Article

Neutrophilic urticaria: clinical features, histological changes and possible mechanisms.

Department of Dermatology, Virchow Klinikum, Humboldt Universität, Berlin, Germany.
British Journal of Dermatology (impact factor: 3.67). 03/1998; 138(2):248-53.
Source: PubMed

ABSTRACT Neutrophilic urticaria (NU) is a histologically defined entity, but its clinical and pathogenetic aspects are poorly understood. We investigated 22 NU patients whom we identified by examining 118 biopsies of weals. The patients comprised 11 of 20 with acute urticaria, nine of 49 with chronic urticaria, one of 10 with cold urticaria and one of 10 controls undergoing prick tests. Clinically, NU patients had a shorter mean duration of disease than other urticaria patients and significantly increased erythrocyte sedimentation rate and leucocytosis. Histologically, not only neutrophil counts, but to a lesser extent also eosinophil counts and mononuclear cell infiltrates were significantly increased in lesional skin of NU, and there was more marked vasodilatation and endothelial swelling. On immunohistochemistry, increased tumour necrosis factor alpha and interleukin (IL)-3 expression was noted, compared with other urticarias, whereas IL-8 expression was only minor. These data characterize NU as an acute phase urticarial reaction associated with an intense inflammatory infiltrate and marked upregulation of some mast cell-derived cytokines.

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Keywords

10 controls undergoing prick tests
 
22 NU patients
 
acute phase urticarial reaction
 
acute urticaria
 
chronic urticaria
 
cold urticaria
 
erythrocyte sedimentation rate
 
IL)-3 expression
 
immunohistochemistry
 
intense inflammatory
 
lesional skin
 
lesser extent
 
leucocytosis
 
mast cell-derived cytokines
 
mononuclear cell infiltrates
 
neutrophil counts
 
Neutrophilic urticaria
 
NU patients
 
pathogenetic aspects
 
urticaria patients
 

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