背景:胆碱能性荨麻疹(CholU)患者的皮肤反应模式各不相同,但是他们的定义,患病率,和临床意义仍然不明确。
方法:患有CholU的患者接受了脉冲控制的测功激发测试,以分析皮肤反应模式及其与位置的相关性,发病,严重程度,出汗行为,临床特征,疾病控制,和生活质量(QoL)受损。
结果:根据大小,颜色,间距,和风团的形状以及它们周围的皮肤反应,我们确定了六种不同类型的CholU皮肤反应,患病率不同,从83%(I型)到11%(VI型)的患者受影响。几乎所有患者(94%)都有≥1型皮肤反应模式。在大多数CholU患者中,出汗减少,在具有VI型皮肤体征的患者中,出汗减少最明显(非常小,圆形,红色,周围有贫血晕的宽间隔的风团),只出现在四肢。V型皮肤体征(大,不规则,贫血,具有中等大小红斑的大间距风团)与最严重的临床表现和最差的QoL相关。
结论:我们的分析表明,大多数患者有不止一种类型的皮肤反应模式,并且不同的皮肤体征与不同的特征有关。未来的研究应确定治疗反应与CholU中皮肤体征类型之间的任何联系。
BACKGROUND: Skin reaction patterns vary across patients with cholinergic urticaria (CholU), but their definition, prevalence, and clinical significance remain ill characterized.
METHODS: Patients with CholU underwent pulse-controlled ergometry provocation testing to analyze skin reaction patterns and their correlation with location, onset, severity, sweating behaviour, clinical features, disease control, and quality of life (QoL) impairment.
RESULTS: Based on the size, color, spacing, and shape of wheals as well as their surrounding skin responses, we identified six distinct types of CholU skin reactions, which differed in prevalence, from 83% (Type I) to 11% (Type VI) of patients affected. Almost all patients (94%) had ≥1 type of skin reaction pattern. Sweating was reduced in the majority of CholU patients and most prominently reduced in patients with Type VI skin signs (very small, round, red, widely spaced wheals with surrounding anemic halo), which emerged exclusively on the extremities. Type V skin signs (large, irregular, anemic, widely spaced wheals with moderate size erythema) were associated with the most severe clinical presentation and poorest QoL.
CONCLUSIONS: Our analysis showed that most patients have more than one type of skin reaction patterns and that different skin signs are linked to distinct features. Future studies should determine any links between treatment response and types of skin signs in CholU.