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Cholinergic urticaria patients of different age groups have distinct features
Author(s) -
Asady A.,
Ruft J.,
Ellrich A.,
Hawro T.,
Maurer M.,
Altrichter S.
Publication year - 2017
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.13023
Subject(s) - medicine , concomitant , disease , atopic dermatitis , epidemiology , age of onset , comorbidity , immunology
Summary Background Cholinergic urticaria (CholU) is a common skin disease characterized by the development of pinpoint‐sized weals and severe itch upon physical exercise. Little is known about the epidemiology of CholU. CholU can occur at any age and has the highest prevalence among young adults. As of now, it is unclear whether patients of different age show differences in the clinical manifestation of CholU, duration of disease, comorbidities or response to treatment. Methods Here, we analysed the demographic data and clinical characteristics including disease duration and comorbidities of 200 patients with CholU, 12‐76 years of age. Results We identified two distinct types of CholU, one with early onset ( EO , 71%) and one with late onset ( LO , 29%). Patients with EO and LO CholU markedly differ in key characteristics: patients with EO , who had a disease onset before the age of 36, showed no gender preponderance and had a significantly higher rate of concomitant atopic dermatitis (16.9% vs 5.2%; P = .028) and higher IgE levels (295.5 vs 267.1 IU /mL; P = .020) as compared to patients with LO , who were mainly female (69%), had a shorter duration of disease (33.3 vs 63.7 months; P = .005), a higher rate of concomitant other forms of urticaria (48.3% vs 33.1%; P = .044) and a higher rate of psychiatric comorbidities (12.1% vs 1.4%; P = .001). Conclusion There are two subtypes of CholU patients with different gender ratios, disease duration and comorbidities. These findings suggest that two distinct underlying pathogenetic pathways are relevant in these two subgroups of patients with CholU.