Cholinergic urticaria patients of different age groups have distinct features

Abstract

Background

Cholinergic Urticaria (CholU) is a common skin disease characterized by the development of pinpoint sized wheals 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 if 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 CholU patients, 12 to 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%). EO and LO CholU patients markedly differ in key characteristics: EO patients, 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= 0.028) and higher IgE-Levels (295.5 vs. 267.1 IU/ml; p= 0.020) as compared to LO patients, who were mainly female (69%), had a shorter duration of disease (33.3 vs. 63.7 months; p= 0.005), a higher rate of concomitant other forms of urticaria (48.3 vs. 33.1%; p=0.044), and a higher rate of psychiatric comorbidities (12.1 vs 1.4%; p= 0.001)..

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 CholU patients.

This article is protected by copyright. All rights reserved.

http://ift.tt/2j0HpGG