Urticaria

Abstract

Several chronic or acute inflammatory skin diseases such as urticaria, atopic dermatitis and psoriasis are associated with pruritus. Interestingly, the clinical presentation of pruritus in these skin diseases is completely different. While patients with atopic dermatitis develop excessive scratching resulting in excoriation and bleeding of the skin, patients with urticaria rather rub their lesions, explaining why excoriation is not a consequence of urticaria. The clinical characteristics of itch in patients with urticaria have been described with stinging, tickling and burning, which is usually worse in the evening or at night. Patients with urticaria describe their itch as bothersome, annoying, unbearable and worrisome. Itch intensity can be assessed by the visual analog score (VAS) and the verbal intensity score. Of note, sensory and affective scores positively correlate with the worst intensity of itch.1 Itch intensity in chronic urticaria (CU) is related to stress. However, this relation is significantly less strong than in other pruritic dermatoses including psoriasis.2 The most frequently involved areas with itch in patients with chronic idiopathic urticaria were the arms (n = 86), the back (n = 78) and the legs (n = 75) as shown in a study of 100 patients.1 © 2010 Springer-Verlag London.