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ID 30807
file
creator
Shindo, Hajime
Mihara, Shoji
Kameyoshi, Yoshikazu
subject
Delayed pressure urticaria
Chronic urticaria
Pressure challenge test
Eosinophil
Steroid
NDC
Medical sciences
abstract
Delayed pressure urticaria (DPU) is characterized by deep dermal wheals that appear in response to a local continuous pressure. Although it has been reported to complicate as many as 40% of cases of Caucasian patients with chronic urticaria, no definitive cases of Asian/Japanese patients have been reported in English literature. Here, we identified 17 cases of DPU, among 540 Japanese patients with urticaria (3.1%), based on careful history taking, pressure challenge test and, ideally, skin biopsy. Twelve out of 17 patients (70.5%) who undertook pressure challenge test developed wheal and erythema in the area of pressure 1-12 h later. Six out of 15 patients (40%) were positive for the autologous serum skin test. All cases were complicated with ordinary chronic urticaria, and all specimens of skin biopsies performed for 12 patients showed substantial eosinophil infiltration. All cases were resistant to antihistamines with or without other non-steroidal medications and eventually treated with 0.25-1.5 mg/day of betamethasone. However, 12 of them (70.6%) were able to cease steroid use because of cure or remission. For those cured or in remission, the duration of steroid administration and that from the onset to diagnosis was 11.2 +/- A 11.0 and 54.8 +/- A 60.2 months (mean +/- A SD), respectively. DPU may be identified as a relatively rare complication of Japanese patients with chronic idiopathic urticaria. A proper diagnosis and a small amount of steroid may be beneficial for the treatment of DPU.
journal title
Archives of Dermatological Research
volume
Volume 302
issue
Issue 8
start page
613
end page
617
date of issued
2010-10
publisher
Springer
issn
1432-069X
ncid
publisher doi
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
author
rights
Copyright (c) 2010 Springer
relation
The original publication is available at www.springerlink.com
relation url
department
Graduate School of Biomedical Science