Stress and urticaria

Abstract

Underlying etiology of urticaria is not identifiable in about 70% of cases. Psychogenic factors are important among approximately 50% of urticaria patients. In the presence of a stressful situation, the patient may develop an urticarial rash as a result of an allergic response; the same allergen may not produce the rash when the Stressor is removed. Childhood abuse and posttraumatic stress disorder may be associated with urticaria and/or angioedema when the patient is exposed to abuse-reminiscent stimuli. The effect of stress on uritcaria is most likely mediated by corticotropin releasing factor (CRH), which can increase mast cell degranulation. CRH is elevated during stress and in psychiatric disorders such as major depression and PTSD. © 2009 Springer Berlin Heidelberg.