December 16, 2013
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Various diseases displayed clinical features of urticarial dermatitis

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Patients with clinical features of urticarial dermatitis were diagnosed with various dermatological diseases, according to recent study results.

Researchers conducted a retrospective review of 146 patients with clinical features of urticarial dermatitis (UD; mean age at onset, 60 years; 60% women) seen in the dermatology department at Mayo Clinic, Rochester, Minn., between January 2006 and May 2012. One hundred eighteen patients (81%) also provided skin biopsy samples, used to identify microscopic criteria for UD.

The trunk (91% of patients), lower extremities (75%) and upper extremities (73%) were the most commonly involved areas. UD was the final diagnosis in 70 patients (48%). Other final diagnoses were: dermatitis not otherwise specified (24 patients), urticaria (14 patients), drug reaction (nine patients), bullous pemphigoid (six patients), atopic dermatitis (five patients) and contact dermatitis (four patients).

Forty patients (mean age at onset, 62 years; 62% women) were identified with clinical and histopathologic features of UD. Thirty-five patients had more than 15 days of follow-up after treatment; 20% had complete response to treatment, 34% had partial response and 46% experienced no response. Four patients had a newly diagnosed concurrent malignancy.

“Our study delineates a broad array of ultimate dermatologic diagnoses in a large cohort of patients presenting initially with UD, which suggests that the clinical features of UD represent a reaction pattern that may be seen in various dermatologic conditions and that diagnostic evaluation is necessary to correlate clinical findings in a given patient,” the researchers concluded. “We also found a minority of patients whose onset of clinical and histopathologic features of UD was temporally associated with a malignancy diagnosis.

“Future studies should prospectively assess patients with UD to determine the optimal evaluation and management of UD.”

Disclosure: The researchers report no relevant financial disclosures.