Factors contributing to chronic urticaria/angioedema and nummular eczema resolution - which findings are crucial?

FACTORS CONTRIBUTING TO CHRONIC URTICARIA/ANGIOEDEMA AND NUMMULAR ECZEMA RESOLUTION - WHICH FINDINGS ARE CRUCIAL? Acta Clin Croat. 2019 Dec;58(4):595-603 Authors: Lugović-Mihić L, Bukvić I, Bulat V, Japundžić I Abstract When working with dermatology patients, the question sometimes arises which diagnostic tests and tools should be used for workup, particularly in cases of chronic urticaria (CU) and discoid nummular eczema, where the treatment of associated systemic diseases and infections may be crucial for patient outcome. The aim was to investigate retrospectively the influence of associated diseases on skin disease outcomes based on medical records of CU and nummular eczema patients in comparison to controls. We included patients admitted to our Dermatology Department over a 6-year period and analyzed their laboratory findings, related factors and outcomes recorded after two years of workup and treatment. Compared to controls, CU patients had a significantly higher prevalence of positive Helicobacter (H.) pylori findings (p=0.020), confirmed allergies (p=0.006), increased IgE (p=0.011) and pathologic thyroid findings (p=0.049), whereas nummular eczema patients only had significantly higher positive H. pylori findings (p=0.046). Meaningful regression of both dermatoses was recorded after treatment of associated diseases, with significant benefit from H. pylori treatment. This indicated that the diagnosis of associated infections (particularly H. py...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research

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CONCLUSION: With proper treatment, nummular eczema can be cleared over a few weeks, although the course can be chronic and characterized by relapses and remissions. Moisturizing of the skin and avoidance of identifiable exacerbating factors such as hot water baths and harsh soaps may reduce the frequency of recurrence. Diseases that present with annular lesions may mimic nummular eczema and the differential diagnosis is broad. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made, and appropriate treatment initiated. PMID: 32778043 [PubMed - as supplied by publisher]
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