Quality of life in chronic urticaria: a survey at a public university outpatient clinic, Botucatu (Brazil).

OBJECTIVE: To evaluate the impact of chronic urticaria on quality of life of outpatients through the university questionnaire Dermatology Life Quality Index (DLQI). METHODS: Survey of the impact on quality of life caused by chronic urticaria, using the DLQI questionnaire validated for the Portuguese language. Patients were interviewed during visits to a specialized outpatient clinic between May 2009 and May 2010 at a Brazilian public service (Botucatu-SP). DLQI scores were analyzed according to the following subgroups: age, gender, education, disease duration, and presence of angioedema. RESULTS: We interviewed 100 patients with chronic urticaria. There was a female predominance (86%), mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82% of patients. The mean DLQI score was 13.5, characterized by serious impact on quality of life, higher than Hansen's disease, psoriasis, atopic eczema, and basal cell carcinoma. The presence of angioedema was associated with higher scores: 14.5 x 9.9 (p < 0.01). Female patients reported greater impact on clothing, while male patients reported treatment interference with work and study (p < 0.05). CONCLUSION: Chronic urticaria seriously compromises the quality of life of patients evaluated at a university service in Brazil, particularly of patients with angioedema.

Qualidade de vida em urticária crônica: inquérito em ambulatório público universitário, Botucatu (Brasil) / Quality of life in chronic urticaria: a survey at a public university outpatient clinic, Botucatu (Brazil)

OBJETIVO: Avaliar o impacto da urticária crônica na qualidade de vida dos pacientes de ambulatório universitário a partir do questionário DLQI (Dermatology Life Quality Index). MÉTODOS: Inquérito sobre o impacto na qualidade de vida infligido pela urticária crônica a partir do questionário DLQI validado para a língua portuguesa. Pacientes foram entrevistados durante suas consultas em ambulatório especializado, entre maio de 2009 e maio de 2010, em serviço público brasileiro (Botucatu-SP). Os escores do DLQI foram analisados segundo subgrupos: idade, gênero, escolaridade, tempo de doença e presença de angioedema. RESULTADOS: Foram entrevistados 100 pacientes com urticária crônica. Predominou o gênero feminino (86 por cento), a idade média foi de 41,8 anos, duração média da doença foi de seis anos e angioedema ocorreu em 82 por cento dos pacientes. O escore médio do DLQI foi de 13,5, caracterizando grave impacto à qualidade de vida, superior a hanseníase, psoríase, eczema atópico e carcinoma basocelular. Presença de angioedema se associou a maiores escores: 14,5 x 9,9 (p < 0,01). Pacientes do gênero feminino referiram maior impacto quanto ao vestuário, já o gênero masculino referiu quanto ao tratamento, trabalho e estudo (p < 0,05). CONCLUSÃO: Urticária crônica inflige grave comprometimento da qualidade de vida nos pacientes avaliados em serviço universitário brasileiro, especialmente nos portadores de angioedema.

OBJECTIVE: To evaluate the impact of chronic urticaria on quality of life of outpatients through the university questionnaire Dermatology Life Quality Index (DLQI). METHODS: Survey of the impact on quality of life caused by chronic urticaria, using the DLQI questionnaire validated for the Portuguese language. Patients were interviewed during visits to a specialized outpatient clinic between May 2009 and May 2010 at a Brazilian public service (Botucatu-SP). DLQI scores were analyzed according to the following subgroups: age, gender, education, disease duration, and presence of angioedema. RESULTS: We interviewed 100 patients with chronic urticaria. There was a female predominance (86 percent), mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82 percent of patients. The mean DLQI score was 13.5, characterized by serious impact on quality of life, higher than Hansen's disease, psoriasis, atopic eczema, and basal cell carcinoma. The presence of angioedema was associated with higher scores: 14.5 x 9.9 (p < 0.01). Female patients reported greater impact on clothing, while male patients reported treatment interference with work and study (p < 0.05). CONCLUSION: Chronic urticaria seriously compromises the quality of life of patients evaluated at a university service in Brazil, particularly of patients with angioedema.

Clinicoepidemiologic features of chronic urticaria in patients having positive versus negative autologous serum skin test: a study of 100 Indian patients.

BACKGROUND: Chronic urticaria patients who demonstrate autoantibodies against the high-affinity receptor of IgE (FceRI) or IgE itself tend to have a high itch and wheal score, and systemic symptoms may have a significant bearing on their management in terms of super pharmacologic doses of antihistamines needed or use of immunomodulators. Most studies have used histamine release assays rather than autologous serum skin tests (ASSTs) for correlating urticaria severity and histamine releasing activity. METHODS: An ASST was performed in 100 (M:F, 31:69) chronic urticaria patients aged between 14 and 63 (mean, 32.69 ± 13) years with an objective to study the clinicoepidemiologic features like age, sex, age of onset and duration, frequency and distribution of wheals, urticaria severity, angioedema and systemic manifestations in ASST-positive and ASST-negative patients. RESULTS: ASST was positive in 46% of the patients and negative in 54% of the patients, respectively. Both groups showed no statistically significant difference for epidemiological details. However, the ASST-positive patients had a higher mean urticaria activity score, frequent involvement of more body sites, particularly palms and soles, presence of throat angioedema and general constitutional, respiratory or gastrointestinal symptoms in comparison with the ASST-negative patients. CONCLUSIONS: Apparently, ASST-positive patients have more severe clinical manifestations of chronic urticaria. The knowledge will be useful for the treating dermatologists and patients alike in view of its therapeutic implications.

Role of stressful life events in induction or exacerbation of psoriasis and chronic urticaria.

BACKGROUND: The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Previous reports addressing its influence on skin psoriasis and chronic urticaria have been mainly anecdotal. OBJECTIVE: The aim of this study was to evaluate the stressful events of life within 1 year preceding onset or exacerbation of skin disease in patients of psoriasis vulgaris and chronic urticaria. METHOD: Fifty consecutive clinically diagnosed psoriasis patients and 50 consecutive clinically diagnosed chronic urticaria patients were examined clinically and administered Gurmeet Singh's presumptive stressful life events scale. RESULTS: Stressful life events were seen in 26% of the patients in the psoriasis vulgaris group and 16% of the patients in the chronic urticaria group within 1 year preceding onset or exacerbation of skin disease. In the psoriasis vulgaris group, the most common stressful life event seen was financial loss or problems (8%), followed by death of close family member (4%), sexual problems (4%), family conflict (2%), major personal illness or injury (2%), and transfer or change in working conditions (2%), failure in examinations (2%), family member unemployed (2%), illness of family member (2%), getting married or engaged (2%), miscellaneous (2%). In the chronic urticaria group, the most common stressful life event seen was death of a close family member (6%), followed by family conflict (2%), financial loss or problems (2%), sexual problems (2%), illness of family member (2%), getting married or engaged (2%), trouble at work with colleagues, superiors, or subordinates (2%), going on a pleasure trip (2%) and extramarital relations (2%). CONCLUSION: Psychological stress plays a significant role in triggering or exacerbating dermatological diseases. Our study indicates the role of relaxation therapies and stress management programs in chronic diseases such as psoriasis and chronic urticaria. Psychological interventions can help individuals to reinterpret events and develop strategies to cope with stressful events, thus decreasing morbidity due to these diseases.

Urticária- angioedema crônico: caracterização sociodemográfica, clinica e etiológica - Estudo em doentes atendidos no HC - FMB - UNESP no período de 1990 a 1998 / Urticaria - chronic angioedema: sociodemographic, clinical and etiological characterization - Study in patients attended at HC - FMB - UNESP from 1990 to 1998

Urticaria cronica-angioedema e uma enfermidade complexa, multicausal, de facil diagnostico clinico, representando cerca de 1,1% das consultas ambulatorial dermatologicas do H.C. da F.M.B., no periodo de 1990 a 1998. Os objetivos deste estudo visaram caracterizar a populacao atendida quanto aos aspectos sociodemograficos, clinicos e etiologicos, assim como o estudo de fatores agravantes e a evolucao da enfermidade nos doentes atendidos no referido periodo. Para os objetivos propostos, foram avaliados 125 doentes atraves de um protocolo previamente elaborado e constava de: identificacao, anamnese dirigida, exame dermatologico, fisico e subsidiario. Na avaliacao dos resultados, observou-se predominancia no sexo feminino, no grupo etario de 20 a 50 anos, principalmente na faixa dos 30 a 40 anos, com idade media de 35 anos para o sexo feminino e 32 para o masculino. Houve predominancia da cor branca e em moradores da zona urbana. Nao houve ocupacao prevelente e cerca de 60% eram casados. Com relacao aos aspectos clinicos, o tempo medio de duracao da enfermidade foi de 45,26 meses, as lesoes tiveram duracao media de 5,6 horas e o surto 6,5 horas. Nao houve horario preferencial para o aparecimento dos surtos e o periodo noturno foi o mais citado para piorar o quadro ja estabelecido. Nao houve fatores associados na maioria dos casos e o estresse foi o fator agravante mais citado. Na metade dos doentes houve associacao com angioedema e o quadro clinico ocorria diariamente, seguido de reaparecimento a intervalos irregulares. A renite foi o antecedente alergico pessoal mais citado e a bronquite a antecedente alergico familiar. A maioria dos doentes nao apresentavam urticaria na 1ª consulta ambulatorial e em 37% havia outra enfermidade associada. Entre outras doencas associadas, as alteracoes no aparelho genito-urinario, digestivo e respiratorio foram os mais citados, seguidos das doencas endocrinas, nutricionais ou metabolicas, transtornos circulatorios e mentais. Ao c...