Eseverri J L, Cozzo M, Castillo M f, Marín A
Unitat d'Al lergologia i Immunologia Clínica Pediàtrica, Hospital Universitari Materno-Infantil "Vall d'Hebron", Barcelona, España.
Allergol Immunopathol (Madr). 1999 Mar-Apr;27(2):104-11.
Urticaria is characterized by the appearance of hives and pruritus. Those hives are formed by oedema and vasodilatation and they disappear when they are pressed on. The acute presentation is extremely common and affects between 10 and 20% of the population at a determined moment. In its simplest form, urticaria is envisioned to represent the same sort of wheal-and-flare reaction observed when histamine is injected into the skin. It produces erythema because of capillary vasodilatation, oedema because of increased permeability in capillary and pruritus secondary at local specific receptors stimulation. Angioedema is caused by the same pathologic alterations that occur in the deep dermis and subcutaneous tissue. Thus, an area involved with angioedema has swelling as the prominent manifestation and appearance of the skin itself may be normal. Due to reduced nerve supply in dermis, angioedema is associated with oppression and not pruritus. Immunoallergological study of urticaria and/or angioedema was requested in 133 cases from 648 from the first patient's visits to the surgery. It supposes a 20.52%. The family suspicion of etiology was food in 62 cases, chemical products in 39 cases, other factors (physical, stings, balloons and other manufactured products.) in 7 cases and 25 cases without a direct relation. Out of 100 children diagnosed of allergic urticaria-angioedema 67 was by food; the foods implicated in frequency order were: eggs and nuts, fruit, milk, vegetables, fish and shellfish. In second place, chemical products were responsible of urticaria in 12 children; five of them were positive in diagnosed proof (prick, oral challenge) for penicillin and amoxicillin, both from beta-lactamic group; two of them had and adverse reaction to anesthetic agents; other two cases were after administration of vaccination and due to tetanus toxin; and three cases were due to aspirin, confirmed by oral provocation test. In 10 children the etiological agent was latex. Other etiologies were: three cutaneous reactions after stings (two by wasps and one by mosquito) three reactions due to spices (paprika, cumin, anise, mustard) and two reactions caused by manufactures products containing additives as yellow-orange.
荨麻疹的特征是出现风疹块和瘙痒。这些风疹块是由水肿和血管扩张形成的，受压时会消失。急性荨麻疹极为常见，在某一特定时刻影响10%至20%的人群。在其最简单的形式中，荨麻疹被认为与将组胺注射到皮肤中时观察到的那种风团和潮红反应相同。它因毛细血管扩张而产生红斑，因毛细血管通透性增加而产生水肿，并因局部特定受体受刺激而继发瘙痒。血管性水肿是由真皮深层和皮下组织中发生的相同病理改变引起的。因此，血管性水肿累及的区域以肿胀为突出表现，皮肤本身外观可能正常。由于真皮中神经供应减少，血管性水肿伴有压迫感而非瘙痒。在648例患者首次就诊于外科时，有133例患者被要求进行荨麻疹和/或血管性水肿的免疫过敏学研究。这占20.52%。家族性病因怀疑中，62例为食物，39例为化学制品，7例为其他因素（物理因素、叮咬、气球及其他制成品），25例无直接关联。在100例被诊断为过敏性荨麻疹 - 血管性水肿的儿童中，67例病因是食物；按出现频率排序，涉及的食物有：鸡蛋和坚果、水果、牛奶、蔬菜、鱼和贝类。其次，化学制品导致12例儿童患荨麻疹；其中5例对青霉素和阿莫西林（均来自β - 内酰胺类）的诊断性试验（点刺、口服激发试验）呈阳性；2例对麻醉剂有不良反应；另外2例在接种疫苗后因破伤风毒素发病；3例因阿司匹林发病，经口服激发试验证实。10例儿童的病因是乳胶。其他病因包括：3例叮咬后的皮肤反应（2例黄蜂叮咬和1例蚊子叮咬），3例因香料（辣椒粉、孜然、茴芹、芥末）引起的反应，以及2例由含黄色素添加剂的制成品引起的反应。
