Department of Dermatology Medical Research Institute, Tokyo Women's Medical University, Tokyo, Japan.
J Dermatol. 2011 Aug;38(8):761-6. doi: 10.1111/j.1346-8138.2010.01106.x. Epub 2010 Nov 22.
Eighty two patients with chronic urticaria and 17 patients with prurigo chronica multiformis were referred to our department from October 2004 to February 2007 and were tested for Helicobacter pylori antigen using the polyclonal H. pylori stool antigen test (enzyme-linked immunosorbent assay method). H. pylori antigen was detected in 25 (30.5%) of the 82 patients with chronic urticaria and in 10 (58.8%) of the 17 patients with prurigo chronica multiformis. Those findings were not significantly higher than the positive rate for H. pylori stool antigen in healthy age-matched controls. In patients positive for H. pylori antigen, seven of the 25 with chronic urticaria had complications of gastritis (six patients) or gastric ulcers (one patient). Three of the 10 patients with prurigo chronica multiformis had complications of gastritis (two patients) or gastric ulcers (one patient). We examined the therapeutic efficacy of antibacterial treatment for the 17 patients with chronic urticaria and the eight patients with prurigo chronica multiformis who were positive for H. pylori antigen and accepted the treatment based on informed consent. We evaluated the effectiveness of treatment by scoring the skin conditions and by using the Skindex-16, a measure of quality of life. The eradication therapy for H. pylori was more effective for treating prurigo chronica multiformis and the skin symptoms started to improve within 3-14 days after the therapy. However, that therapy was not always effective for treating chronic urticaria. We suggest that H. pylori may be an important pathogenetic factor, especially for prurigo chronica multiformis, and that eradication therapy should be considered to treat intractable cases.
从 2004 年 10 月至 2007 年 2 月，82 例慢性荨麻疹患者和 17 例多形性慢性痒疹患者被转诊到我科，采用多克隆幽门螺杆菌粪便抗原检测（酶联免疫吸附法）检测幽门螺杆菌抗原。在 82 例慢性荨麻疹患者中，25 例（30.5%）和 17 例多形性慢性痒疹患者中 10 例（58.8%）检测到幽门螺杆菌抗原。这些发现与健康年龄匹配对照者的幽门螺杆菌粪便抗原阳性率没有显著差异。在幽门螺杆菌抗原阳性的患者中，25 例慢性荨麻疹中有 7 例（6 例胃炎，1 例胃溃疡）伴有并发症。10 例多形性慢性痒疹中有 3 例（2 例胃炎，1 例胃溃疡）伴有并发症。我们检查了 17 例慢性荨麻疹和 8 例幽门螺杆菌抗原阳性且根据知情同意接受治疗的多形性慢性痒疹患者的抗菌治疗疗效。我们通过评分皮肤状况和使用 Skindex-16（衡量生活质量的指标）来评估治疗效果。幽门螺杆菌的根除疗法对多形性慢性痒疹的治疗更有效，皮肤症状在治疗后 3-14 天内开始改善。然而，该疗法并不总是对慢性荨麻疹有效。我们认为，幽门螺杆菌可能是一个重要的致病因素，特别是对多形性慢性痒疹，应考虑根除治疗来治疗难治性病例。
