Titlebook: Urticaria; Clinical, Diagnostic Beate M. Henz,Torsten Zuberbier,Eugene Monroe Book 1998 Springer-Verlag Berlin Heidelberg 1998 Internal med

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Book 1998patients and physicians alike. Nevertheless, the disease is highly complex regarding its eliciting causes, its clinical manifestations and its therapy. Thus, a famous New York dermatologist once mentioned that he would rather have a lion than a patient with chronic urticaria walk into his office. Th

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The Spectrum of Urticaria,etween the disease and the uptake of food proteins. The modern understanding of the disease was markedly enhanced with the discovery of the mast cell by Paul Ehrlich (1879), of histamine by Dale and Wardlaw (1910) and of IgE by Ishizaka (1966) (Czarnetzki 1989a).

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Acute and Chronic Urticaria,due to mast cell proliferation (mastocytosis). Cholinergic urticaria and urticarial vasculitis are generally not grouped with chronic urticaria because of their distinct pathogenesis and clinical aspect (see Chapters 6 and 8).

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Urticarial Vasculitis Syndrome,as systemic lupus erythematosus, hepatitis B and neoplasias. A differentiation of urticarial vasculitis from ordinary urticaria is thus of great importance, particularly regarding treatment and prognosis. On the basis of laboratory changes, the syndrome is further classified into hypocomplementemic and normocomplementemic vasculitis.

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Angioedema, or the submucosal tissue which persists for up to 72 hours. It can occur alone or in association with urticaria and involve individual or several regions of the body, preferentially in a unilateral distribution. Involvement of the upper airways can lead to life threatening situations.

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Mastocytosis (Urticaria Pigmentosa),itation. Unna (1887) first noted a local proliferation of mast cells in the dermis underlying these brown spots. Until the 1930ties, the disease was named urticaria pigmentosa. With the discovery that other organs may be involved as well, Sézary changed the name to mastocytosis.

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Diagnosis of Urticaria, accordingly frustrating. The general principles of diagnosis, as outlined here, are to provide simple guidelines for a straight forward and logical diagnostic approach. For the diagnosis of specific types of urticaria, the reader is referred to the respective chapters of this book where these are discussed more extensively and in greater detail.

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Cholinergic Urticaria,The lesions of cholinergic urticaria present with typical pin-size wheals on an erythematous base, and they appear after a brief rise of the body’s core temperature (Jorizzo 1987; Casale et al. 1986; Hirschmann et al. 1987).