B.M. Henz T. Zuberbier. J. Grabbe E. Monroe (Eds.):

Transcription

1 B.M. Henz T. Zuberbier. J. Grabbe E. Monroe (Eds.): URTICARIA

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3 B.M. Henz T. Zuberbier J. Grabbe E. Monroe (Eds.) URTICA A Clinical, Diagnostic and Therapeutic Aspects With 39 Figures and 42 Tables i Springer

4 Prof. Dr. med. BEATE M. HENZ Charite-Virchow Klinikum, Medizinische Fakultiit der Humboldt-Universitiit zu Berlin Dermatologische Universitiitsklinik und Poliklinik Augustenburger Platz 1, D Berlin, Germany Priv.-Doz. Dr. med. TORSTEN ZUBERBIER Charite-Virchow Klinikum, Medizinische Fakultiit der Humboldt-Universitiit zu Berlin Dermatologische Universitiitsklinik und Poliklinik Schumannstr , D-I0117 Berlin, Germany Priv.-Doz. Dr. med. JURGEN GRABBE Medizinische Universitiit zu Lubeck Klinik ffir Dermatologie und Venerologie Ratzeburger Allee 160, D Lubeck, Germany EUGENE MONROE, M. D. Milwaukee Medical Clinic Good Hope Road Center 3003 West Good Hope Road Milwaukee, WI 53217, USA ISBN-I3 : library of Congress Cataloging-in-Publication Data Urtikaria. English. Urticaria 1 B.M. Henz, T. Zuberbier, J. Grabbe (eds.). p. em. ISBN-13 : e-isbn-13 : DOl: / Urticaria. I. Henz, B.M. (Beate M.), II. Zuberbier, T. (Torsten), III. Grabbe, J. Oiirgen), IV. title. RL249.U '1--dc21 This work is subject to copyright. All rights are reserved, whether the whole part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. Springer-Verlag Berlin Heidelberg 1998 Softcover reprint of the hardcover 1st edition 1998 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Cover design: Design & Production, Heidelberg Typesetting: Fotosatz-Service Kohler OHG, Wiirzburg SPIN: / Printed on acid-free paper

5 Authors R.BREHLER* S. CHANTRAINE-HESS B.CREMER I. EHLERS J.GRABBE** N.HAAS B.M.HENZ S.JEEP S. KRUGER-KRASAGAKES A.MoLLER P.MOLLER E.MoNROE*** W. NURNBERG CH. PFROMMER T. ROSENBACH T. ZUBERBIER Address of the authors: Charite-Virchow Clinics, Humboldt University, Department of Dermatology, Augustenburger Platz 1, D Berlin * Department of Dermatology, Westfalische Wilhelms Universitiit, v. Esmarchstr. 56, D Miinster ** Department of Dermatology, Medical University of Luebeck, Ratzeburger Allee 160, D Liibeck *** Milwaukee Medical Clinic, Good Hope Road Center, 3003 West Good Hope Road, Milwaukee, WI 53217

6 Preface Urticaria is one of the most common dermatological and allergological cutaneous reactions and, compared to other diseases, it is easily recognized by patients 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. This may seem surprising since, to the uninitiated, different types of urticaria look alike, and the pathomechanisms are rather well understood, with mast cells being almost invariably the main effector cells. In 1986, a monograph of the first editor (Prof. Czarnetzki, now with the married name Henz) appeared, giving a detailed and thorough review of the then current state of knowledge regarding all aspects of the disease. Since then, two updates of this book have appeared in the German language, with coworkers of the clinic of Prof. Henz helping in the revision of the various chapters of the old monograph, and with particular emphasis on practical aspects of the disease. The present book is mainly a translation of the second German edition, with only minor updates and with more citations from the literature since the 1986 monograph is no longer available for purchase. The editors of the previous editions of this book feel fortunate that an American collegue with particular interest in the field, Dr. Eugene Monroe from Milwaukee, USA, has joined them to help with this new English edition, particularly regarding aspects relevant to colleagues practicing medicine outside of Europe. As with the German editions, the authors have omitted complex theoretical discourses and have instead focused on practical guidelines regarding the diagnosis and therapy of urticaria, giving preference to the citation of reviews for further reading rather than to a detailed listing of older original literature.

7 VIII Preface The editors and authors have designed this book to serve as a useful guideline and reference book to dermatologists, auergologists, pediatricians and practicioners in general medicine alike, and they hope that it will provide support to the reader so that he can manage his urticaria patients more effectively. Berlin, Lubeck and Milwaukee, PROF. DR. MED. B.M. HENZ, M. D. PD DR. MED. T. ZUBERBIER PD DR. MED. J. GRABBE E. MONROE, M.D.

8 Contents 1 The Spectrum of Urticaria B.M.HENZ 1.1 Historical Aspects Definition and Classification 1.3 Pathogenesis Epidemiology Clinical Aspects Cutaneous Manifestations Extracutaneous Symptoms Anaphylaxis Serum Sickness Clinical Aspects of Intolerance Reactions 2 Causes of Urticaria B.M. HENZ and T. ZUBERBIER 2.1 General Aspects Allergic Urticaria Pathomechanisms Routes of Elicitation Drugs Inhalent Allergens Food 2.3 Pseudo allergies Definitions Classification and Frequency Epidemiology Infections and Infestations Internal Diseases Hormones and Hormonal Dysfunctions 2.7 Neurologic and Psychological Factors 2.8 Stinging Insects and Plants

9 x 3 Acute and Chronic Urticaria T. ZUBERBIER and B. M. HENZ 3.1 Definition General Aspects 3.3 Epidemiology Acute Urticaria Clinical and Diagnostic Aspects Therapy Chronic Urticaria Clinical Aspects and Diagnosis Therapy Angioedema P. MOLLER and B.M. HENZ 4.1 Definition Epidemiology Clinical Manifestations Cutaneous Symptoms Extracutaneous Symptoms Course and Prognosis 4.5 Diagnosis Differential Diagnosis 4.7 Therapy Physical Urticaria... B.M.HENZ 5.1 General Aspects Defmition and Classification Epidemiology Clinical Manifestations Diagnosis Therapy Dermographic Urticaria S. JEEP and B. M. HENZ Definition Epidemiology Clinical Aspects Diagnosis and Differential Diagnosis Associated Symptoms and/or Diseases Therapy Contents

10 Contents 5.3 Delayed Pressure Urticaria S. KRUGER-KRASAGAKES and B.M. HENZ Definition Epidemiology Clinical Manifestations Associated Diseases Diagnosis Differential Diagnosis Therapy Cold Urticaria A. MOLLER and B. M. HENZ Definition and Classification Epidemiology Clinical Manifestations Associated Diseases Diagnosis Differential Diagnosis Therapy Heat Contact Urticaria.... B. CREMER and B. M. HENZ Definition and Causes General Aspects Clinical Manifestations Associated Diseases Diagnosis Differential Diagnosis Prognosis Therapy Solar Urticaria T. ROSENBACH and B.M. HENZ General Aspects Clinical Manifestations Diagnosis Differential Diagnosis Therapy XI Cholinergic Urticaria T. ZUBERBIER 6.1 Definition Epidemiology Clinical Manifestations

11 XII Contents 6.4 Associated Diseases Diagnosis Differential Diagnosis 6.7 Related Diseases Therapy Contact Urticaria J.GRABBE Definition Epidemiology Clinical Manifestations Different Types of Contact Urticaria Allergic Contact Urticaria Non-Allergic Contact Urticaria Substances with Unknown Mechanisms of Action Diagnosis Differential Diagnosis Associated Diseases Therapy LatexAllergy R.BREHLER Preparation and Use of Latex Epidemiology Clinical Manifestations Predisposing Factors Characterization of Latex Allergens Diagnostic Procedures Cross Reactions Therapy Aquagenic Urticaria 111 J.GRABBE 8 Urticarial Vasculitis Syndrome W.NURNBERG 8.1 Introduction Epidemiology Clinical Manifestation 8.4 Diagnosis Associated Diseases 8.6 Differential Diagnosis 8.7 Therapy

12 Contents XIII 9 Mastocytosis (Urticaria Pigmentosa) N. HAAS and B. M. HENZ 9.1 Definition Epidemiology Clinical Manifestations Cutaneous Mastocytosis Systemic Mastocytosis 904 Symptomatology Histology Laboratory Findings 9.7 Diagnosis 9.8 Prognosis 9.9 Therapy Diagnosis of Urticaria... T. ZUBERBIER and B.M. HENZ Practical Approach Tests for Allergy General Aspects Skin Tests for Type-I Allergies Provocation Tests for Type-I Allergies Laboratory Tests for Type-I Allergies 10.3 Diagnosis of Intolerance Reactions loa Other Laboratory Tests 10.5 Differential Diagnosis 11 Urticaria Therapy B. M. HENZ, T. ZUBERBIER and E. MONROE Basic Therapeutic Considerations.... Treatment of Causes Removing or Avoidance of the Cause Dietary Management of Chronic Urticaria Due to Pseudoallergens Practical Guidelines for the Dietary Avoidance of Pseudo allergens I. EHLERS and T. ZUBERBIER Specific Immunotherapy.... B.M. HENZ, T. ZUBERBIER and E. MONROE Mast Cell-Directed Therapy Therapy at the Target Organ

13 XIV HA.l Antihistamines Further Therapeutic Possibilities 11.5 Prophylactic Therapy 11.6 Emergency Treatment Appendix.... A Urticaria Questionnaire B Urticaria Diary... C Test Protocol: Physical Urticaria D 1 Low Pseudo allergen Diet D 2 Expansion of the Low Pseudoallergen Diet After Freedom of Symptoms Has Been Obtained.... E Low Pseudo allergen Diet - Suggestions for Recipes.... I. EHLERS Contents Subject Index