疹是多数病因不明、病程长且治疗困难的皮肤病。作者复习有关文献介绍对慢性荨麻疹的非药物和药物治疗 ,其重点为药物治疗。     

慢性荨麻疹的治疗进展

慢性荨麻疹（CU）是一种常见的皮肤病。其中慢性特发性荨麻疹的发病率约为0．1％～3％。其主要的特征为复发性并短时存在的瘙痒性风团,时间超过6周,病程迁延,经常持续数年甚至数十年不愈。研究数据显示,CU患者的健康状况评分与冠状动脉疾病患者的评分相当。CU患者健康状况和主观满意度低于健康人群和呼吸系统过敏的患者。由于CU易诊难治,需长期服药,因此,规范治疗方案尤为重要。     

国产西替利嗪治疗荨麻疹疗效观察

我科从1997年8月～10月应用西替利嗪(常州市四药制药有限公司生产)治疗荨麻疹,并以仙特敏(比利时ＵＣＢ公司生产)进行临床对照,现将结果报告如下。临床资料　随机从门诊病人中抽取40例急慢性荨麻疹患者作对照观察。急慢性荨麻疹各20例,男18例,女22例。年龄13～70岁。病程:急性荨麻疹2ｈ～1周,慢性荨麻疹2月～6年。治疗方法　40例病人随机分为治疗组和对照组。经统计学处理,两组病例构成差异无显著性意义(Ｐ>0.05)。治疗组20例服西替利嗪,对照组20例服仙特敏,均每次10ｍｇ,1次/ｄ,6天为1疗程。急性荨麻疹用1疗程,慢性荨麻疹用2疗程。观察病情…     

A Case Series Study of Eighty-Five Chronic Spontaneous Urticaria Patients Referred to a Tertiary Care Center

Background

Chronic spontaneous urticaria is a debilitating disease for the patients and often considered by the doctors a very difficult disease to treat. In 2009 the European Academy of Allergy and Clinical Immunology/Global Allergy and Asthma European network/European Dermatology Forum/World Allergy Organization (EAACI/GA²LEN/EDF/WAO) published a revised version of the guidelines for the treatment of urticaria which included an algorithm for the treatment.

Objective

The objective of this study was to examine the clinical effect and the practical use of the algorithm.

Methods

The study was performed as a case-series study of all newly referred patients to our urticaria clinic over a period of 18 months.

Results

Our results show that the single most important and efficient treatment of urticaria patients is up dosing non-sedating antihistamines as recommended by the EAACI/GA²LEN/EDF/WAO guidelines. We did not find any predicting factors for responders to the antihistamine treatment, but about one third of the patients did not respond to the up-dosing of the antihistamines.

Conclusion

Antihistamines seems to be the most efficient treatment for urticaria; other treatments such as montelukast, azathioprine, and mycophenolate mofetil may also be used, but only in combination with antihistamines and only in the case of an independent antihistamines treatment failure. The EAACI/GA²LEN/EDF/WAO guideline for the treatment of urticaria offers an efficient and simple guidelines for the treatment of urticaria.     

大疱性色素性荨麻疹1例

患儿女,1岁,躯干、四肢反复起斑丘疹、水疱1年伴痒。全身可见褐色斑丘疹,部分斑丘疹上见水疱,摩擦斑丘疹后局部出现风团样损害,即Darier征(+)。皮损组织病理示:表皮下大疱形成,真皮浅层可见大量肥大细胞浸润,Gimsa染色阳性,直接免疫荧光阴性。     

荨麻疹患者血清5-羟色胺测定及其临床意义

目的 探讨５－羟色胺（５－ＨＴ）在荨麻疹的发病机理及其意义。方法 用荧光分光光度法测定４６例患者治疗前后血清５－ＨＴ含量,并与正常对照组相比较。结果 ２３例急性荨麻疹（含４例急性胃肠型荨麻疹）和２３例慢性荨麻疹治疗前血清５－ＨＴ含量低于正常对照组,治疗后血清５－ＨＴ含量与正常对常组相接近。结论 ５－ＨＴ在荨麻疹的发病中起着重要的作用,其机理可能与５－ＨＴ和血管内皮细胞膜５－ＨＴ受体结合,引起内波细     

荨麻疹患者血中组胺的测定及其意义

目的探讨组胺(HA)在荨麻疹发病中的意义。方法 用荧光分光光度法测定56例患者治疗前后血中HA含量,并与正常对照组相比较。结果31例急性荨麻疹和25例慢性荨麻疹治疗前血浆中HA含量高于正常对照组,治疗后血中HA含量与正常对照组相接近。结论HA是参与荨麻疹病理生理过程的主要介质之一,测定患者血中HA水平可反映机体对HA的释放情况,有利于临床观察病情、判断疗效,解释其发病机理。     

Daily Clinical Practice in the Management of Chronic Urticaria in Spain: Results of the UCREX Study

BackgroundChronic Urticaria (CU) is a debilitating disease whose treatment is mainly symptomatic. UCREX study aimed to identify CU patients’ profile, disease management and quality-of-life (QoL) in daily clinical practice in Spain.MethodsObservational, 12-months prospective, multicenter study, included de novo or established CU patients attending to dermatology/allergy consultations in 39 Spanish hospitals. Main variables: Urticaria Activity Score (UAS), UAS over 7 days (UAS7). Secondary variables: CU-QoL Questionnaire (CU-Q₂oL), EuroQol-5 dimensions (EQ-5D), Medical Outcomes Study Sleep (MOS-Sleep) scale, Hospital Anxiety and Depression Scale (HADS).Results361 patients included. Of them, 176 (48.8%) considered for the main objective analysis. Mean age (SD) of 46.6 (14.2) years and 71.8% women. The year prior to inclusion, most patients (57.1%) were treated with non-sedating H1-antihistamines (NS-H1AH). At baseline, mean (SD) 3.6 (6.8) visits were registered to primary care. Mean (SD) UAS7 at baseline was 14.3 (11.0) and CU-Q₂oL 24.1 (17.0) which tended to improve by 8.6 (9.7) and 13.9 (15.0), respectively, at 12-months. MOS-Sleep and EQ-5D remained steady during the study, except pain/discomfort and anxiety/depression which went from 58.7% and 49.6% to 29.6% and 26.9%, respectively. At baseline, HADS showed a mean (SD) anxiety of 8.7 (4.5) and depression 5.1 (4.4), decreasing to 7.0 (4.3) and 4.7 (4.3), respectively, at 12-months.ConclusionsAlthough most CU patients are treated with NS-H1AH, disease activity is still important, negatively affecting patients’ QoL, work activity and healthcare resources use. An appropriate disease management could be the basis for symptoms control, QoL improvement and resources optimization.     

Natural History of Chronic Urticaria in Korea

BackgroundData on the natural history and prognostic variables of chronic urticaria (CU) are rare and information about spontaneous remission of CU is limited.ObjectiveThis study evaluated the natural history of CU and identified predictors for remission.MethodsTotal 329 Korean patients with CU, who had follow-ups more than 6 months after diagnosis during a 7-year period in the department of dermatology in three university hospitals were enrolled. Clinical data and laboratory findings obtained by medical records and telephone interviews were analyzed, retrospectively.ResultsThe proportion recovered in 1, 3, and 5 years after the onset of CU was 10.8%, 18.8%, and 32.9%, respectively. The mean duration of CU was 6.3 years. There were no significant differences in median recovery time depending on sex, age group, severity of CU, and type of CU. The presence of angioedema was significantly related to CU severity. There were no differences in prognosis with respect to the presence of dermographism or angioedema. Patients with atopic dermatitis (AD) had a significantly worse prognosis than patients without a history of AD; but not in patients with the history of allergic rhinitis or asthma. Patients with abnormal laboratory findings did not differ significantly in prognosis.ConclusionCU remission rate significantly differ according to the presence of AD. This study provides information about the natural course of CU of Korean patients.     

荨麻疹患者白介素13的检测

目的 研究白介素(IL)-13在急、慢性荨麻疹患者中的作用。方法 对22例急性荨麻疹患者和20例慢性荨麻疹患者,采用流式细胞仪检测淋巴细胞内IL-13、IL-4、干扰素酌(IFN-酌);用ELISA法测定血清IL-13和总IgE,并与正常人对照组进行比较。结果 经流式细胞仪检查发现,急性荨麻疹患者淋巴细胞IL-13的表达显著升高,与正常人对照组差异有统计学意义;而慢性荨麻疹患者的IL-13表达略有升高,与正常人对照组差异无统计学意义;IL-4的表达在两组患者中差异均无统计学意义。ELISA检测血清IL-13的结果与流式细胞仪检测结果相符;急慢性荨麻疹患者IL-4的表达与正常人对照组差异无统计学意义;IFN-酌的表达在荨麻疹患者中无明显改变。IgE的表达在急、慢性患者中均显著升高。但IL-13的表达和IgE抗体的量无相关性。结论 IL-13在荨麻疹的发病中发挥了重要作用,尤其是急性荨麻疹。     

儿童细菌感染性荨麻疹118例临床分析

目的了解儿童细菌感染性荨麻疹的发病特点,寻找最佳治疗方案和防治策略。方法对本科2009年7月-2011年12月诊治的儿童细菌感染性荨麻疹患儿临床资料进行回顾性分析。结果发热66例,皮肤瘙痒118例,颈部及耳后淋巴结肿大34例,咽充血118例,扁桃体肿大84例。血常规WBC升高(10.0×109～17.6×109)112例,102例中性粒细胞比值>0.7,110例CRP(>2.87mg/L)升高。3天的临床治愈率90.68%,5天的临床治愈率94.92%,7d的临床治愈率100%。结论儿童细菌感染性荨麻疹常伴发热、咽充血和扁桃体肿大,血WBC数和中性粒细胞比值升高,CRP值也升高。这类荨麻疹治疗方案的关键为同时抗感染及抗过敏治疗,辅以对症治疗。     

Turkish dermatologists' approach for chronic spontaneous urticaria: A questionnaire based study

Background/Objectives

Chronic spontaneous urticaria (CSU) is a common skin disorder which represents a challenge both for the patients and physicians. Guidelines and treatment algorithms have been created to help physicians to ease management. Our aim was to determine Turkish dermatologists' approach to CSU with regard to treatment, search for causative factors and use of instruments to assess the quality of life and severity of the disease.