الفهرس 
Chronic UrticariaOnly 14 pages are availabe for public view
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Abstract
C
hronic urticaria is characterized by hives or wheals, which are edematous and pruritic. In angioedema, the swelling is deeper than wheals and may affect mucosal surfaces. Urticaria is not a single disease but a reaction pattern that represents cutaneous mast cell degranulation, with the condition being defined as chronic if it persists for longer than 6 weeks.
Cholinergic urticaria is a physical type of urticaria caused by an increase in core body temperature after exercise, intake of spicy foods, or exposure to stress. Lesions appear as itchy, numerous, small, 1 to 5 mm papules or wheals that last for a few minutes to an hour.
Cholinergic urticaria is induced by exercise, elevation in body temperature, strong emotions, ingestion of hot or spicy foods, or showering in hot water. Cholinergic urticaria is characterized by generalized flushing & wheals and urticarial rash (2- to 4-mm wheal surrounded by macular erythema), and pruritus.
The aim of this study was to assess the frequency of cholinergic urticaria among medical students at Ain Shams university and its impact on quality of life.
The study included 400 medical students from the Faculty of Medicine- Ain shams University, Cairo-Egypt, studying at year 5 and 6. Patients who reported positive symptoms, were subjected to ’questionnaire of cholinergic urticaria’ to assess the impact of cholinergic urticaria on the QOL.
The whole sample (400 students) age ranged from 20 to 28 years with a mean of 24.5 + 2.5 years. As regard the gender, the studied students included 180 females (45%) and 220/males (55%).
We concluded that among 400 studied participants, 7.5% of young adults complained of cholinergic urticaria, the cases’ age ranged from 20 to 28 years with a mean ±SD of 23.7 ± 1.89 years. The mean height, weight and BMI was 168.2 ±10.22, 80.3±10.9, and 27.53±3.22 respectively. As regard the gender, cholinergic cases included 22 females (73.3%) and 8 males (26.7%).
There was no significant difference between cases and controls as regard mean BMI as it was 27.5 ±3.2 while for controls it was 26.82 ±5.3 and 13.3% of cases had a sun exposure more than 15 hours per week, 20% exercise regularly, 23.3% have daily shower, 20% had healthy diet and 33.3% reported medication intake The duration started at age of 0-20 in 16.7% and at the age of 21-28 in 83.3%. About 73% of cases had their symptoms in form of itching/tingling only. Regarding symptoms’ the back was the most common site (90%), followed by the chest, legs then arms and neck. First hives occur during winter was reported by 36.7% of cases. Decreased ability to sweat after hives present among 66.7% of cases.
Our study results showed that the DLQI score ranged from 2 to 28 with a mean of 16.9 + 5.67. More than half of cases (56.7%) were largely affected. The mean CU-Qol score was 40.17 ±5.62 .
This study indicated a surprisingly high prevalence of cholinergic urticaria. The discrepancy between the actual number of patients seen by clinicians and the high prevalence among young adults, as in our study, may be explained by that only small number of patients with cholinergic urticaria suffer sufficiently to seek medical advice.
We found that there is a high prevalence of cholinergic urticaria among medical students (30 out of 400 7.5%). Most affected persons reported that cholinergic urticaria had major negative impact on their daily activity & worsen their quality of life. Not all affected persons reported that cholinergic urticaria could be induced by all eliciting factors. The top eliciting stimuli were spicy food, hot shower & weather changes.
Most cases complained only of itching & tingling, the back was the most common site affected, & most of them experienced decreased ability to sweat after hives.
To the best of our knowledge,our study was the first in Egypt to state out the prevalence of cholinergic urticaria among young adults, & it is so important as the majority of our sample who found out that they had cholinergic urticaria didint know until we have done the awareness phase.
We would recommend further studies to be done to confirm the high prevalence of chronic urticaria among young adults & its effect on the quality of life.
Conclusion: This study shows that there is a high prevalence of cholinergic urticaria among medical students & it may affect the quality of life.