A Clinical Epidemiological Survey On Chronic Urticaria

[Objective] The survey about chronic urticaria was conducted from May2010to February2013in our hospital in order to analyze the clinical epidemiological feature of chronic urticaria.[Methods] The questionnaire from Chinese medical doctor association, department of dermatology, branch designed the urticaria survey of national CAUSE project.450subjects were diagnosed chronic urticaria by dermatologists and required to fulfill the designed questionnaires. The basic information of the subjects included the demographic characteristics,the age of onset, the course of disease, eliciting/aggravating factors, classifications, pruritus degree, frequency, combination of angioedema, UAS, family history of allergic diseases, personal history of deseases, previous therapies. EXCEL and SPSS17.0were utilized for statistical analysis, including nonparametric statistics, descriptive statistics, chi-square test, rank sum test, and so on.[Results] Among the450subjects, the ratio of sex male to female was1:1.85.The average age of subjects with chronic urticaria at first episode was(32.3±14.1years), ranging from0.5to74years. It peaked in patients aging from21to40years.The course of disease from2months to59years, in7.8%of patients the urticaria lasted for more than10years. The self-reported eliciting factors of urticaria were as follows:unknown factors215(47.8%), physical stimuli114(25.3%), food factors54(12.0%), drug factors28(6.2%), mental factors22(4.9%), inhaled allergens18(4.0%), strenuous exercise10(2.2%), gastrointestinal discomfort9(2.0%).42.9%patients had different degrees of sleep disorders,and10.0%patients’ mental status was affected.About1/3first-grade relatives of patients accompanied with allergic disease.. Urticaria in87cases (19.3%),allergic rhinitis in54cases(12%), asthma in19cases (4.2%), atopic dermatitis in6cases (1.3%), contact dermatitis in4cases (0.9%), allergic conjunctivitis in1cases (0.2%). Chronic infectious disease is a common concomitant disease of chronic urticaria, gastritis or ulcer (26.9%)which mostly associated with Hp infection found to be the first accompanying disease and the tonsillitis/pharyngitis(17.1%) was the second, thyroid disease(5.8%)was the third.Among various clinical types, chronic spontaneous urticaria was the most common type, which accounted for294(65.3%), followed by physical urticaria104(23.1%),while among it, dermatographism is the most common type.47patients(10.4%) had dermatographism associated with chronic spontaneous urticaria. About1/3patients not only had wheal,but also angioedema. Furthermore,patients with angioedema who felt itching much more than patients without vangioedema, and patients with angioedema urticarial severity also aggravated trend,lasting time of wheal was longer. The onset of chronic urticaria circadian rhythm changes,51.3%patients attacked or exacerbated at night, while the majority of chronic urticaria patients did not have obvious seasonal exacerbation.In411patients whom used antihistamines, only a small part of patients were ineffective, still existed sleep disorders. However,more than90%of patients gained significantly remission (no pruritus account for72.3%; mild pruritus accounted for21.4%).About1/5patients received corticosteroids when they are first visited hospital,and of which5patients only used it, did not add any H1antihistamines.169patients had been detected thyroid autoantibodies and function,115subjects showed normal,57subjects showed abnormal. The positive rate of TGAb, TMAb is21.3%, respectively. Furthermore, the group of patients with thyroid autoantibodies or dysfunction compared with normal group, the abnormal group has gained higher UAS scores.[Conclusion]1. Chronic urticaria can be found in any ages. It oftten occurs among females.The prevalence of chronic urticaria peaked in patients aging from21to40years. in17.6%of patients the urticaria lasted for more than10years, up to a maximum of59years.2.Gastritis or ulcer which mostly found to be the accompanying disease and the tonsillitis/pharyngitis, The results indicate that Hp and streptococcus infections may be associated with the pathogenesis of chronic urticaria, We will further study. chronic urticaria is closely related with autoimmune thyroid disease, the group which has thyroid autoantibodies or dysfunction compared with normal group, the abnormal group has gained higher UAS scores.3. Among various clinical types, chronic spontaneous urticaria was the most common type. Dermatographism were the most common in physical urticaria which can occur dependently or with chronic spontaneous urticaria.The ratio of angioedema in chronic urticaria accounted for1/3. Furthermore,patients with angioedema who felt itching much more than patients without vangioedema, and patients with angioedema urticarial severity also aggravated trend,lasting time of wheal was longer.