Ann Dermatol.  2017 Apr;29(2):143-148. 10.5021/ad.2017.29.2.143.

Urticarial Dermatitis: Clinical Characteristics of Itch and Therapeutic Response to Cyclosporine

• Kim JM
• Lim KM
• Kim HS
• Ko HC
• Kim MB
• Kim BS

• KMID: 2394836
• DOI: http://doi.org/10.5021/ad.2017.29.2.143

Abstract

BACKGROUND
Urticarial dermatitis, which is characterised by persistent wheals with eczematous papules and plaques, is frequently misdiagnosed and difficult to treat. Patients commonly experience intolerable pruritus which may greatly affect their quality of life.
OBJECTIVE
The objective of this study is to characterize the clinical patterns of pruritus in patients with urticarial dermatitis and to determine the effectiveness of cyclosporine treatment.
METHODS
This prospective study included 50 histopathologically confirmed patients with urticarial dermatitis. A face-to-face structured questionnaire was given to all patients, and they were treated with low-dose cyclosporine (1~3 mg/kg/d) for at least 2 weeks.
RESULTS
The majority of patients (80.0%) had moderate to severe pruritus. Most patients experienced exacerbation of the itch in the evening (74.0%), with the extremities (upper, 86.0%; lower, 94.0%) being the most commonly involved sites. Due to severe pruritus, patients complained about reduced social contact, quality of life and difficulties in falling asleep et al. Cyclosporine significantly reduced the mean itch score and extent of erythema, and improved interference with daily activities and sleep.
CONCLUSION
Our study highlights the detailed description and characteristics of pruritus in patients with urticarial dermatitis. And we recommend alternative and effective therapeutic option of low-dose cyclosporine.

Keyword

Cyclosporine; Pruritus; Urticarial dermatitis

MeSH Terms

Accidental Falls
Cyclosporine*
Dermatitis*
Erythema
Extremities
Humans
Prospective Studies
Pruritus
Quality of Life
Cyclosporine

Figure

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  Fig. 1 Histological examination of a skin biopsy specimen from patient 3 showed minimal epidermal spongiosis and superficial perivascular infiltration of lymphocytes and eosinophils in upper dermis (H&E; A: ×100, B: ×400).

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  Fig. 2 (A) Representative image of erythematous wheals and papules on the back were observed at the first visit. (B) After treatment with low-dose cyclosporine for 2 weeks, only mild post-inflammatory hyper pigmentation left remained, with resolution of pruritus is observed.

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