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Chronic urticaria and infections.

Bettina Wedi1, Ulrike Raap, Alexander Kapp

  • 1Department of Dermatology and Allergology, Hannover Medical University, Hannover, Germany. Bettina_Wedi@t-online.de

Current Opinion in Allergy and Clinical Immunology
|September 7, 2004
PubMed
Summary

While infections can trigger acute hives, their causal role in chronic urticaria is uncertain. However, infections may exacerbate existing chronic hives in susceptible individuals, suggesting a complex immune response.

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Area of Science:

  • Dermatology
  • Immunology
  • Infectious Diseases

Background:

  • Chronic urticaria pathogenesis is complex and multifactorial, with a lack of specific treatments.
  • While acute urticaria often links to infections, the role of infections in chronic urticaria is debated, though they can worsen symptoms.

Purpose of the Study:

  • To review current peer-reviewed literature on the relationship between infections and chronic urticaria.
  • To analyze the evidence for infections as a cause or exacerbating factor in chronic urticaria.

Main Methods:

  • Systematic review of English-language publications.
  • Analysis of studies investigating infections in patients with chronic urticaria.

Main Results:

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  • Evidence suggests infections may not increase in prevalence but can trigger chronic urticaria in susceptible individuals via immune responses.
  • A potential infection-associated autoreactive response exists, particularly in patients with positive autologous serum skin tests, possibly involving molecular mimicry.
  • Conclusions:

    • Evidence for a direct causal role of underlying infections in chronic urticaria is currently weak.
    • Establishing a definitive link between infections and chronic urticaria is challenging due to confounding factors and lack of challenge tests.
    • Future research should explore the interplay between urticaria, autoimmunity, non-IgE hypersensitivity, and infections to develop targeted therapies.