Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press157310.36691/RJA1573Original studiesОригинальные исследованияResearch ArticleEpidemiology of chronic inducible urticaria in MoscowЭпидемиология хронических индуцированных крапивниц в городе Москвеhttps://orcid.org/0000-0002-5083-66373023-4538FominaDaria S.ФоминаДарья Сергеевна
Russian Federation

MD, Cand. Sci. (Med.), Associate Professor

к.м.н., доцент

daria_fomina@mail.ruhttps://orcid.org/0000-0002-4022-35702588-5718MaltsevaNatalya P.МальцеваНаталья Петровна
Russian Federation

MD

filippova-nataly@mail.ruhttps://orcid.org/0000-0001-8472-11526644-6715SerdotetskovaSofia A.СердотецковаСофья Александровна
Russian Federation

MD

darklynx813@gmail.comhttps://orcid.org/0000-0002-8279-21734547-3948DanilychevaInna V.ДанилычеваИнна Владимировна
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

ivdanilycheva@mail.ruhttps://orcid.org/0000-0002-9545-47201857-8154LebedkinaMarina S.ЛебедкинаМарина Сергеевна
Russian Federation

MD

marina.ivanova0808@yandex.ruhttps://orcid.org/0000-0003-0921-92122841-9652MikhaylovaValeriya I.МихайловаВалерия Игоревна
Russian Federation

MD

lera1208@list.ruhttps://orcid.org/0000-0002-1212-37673078-0976KovalkovaElena V.КовальковаЕлена Вячеславовна
Russian Federation

MD

kovalkova@ya.ruhttps://orcid.org/0000-0002-0643-9423ChikunovNikita S.ЧикуновНикита Сергеевич
Russian Federation

MD

artlicasio@gmail.comhttps://orcid.org/0000-0002-1930-54244122-5565KaraulovAlexander V.КарауловАлександр Владимирович
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

drkaraulov@mail.ruhttps://orcid.org/0000-0001-6010-79753887-6250LysenkoMariana A.ЛысенкоМарьяна Анатольевна
Russian Federation

MD, Dr. Sci. (Med.)

д.м.н.

gkb52@zdrav.mos.ruCity Clinical Hospital No. 52Городская клиническая больница № 52First Sechenov Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)National Research Center ― Institute of Immunology Federal Medical-Biological Agency of RussiaГосударственный научный центр «Институт иммунологии»Moscow Center for Innovative Technologies in HealthcareМосковский центр инновационных технологий в здравоохранении24092022081020221933173272308202216092022Copyright ©; 2022, Pharmarus Print MediaCopyright ©; 2022, Фармарус Принт Медиа2022Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/1573

BACKGROUND: Chronic inducible urticaria is a group of diseases that is characterized by the development of wheals, angioedema, or both in response to specific triggers for ≥6 weeks. According to global scientific international literature, the occurrence of chronic inducible urticaria is 0.5% in the general population and approximately 20%−30% in all chronic urticarias. The prevalence of chronic inducible urticaria has no statistical data in the Russian Federation.

AIM: This study aimed to evaluate the region-specific epidemiology of different forms of chronic inducible urticaria.

MATERIALS AND METHODS: The analysis is based on the number of unique cases extracted from the medical care records in the adults’ segment of the digital platform United medical information and analytical system (UMIAS) (outpatient forms) in Moscow from 2017 to 2021, including keyword search.

RESULTS: This study indicated that the prevalence of chronic inducible urticaria in Moscow is correlated with published global epidemiological data. Among patients with chronic inducible urticarial, females predominate (74.2%), and the median age was 43.8 years (37 years in males and 46.4 in females). The most common form in all verified cases of chronic inducible urticaria is symptomatic dermographism (11.12%), followed by contact urticaria (5.36%), cholinergic urticaria (2.28%), cold urticaria (1.92%), delayed pressure urticaria (0.36%), vibratory urticaria (0.11%), aquagenic urticaria (0.1%), and heat urticaria (0.08%). Chronic inducible urticaria rates in Moscow are high, which increase as in global practice. This research has limitations, including the lack of ubiquitous implementation of standard protocols of provocation testing in outpatient units and the low percentage of using validated questionnaires in the routine management of patients with chronic inducible urticaria.

CONCLUSIONS: Further studies dedicated to this topic are greatly necessary to answer a wide spectrum of questions, including the diagnosis process and evaluation of the severity of chronic inducible urticaria, comorbid conditions, and optimization of the treatment protocols adapted for the particular phenotype.

Обоснование. Хронические индуцированные формы крапивницы ― группа заболеваний, характеризуемая развитием уртикарных высыпаний и/или ангиоотёков в течение 6 и более недель в ответ на воздействие специфических триггеров. По данным мировой научной литературы, встречаемость хронических индуцированных форм крапивницы достаточно высока и составляет 0,5% общей популяции и примерно 20–30% всех хронических крапивниц. Статистических данных о распространённости физических форм крапивницы в Российской Федерации нет.

Цель ― оценка эпидемиологии хронических индуцированных крапивниц в рамках популяции одного региона.

Материалы и методы. Анализ осуществлялся посредством подсчёта количества уникальных случаев обращений взрослого населения по поводу данной патологии в амбулаторных формах Единой медицинской информационно-аналитической системы (ЕМИАС) г. Москвы с 2017 по 2021 г., включая поиск по ключевым словам.

Результаты. Распространённость хронических индуцированных форм крапивницы в Москве коррелирует с опубликованными международными эпидемиологическими данными. Среди обратившихся по поводу хронических индуцированных форм крапивницы превалировали женщины (74,2%), медиана возраста составила 43,0 года (37 лет у мужчин и 46,4 года у женщин). Из всех верифицированных случаев хронических индуцированных форм крапивницы самым распространённым типом является дермографическая крапивница (11,12%), далее следуют контактная (5,36%), холинергическая (2,28%), холодовая (1,92%), замедленная крапивница от давления (0,36%), вибрационная (0,11%), аквагенная (0,1%) и тепловая (0,08%) формы. Показатели хронических индуцированных форм крапивницы в Москве высоки и так же, как и в мировой практике, имеют значимую тенденцию к росту. Необходимо внедрение провокационного тестирования для верификации диагноза, использование валидизированных опросников и систематического наблюдения пациентов с хроническими индуцированными формами крапивницы.

Заключение. Таким образом, необходимо дальнейшее изучение данной когорты пациентов с целью верификации диагноза, оценки тяжести течения хронических индуцированных форм крапивницы, коморбидных заболеваний и ответа на проводимую терапию.

chronic inducible urticariaepidemiologyprovocation testingхроническая индуцированная крапивницаэпидемиологияпровокационное тестированиеRussian Association of Allergologists and Clinical Immunologists; Russian Society of Dermatovenerologists and Cosmetologists. Federal clinical guidelines. Urticaria. Moscow; 2019. 60 р. (In Russ).Российская ассоциация аллергологов и клинических иммунологов; Российское общество дерматовенерологов и косметологов. Клинические рекомендации. Крапивница. Москва, 2019. 60 с.Borzova EY. Diagnosis of chronic induced urticaria. Russ Allergol J. 2019;16(2):5−13. (In Russ).Борзова Е.Ю. Диагностика хронических индуцированных крапивниц // Российский аллергологический журнал. 2019. Т. 16, № 2. С. 5−13.Zuberbier T, Latiff AH, Abuzakouk M, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734–766. doi: 10.1111/all.15090Zuberbier T., Latiff A.H., Abuzakouk M., et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria // Allergy. 2022. Vol. 77, N 3. Р. 734–766. doi: 10.1111/all.15090Dice JP. Physical urticaria. Immunol Allergy Clin North Am. 2004;24(2):225–246.vi. doi: 10.1016/j.iac.2004.01.005Dice J.P. Physical urticaria // Immunology and allergy clinics of North America. 2004. Vol. 24, N 2. Р. 225–246.vi. doi: 10.1016/j.iac.2004.01.005Maurer M, Fluhr JW, Khan DA. How to approach chronic inducible urticaria. J Allergy Clin Immunol Pract. 2018;6(4):1119–1130. doi: 10.1016/j.jaip.2018.03.007Maurer M., Fluhr J.W., Khan D.A. How to approach chronic inducible urticaria // J Allergy Clin Immunol Pract. 2018. Vol. 6, N 4. Р. 1119–1130. doi: 10.1016/j.jaip.2018.03.007Weller K, Altrichter S, Ardelean E, et al. Chronic urticaria. Prevalence, course, prognostic factors and impact. (In German). Hautarzt. 2010;61(9):750–757. doi: 10.1007/s00105-010-1933-8Weller K., Altrichter S., Ardelean E., et al. Chronic urticaria. Prevalence, course, prognostic factors and impact. (In German) // Hautarzt. 2010. Vol. 61, N 9. Р. 750–757. doi: 10.1007/s00105-010-1933-8Siebenhaar F, Weller K, Mlynek A, et al. Acquired cold urticaria: clinical picture and update on diagnosis and treatment. Clin Experimental Dermatol. 2007;32(3):241–245. doi: 10.1111/j.1365-2230.2007.02376.xSiebenhaar F., Weller K., Mlynek A., et al. Acquired cold urticaria: clinical picture and update on diagnosis and treatment // Clin Experimental Dermatol. 2007. Vol. 32, N 3. Р. 241–245. doi: 10.1111/j.1365-2230.2007.02376.xMöller A, Henz BM. Cold urticaria. In: Henz BM, Zuberbier T, Grabbe J, Monroe E, eds. Urticaria. Springer; 1998. Р. 69−78.Möller A., Henz B.M. Cold urticaria // Henz B.M., Zuberbier T., Grabbe J., Monroe E., eds. Urticaria. Springer; 1998. Р. 69−78.Katsarou-Katsari A, Makris M, Lagogianni E, et al. Clinical features and natural history of acquired cold urticaria in a tertiary referral hospital: a 10-year prospective study. JEADV. 200822(12):1405–1411. doi: 10.1111/j.1468-3083.2008.02840.xKatsarou-Katsari A., Makris M., Lagogianni E., et al. Clinical features and natural history of acquired cold urticaria in a tertiary referral hospital: a 10-year prospective study // JEADV. 2008. Vol. 22, N 12. Р. 1405–1411. doi: 10.1111/j.1468-3083.2008.02840.xZuberbier T, Althaus C, Chantraine-Hess S, Czarnetzki BM. Prevalence of cholinergic urticaria in young adults. J Am Academy Dermatol. 1994;31(6):978–981. doi: 10.1016/s0190-9622(94)70267-5Zuberbier T., Althaus C., Chantraine-Hess S., Czarnetzki B.M. Prevalence of cholinergic urticaria in young adults // J Am Academy Dermatol. 1994. Vol. 31, N 6. Р. 978–981. doi: 10.1016/s0190-9622(94)70267-5Chong WS, Khoo SW. Solar urticaria in Singapore: an uncommon photodermatosis seen in a tertiary dermatology center over a 10-year period. Photodermatol Photoimmunol Photomed. 2004;20(2): 101–104. doi: 10.1111/j.1600-0781.2004.00083.xChong W.S., Khoo S.W. Solar urticaria in Singapore: an uncommon photodermatosis seen in a tertiary dermatology center over a 10-year period // Photodermatol Photoimmunol Photomed. 2004. Vol. 20, N 2. Р. 101–104. doi: 10.1111/j.1600-0781.2004.00083.xKontou-Fili K, Borici-Mazi R, Kapp A, et al. Physical urticaria: classification and diagnostic guidelines. An EAACI position paper. Allergy. 1997;52(5):504–513. doi: 10.1111/j.1398-9995.1997.tb02593.xKontou-Fili K., Borici-Mazi R., Kapp A., et al. Physical urticaria: classification and diagnostic guidelines. An EAACI position paper // Allergy. 1997. Vol. 52, N 5. Р. 504–513. doi: 10.1111/j.1398-9995.1997.tb02593.xJain SV, Mullins RJ. Cold urticaria: a 20-year follow-up study. JEADV. 2016;30(12):2066–2071. doi: 10.1111/jdv.13841Jain S.V., Mullins R.J. Cold urticaria: a 20-year follow-up study // JEADV. 2016. Vol. 30, N 12. Р. 2066–2071. doi: 10.1111/jdv.13841Kring Tannert L, Stahl Skov P, Bjerremann Jensen L, et al. Cold urticaria patients exhibit normal skin levels of functional mast cells and histamine after tolerance induction. Dermatol (Basel, Switzerland). 2012;224(2):101–105. doi: 10.1159/000336572Kring T.L., Stahl S.P., Bjerremann J.L., et al. Cold urticaria patients exhibit normal skin levels of functional mast cells and histamine after tolerance induction // Dermatol (Basel Switzerland). 2012. Vol. 224, N 2. Р. 101–105. doi: 10.1159/000336572Curto-Barredo L, Archilla LR, Vives GR, et al. Clinical features of chronic spontaneous urticaria that predict disease prognosis and refractoriness to standard treatment. Acta Derm Venereol. 2018;98(7):641–647. doi: 10.2340/00015555-2941Curto-Barredo L., Archilla L.R., Vives G.R., et al. Clinical features of chronic spontaneous urticaria that predict disease prognosis and refractoriness to standard treatment // Acta Derm Venereol. 2018. Vol. 98, N 7. Р. 641–647. doi: 10.2340/00015555-2941Vadas P, Sinilaite A, Chaim M. Cholinergic urticaria with anaphylaxis: an underrecognized clinical entity. J Allergy Clin Immunol Pract. 2016;4(2):284–291. doi: 10.1016/j.jaip.2015.09.021Vadas P., Sinilaite A., Chaim M. Cholinergic urticaria with anaphylaxis: an underrecognized clinical entity // J Allergy Clin Immunol Pract. 2016. Vol. 4, N 2. Р. 284–291. doi: 10.1016/j.jaip.2015.09.021Bizjak M, Košnik M, Dinevski D, et al. Risk factors for systemic reactions in typical cold urticaria: results from the COLD-CE study. Allergy. 2022;77(7):2185–2199. doi: 10.1111/all.15194Bizjak M., Košnik M., Dinevski D., et al. Risk factors for systemic reactions in typical cold urticaria: results from the COLD-CE study // Allergy. 2022. Vol. 77, N 7. Р. 2185–2199. doi: 10.1111/all.15194Trevisonno J, Balram B, Netchiporouk E, Ben-Shoshan M. Physical urticaria: review on classification, triggers and management with special focus on prevalence including a meta-analysis. Postgraduate Med. 2015;127(6):565–570. doi: 10.1080/00325481.2015.1045817Trevisonno J., Balram B., Netchiporouk E., Ben-Shoshan M. Physical urticaria: review on classification, triggers and management with special focus on prevalence including a meta-analysis // Postgraduate Med. 2015. Vol. 127, N 6. Р. 565–570. doi: 10.1080/00325481.2015.1045817Sánchez J, Amaya E, Acevedo A, et al. Prevalence of inducible urticaria in patients with chronic spontaneous urticaria: associated risk factors. J Allergy Clin Immunol Pract. 2017;5(2):464–470. doi: 10.1016/j.jaip.2016.09.029Sánchez J., Amaya E., Acevedo A., et al. Prevalence of inducible urticaria in patients with chronic spontaneous urticaria: associated risk factors // J Allergy Clin Immunol Pract. 2017. Vol. 5, N 2. Р. 464–470. doi: 10.1016/j.jaip.2016.09.029Kozel MM, Mekkes J, Bossuyt PM, Bos JD. Natural course of physical and chronic urticaria and angioedema in 220 patients. J Am Academy Dermatol. 2001;45(3):387–391. doi: 10.1067/mjd.2001.116217Kozel M.M., Mekkes J.R., Bossuyt P.M., Bos J.D. Natural course of physical and chronic urticaria and angioedema in 220 patients // J Am Academy Dermatol. 2001. Vol. 45, N 3. Р. 387–391. doi: 10.1067/mjd.2001.116217Diehl KL, Erickson C, Calame A, Cohen PR. A woman with solar urticaria and heat urticaria: a unique presentation of an individual with multiple physical urticarias. Cureus. 2021;13(8):e16950. doi: 10.7759/cureus.16950Diehl K.L., Erickson C., Calame A., Cohen P.R. A woman with solar urticaria and heat urticaria: a unique presentation of an individual with multiple physical urticarias // Cureus. 2021. Vol. 13, N 8. Р. e16950. doi: 10.7759/cureus.16950Cheon HW, Han SJ, Yeo SJ, et al. A case of combined cholinergic and cold urticaria. Korean J Internal Med. 2012;27(4):478–479. doi: 10.3904/kjim.2012.27.4.478Cheon H.W., Han S.J., Yeo S.J., et al. A case of combined cholinergic and cold urticaria // Korean J Internal Med. 2012. Vol. 27, N 4. Р. 478–479. doi: 10.3904/kjim.2012.27.4.478Zimmer S, Peveling-Oberhag A, Weber A, et al. Unique coexistence of cold and solar urticaria and its efficient treatment. Brit J Dermatol. 2016;174(5):1150–1152. doi: 10.1111/bjd.14354Zimmer S., Peveling-Oberhag A., Weber A., et al. Unique coexistence of cold and solar urticaria and its efficient treatment // Brit J Dermatol. 2016. Vol. 174, N 5. Р. 1150–1152. doi: 10.1111/bjd.14354Mathelier-Fusade P, Aissaoui M, Chabane MH, et al. Association of cold urticaria and aquagenic urticaria. Allergy. 1997;52(6):678–679. doi: 10.1111/j.1398-9995.1997.tb01055.xMathelier-Fusade P., Aissaoui M., Chabane M.H., et al. Association of cold urticaria and aquagenic urticaria // Allergy. 1997. Vol. 52, N 6. Р. 678–679. doi: 10.1111/j.1398-9995.1997.tb01055.xChurch MK, Kolkhir P, Metz M, Maurer M. The role and relevance of mast cells in urticaria. Immunol Rev. 2018;282(1):232–247. doi: 10.1111/imr.12632Church M.K., Kolkhir P., Metz M., Maurer M. The role and relevance of mast cells in urticaria // Immunol Rev. 2018. Vol. 282, N 1. Р. 232–247. doi: 10.1111/imr.12632Magerl M, Altrichter S, Borzova E, et al. The definition, diagnostic testing, and management of chronic inducible urticarias ― The EAACI/GA2LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy. 2016;71(6):780–802. doi: 10.1111/all.12884Magerl M., Altrichter S., Borzova E., et al. The definition, diagnostic testing, and management of chronic inducible urticarias ― The EAACI/GA2LEN/EDF/UNEV consensus recommendations 2016 update and revision // Allergy. 2016. Vol. 71, N 6. Р. 780–802. doi: 10.1111/all.12884Pereira A, Motta AA, Kalil J, Agondi RC. Chronic inducible urticaria: confirmation through challenge tests and response to treatment. Einstein (Sao Paulo Brazil). 2020;18:eAO5175. doi: 10.31744/einstein_journal/2020ao5175Pereira A., Motta A.A., Kalil J., Agondi R.C. Chronic inducible urticaria: confirmation through challenge tests and response to treatment // Einstein (Sao Paulo Brazil). 2020. Vol. 18. Р. eAO5175. doi: 10.31744/einstein_journal/2020ao5175Maurer M, Giménez-Arnau A, Ensina LF, et al. Chronic urticaria treatment patterns and changes in quality of life: AWARE study 2-year results. World Allergy Organization J. 2020;13(9):100460. doi: 10.1016/j.waojou.2020.100460Maurer M., Giménez-Arnau A., Ensina L.F., et al. Chronic urticaria treatment patterns and changes in quality of life: AWARE study 2-year results // World Allergy Organization J. 2020. Vol. 13, N 9. Р. 100460. doi: 10.1016/j.waojou.2020.100460Koch K, Weller K, Werner A, et al. Antihistamine updosing reduces disease activity in patients with difficult-to-treat cholinergic urticaria. J Allergy Clin Immunol. 2016;138(5):1483–1485.e9. doi: 10.1016/j.jaci.2016.05.026Koch K., Weller K., Werner A., et al. Antihistamine updosing reduces disease activity in patients with difficult-to-treat cholinergic urticaria // J Allergy Clin Immunol. 2016. Vol. 138, N 5. Р. 1483–1485.e9. doi: 10.1016/j.jaci.2016.05.026Abajian M, Curto-Barredo L, Krause K, et al. Rupatadine 20 mg and 40 mg are effective in reducing the symptoms of chronic cold urticaria. Acta Derm Venereol. 2016;96(1):56–59. doi: 10.2340/00015555-2150Abajian M., Curto-Barredo L., Krause K., et al. Rupatadine 20 mg and 40 mg are effective in reducing the symptoms of chronic cold urticaria // Acta Derm Venereol. 2016. Vol. 96, N 1. Р. 56–59. doi: 10.2340/00015555-2150Rossi O, Piccirillo A, Iemoli E, et al. Socio-economic burden and resource utilisation in Italian patients with chronic urticaria: 2-year data from the AWARE study. World Allergy Organization J. 2020;13(12):100470. doi: 10.1016/j.waojou.2020.100470Rossi O., Piccirillo A., Iemoli E., et al. Socio-economic burden and resource utilisation in Italian patients with chronic urticaria: 2-year data from the AWARE study // World Allergy Organization J. 2020. Vol. 13, N 12. Р. 100470. doi: 10.1016/j.waojou.2020.100470Maurer M, Metz M, Brehler R, et al. Omalizumab treatment in patients with chronic inducible urticaria: a systematic review of published evidence. J Allergy Clin Immunol. 2018;141(2):638–649. doi: 10.1016/j.jaci.2017.06.032Maurer M., Metz M., Brehler R., et al. Omalizumab treatment in patients with chronic inducible urticaria: a systematic review of published evidence // J Allergy Clin Immunol. 2018. Vol. 141, N 2. Р. 638–649. doi: 10.1016/j.jaci.2017.06.032Metz M, Schütz A, Weller K, et al. Omalizumab is effective in cold urticaria-results of a randomized placebo-controlled trial. J Allergy Clin Immunol. 2017;140(3):864–867.e5. doi: 10.1016/j.jaci.2017.01.043Metz M., Schütz A., Weller K., et al. Omalizumab is effective in cold urticaria-results of a randomized placebo-controlled trial // J Allergy Clin Immunol. 2017. Vol. 140, N 3. Р. 864–867.e5. doi: 10.1016/j.jaci.2017.01.043Metz M, Ohanyan T, Church MK, Maurer M. Omalizumab is an effective and rapidly acting therapy in difficult-to-treat chronic urticaria: a retrospective clinical analysis. J Dermatological Sci. 2014;73(1):57–62. doi: 10.1016/j.jdermsci.2013.08.011Metz M., Ohanyan T., Church M.K., Maurer M. Omalizumab is an effective and rapidly acting therapy in difficult-to-treat chronic urticaria: a retrospective clinical analysis // J Dermatological Sci. 2014. Vol. 73, N 1. Р. 57–62. doi: 10.1016/j.jdermsci.2013.08.011Maure M, Schütz A, Weller K, et al. Omalizumab is effective in symptomatic dermographism-results of a randomized placebo-controlled trial. J Allergy Clin Immunol. 2017;140(3):870–873.e5. doi: 10.1016/j.jaci.2017.01.042Maurer M., Schütz A., Weller K., et al. Omalizumab is effective in symptomatic dermographism-results of a randomized placebo-controlled trial // J Allergy Clin Immunol. 2017. Vol. 140, N 3. Р. 870–873.e5. doi: 10.1016/j.jaci.2017.01.042Ghazanfar MN, Sand C, Thomsen SF. Effectiveness and safety of omalizumab in chronic spontaneous or inducible urticaria: evaluation of 154 patients. Brit J Dermatol. 2016;175(2):404–406. doi: 10.1111/bjd.14540Ghazanfar M.N., Sand C., Thomsen S.F. Effectiveness and safety of omalizumab in chronic spontaneous or inducible urticaria: evaluation of 154 patients // Brit J Dermatol. 2016. Vol. 175, N 2. Р. 404–406. doi: 10.1111/bjd.14540