Diagnosis and incidence of delayed pressure urticaria in patients with chronic urticaria.

Abstract:

BACKGROUND:The incidence of delayed pressure urticaria (DPU) may have been underestimated, particularly in patients with widespread wheals of concurrent idiopathic urticaria, because of difficulty in recognizing the association between pressure-related swellings and the preceding physical stimulus. Diagnostic tests for DPU have not been done routinely in studies of urticaria and have not been compared. OBJECTIVE:Our purpose was to establish the incidence of DPU and other physical urticarias in patients with chronic urticaria and to compare two reproducible pressure challenge tests. METHODS:One hundred thirty-five patients were tested for immediate dermographism, for DPU and, when indicated by the history, for cholinergic and/or cold urticaria. In patients with pressure-related symptoms, pressure challenge testing with a dermographometer (100 gm/mm2) was compared with a test that involves the application of 1.5 cm diameter weighted rods and more closely resembles a naturally occurring pressure stimulus. RESULTS:Physical urticarias were present in 96 patients (71%). Thirty patients (22%) had immediate dermographism, 50 (37%) had DPU, 15 (11%) had cholinergic urticaria, and 3 (2%) had cold urticaria. A 70-second pressure challenge with the dermographometer gave results comparable to the use of the weighted rods. CONCLUSION:DPU appears to be more common in chronic urticaria than previously reported and is present in some patients who do not report pressure-related wheals.

journal_name

J Am Acad Dermatol

authors

Barlow RJ,Warburton F,Watson K,Black AK,Greaves MW

doi

10.1016/0190-9622(93)70273-v

subject

Has Abstract

pub_date

1993-12-01 00:00:00

pages

954-8

issue

6

eissn

0190-9622

issn

1097-6787

pii

0190-9622(93)70273-V

journal_volume

29

pub_type

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