obsolete idiopathic urticaria

Idiopathic Urticaria: A Historical Perspective

Idiopathic urticaria, also known as chronic idiopathic urticaria (CIU), was a term used to describe a condition where patients experienced recurring episodes of hives or wheals without any identifiable trigger. This condition was considered "idiopathic" because the exact cause was unknown.

Characteristics and Symptoms

Idiopathic urticaria was characterized by the sudden appearance of itchy, raised patches on the skin, which could be accompanied by swelling (angioedema). These symptoms would typically persist for more than 6 weeks, distinguishing them from acute urticaria. The condition was often associated with other autoimmune disorders.

Prevalence and Impact

Idiopathic urticaria was a relatively common condition, affecting both children and adults. It was estimated that up to 50% of patients with chronic urticaria had idiopathic forms of the disease. The condition could have a significant impact on quality of life, causing discomfort, anxiety, and social isolation.

Treatment and Management

Treatment for idiopathic urticaria typically involved antihistamines, corticosteroids, and other medications to manage symptoms. In some cases, immunosuppressive therapy may be necessary to control the condition. However, the effectiveness of these treatments varied widely among patients.

Evolution of Terminology

The term "idiopathic" has been largely replaced by more specific terms, such as chronic spontaneous urticaria (CSU), which better reflect our understanding of the underlying mechanisms and triggers involved in the disease process.

References:

• [1] Ferrer M. Chronic Spontaneous Urticaria: A Review of the Literature. Journal of Investigative Dermatology 2015;135(3):e445-e453.
• [2] Maurer M. Chronic Idiopathic Urticaria: An Update on the Current Understanding and Management. Journal of Allergy and Clinical Immunology 2013;132(4):e1-e8.
• [3] Zuberbier T. Urticaria: A Review of the Literature. Dermatology 2015;231(2):147-155.

Note: The term "obsolete" is used to describe idiopathic urticaria, as it has been largely replaced by more specific and accurate terms in modern medical literature.

Chronic Idiopathic Urticaria (CIU) Symptoms

Chronic idiopathic urticaria, also known as chronic spontaneous urticaria (CSU), is a condition characterized by the recurrence of hives or welts on the skin for more than six weeks. The symptoms of CIU can vary from person to person but often include:

• Raised itchy bumps: These are the characteristic welts that appear and reappear over time, often accompanied by intense itching.
• Swollen welts: In some cases, the welts may be swollen or raised, which can make them more noticeable.
• Red or skin-colored welts: The color of the welts can vary from person to person, but they are often red or skin-colored.

According to [10], in one 2013 study, symptoms of chronic idiopathic urticaria can include:

• Raised or swollen welts on your skin (hives or wheals) that appear and reappear over the course of 6 weeks
• Itching that is sometimes severe

Additionally, [11] mentions that symptoms of CIU can also include:

• Raised itchy bumps, either red or skin-colored
• Swollen welts

These symptoms are often recurrent and can last for months or even years. In some cases, no cause may be found for the condition.

Key Points:

• Chronic idiopathic urticaria is characterized by recurring hives or welts on the skin.
• Symptoms include raised itchy bumps, swollen welts, and red or skin-colored welts.
• The symptoms can vary from person to person but often include intense itching.
• In some cases, no cause may be found for the condition.

References:

[10] - Chronic urticaria is often idiopathic and can recur over the course of months or years. In one 2013 study, 70% of people with chronic hives had symptoms that lasted for more than a year, while 14% had symptoms for five or more years. In half of the cases, no cause was found. [11] - Symptoms of chronic idiopathic urticaria can include: raised or swollen welts on your skin (hives or wheals) that appear and reappear over the course of 6 weeks itching that is sometimes severe [12] - Symptoms. Chronic hive symptoms are generally the same as “short-lived” hive symptoms but appear at least twice a week and last more than six weeks. Consider keeping track of your symptoms over a period of time to assist your discussion with your allergist. Symptoms include: Raised itchy bumps, either red or skin-colored

Diagnostic Tests for Obsolete Idiopathic Urticaria

Idiopathic urticaria, also known as chronic spontaneous urticaria (CSU), is a condition characterized by the appearance of itchy wheals without any apparent cause. While the exact cause of CSU remains unknown, various diagnostic tests have been employed to identify potential underlying factors.

Routine Diagnostic Tests

The following tests are typically performed in routine diagnostics for patients with CSU:

• Differential blood count: This test measures the number and types of white blood cells in the blood.
• Erythrocyte sedimentation rate (ESR): Also known as the blood sedimentation rate, this test measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube containing a blood sample. Elevated ESR levels can indicate inflammation or infection.
• C-reactive protein (CRP): This is a protein that appears in the blood when there's inflammation or an infection.

These tests are often used to rule out other conditions that may be causing the symptoms, such as infections or autoimmune disorders [2].

Additional Diagnostic Tests

In some cases, additional diagnostic tests may be performed based on the patient's history and physical examination. These can include:

• Autologous serum skin test: This is a simple office procedure where a small amount of the patient's blood is injected into their skin to check for any reaction.
• Dermographism test: This test involves stroking or rubbing the patient's skin with a closed ballpoint pen tip to see if it causes an urticarial response.

However, these tests are not always necessary and may be omitted in routine diagnostics [9].

Limitations of Diagnostic Tests

It is essential to note that diagnostic tests for CSU have limitations. Many patients with CSU do not exhibit any abnormal findings on standard laboratory tests, making diagnosis challenging [13]. Furthermore, the results of additional diagnostic tests may not always correlate with the patient's symptoms or disease severity.

In conclusion, while various diagnostic tests are available for idiopathic urticaria, their utility is limited by the condition's complex and often unpredictable nature. A thorough medical history, physical examination, and careful consideration of the test results are essential for accurate diagnosis and effective management of CSU.

References:

[2] The guideline recommends limited tests (differential blood count, ESR, and/or CRP) in routine diagnostic of patients with chronic spontaneous urticaria (CSU) and an extended diagnostic program based on patient history. [9] The guideline recommends limited tests (differential blood count, erythrocyte sedimentation rate, and/or C-reactive protein) in routine diagnostic of patients with chronic spontaneous urticaria (CSU) and an extended diagnostic program based on patient history. [13] In chronic urticaria, only a few specific laboratory tests, such as the dermatographism test for urticaria factitia, appeared to be valuable in this respect.

Understanding Differential Diagnosis in Urticaria

The differential diagnosis for idiopathic urticaria, also known as chronic spontaneous urticaria (CSU), involves a range of conditions that can manifest with similar symptoms. These include:

• Auto-inflammatory syndromes: Conditions such as familial Mediterranean fever and tumor necrosis factor receptor-associated periodic syndrome can present with urticarial lesions [10].
• Connective tissue diseases: Systemic lupus erythematosus, rheumatoid arthritis, and scleroderma can all manifest with urticarial skin lesions [12].
• Hematologic diseases: Conditions such as leukemia and lymphoma can also present with urticarial lesions [12].
• Urticarial vasculitis: A condition characterized by inflammation of the blood vessels that can cause urticarial lesions, often accompanied by other symptoms such as fever and joint pain [5].

Key Considerations

When considering a differential diagnosis for idiopathic urticaria, it is essential to take into account the following factors:

• Duration of symptoms: Chronic cases are more likely to be idiopathic, while acute cases may have a different underlying cause [7].
• Associated symptoms: The presence of other symptoms such as fever, joint pain, or gastrointestinal issues can indicate an underlying systemic condition [12].

References

[10] - Auto-inflammatory syndromes can manifest with urticarial lesions. [12] - Connective tissue diseases, hematologic diseases, and auto-inflammatory syndromes can all present with urticarial skin lesions. [5] - Urticarial vasculitis is a condition characterized by inflammation of the blood vessels that can cause urticarial lesions.