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BACKGROUND: Chronic urticaria is a debilitating disease that considerably affects health-related quality of life, and the Chronic Urticaria Quality of Life Questionnaire is the only questionnaire specifically designed for its evaluation. OBJECTIVE: To evaluate the quality of life of patients with chronic urticaria, using the Brazilian Portuguese version of the Chronic Urticaria Quality of Life Questionnaire. METHODS: The Chronic Urticaria Quality of Life Questionnaire was self-administered in 112 chronic urticaria patients and disease activity was assessed through the Urticaria Activity Score. Clinical and socio-demographic characteristics of patients were studied, such as: age, sex, etiologic diagnosis of chronic urticaria, duration of disease and Urticaria Activity Score. RESULTS: The population studied was composed 85.72% of women with a mean age of 46 years (18-90), while the median disease duration period was 10 years (3 months-60 years). Regarding the etiologic diagnosis, 48.22% had chronic spontaneous urticaria; 22.32% associated with inducible urticaria, 28.57% with chronic autoimmune urticaria, and 23.21% had physical urticaria alone. Disease activity evaluated using the Urticaria Activity Score was 1.04 ± 1.61 (0-6). The total score for the Chronic Urticaria Quality of Life Questionnaire was 36 (0-100) and dimension I (sleep/mental status/eating) had a greater impact on quality of life. The items with the highest mean scores were nervousness and shame over lesions, while the items with the lowest scores were lip swelling and limitations on sporting activities. CONCLUSIONS: Chronic urticaria compromises patients' quality of life, mainly those with more severe disease or who are diagnosed with chronic autoimmune urticaria.

BACKGROUND: Atopic Dermatitis is a chronic inflammatory skin disease. Food allergens are important in the pathogenesis in 1/3 of the cases. Several mechanisms are involved in the pathogenesis of Atopic Dermatitis. Immediate reactions are identified by both measurement of specific IgE and skin prick test. Atopy Patch Test seems to be relevant in the investigation of patients with suspected delayed-type reactions. OBJECTIVES: To evaluate the standardization of this method concerning allergen concentration, occlusion time and interpretation, and determine the specificity and sensitivity of the Atopy Patch Test according to the skin prick test and specific IgE levels in food allergy diagnosis in children with Atopic Dermatitis. METHODS: Seventy-two children, aged 2-12 years were selected and followed at the allergy clinic of the Hospital São Zacharias. Skin prick test, specific IgE and food Atopy Patch Test (cow's milk, egg, soy and wheat) were carried out. Three groups were submitted to the Atopy Patch Test: (1) Atopic Dermatitis with or without Rhinitis and Asthma; (2) Rhinitis and or Asthma without AD; (3) Healthy individuals. RESULTS: In group 1, 40% of the patients presented positive reactions. The longer the exposure time (48h and 72h), the higher the sensitivity. In group 2, the test was more specific than sensitive for all the extracts, with increased sensitivity the longer the time of exposure (72h). In group 3, 8.3% presented positive tests. CONCLUSION: APT evidenced a great diagnostic value in late-phase reactions to food, with high specificity. It showed to be a specific and reliable tool in comparison with the healthy group's results. FUNDAMENTOS: A Dermatite Atópica é uma doença inflamatória crônica da pele. Os alimentos são importantes na patogênese da doença em 1/3 dos casos. Diversos mecanismos estão envolvidos na fisiopatogenia da dermatite Atópica. As reações imediatas são identificadas pela dosagem de IgE específica e teste de puntura. O teste de contato atópico parece ter relevância na investigação de pacientes com suspeita de reação tardia. OBJETIVOS: Avaliar a padronização do método com relação à concentração do alérgeno, tempo de oclusão e de interpretação; e determinar a especificidade e a sensibilidade do teste de contato atópico em relação ao teste de puntura e a dosagem de IgE específica, no diagnóstico de alergia alimentar em crianças com dermatite Atópica. MÉTODOS: Setenta e duas crianças com 2 a 12 anos foram submetidas a teste de puntura e dosagem de IgE específicas para alimentos (leite de vaca, ovo, soja, trigo). O teste de contato atópico foi aplicado em 3 grupos: (1) Dermatite Atópica com ou sem Rinite e Asma; (2) Rinite e ou Asma sem Dermatite Atópica; (3) Saudáveis. RESULTADOS: No grupo 1, 40% dos pacientes apresentaram reação positiva. Quanto maior o tempo de exposição, maior foi a sensibilidade. No grupo 2, o teste foi mais específico que sensível para todos os extratos; com aumento da sensibilidade com maior tempo de exposição (72h). No grupo 3, 8.3% apresentaram testes positivos. CONCLUSÃO: O teste de contato atópico mostrou ter valor diagnóstico em relação às reações de fase tardia a alimentos, com elevada especificidade. Mostrou-se um teste específico e confiável ao comparar com os resultados do grupo controle.

Methods We report a case of drug rash induced by levothyroxine and currently oral desensitization. A 31 year-old woman had been diagnosed as Hashimoto’s Thyroiditis. She was having levothyroxine for 9 years when she begun to present bilateral eyelids maculopapular rash. Blood exams and physical examination were normal except for the eyelids rash. As she stopped using levothyroxine, the rash has disappeared. Her endocrinologist prescribed her other brands of levothyroxine, and the patient reported the same reaction.

Background Progesterone induced dermatitis is a rare autoimmune response to endogenous progesterone that usually occurs in fertile females, in the third decade. Skin lesions occur periodically during the luteal phase of the menstrual cycle due to increase of progesterone, the symptom usually occurs 3-10 days prior to the onset of menstrual flow and resolve 2 days into menses. It may present a variety of cutaneous and mucosal manifestations, from a mild urticarial to an anaphylaxis.

Background Chronic spontaneous urticaria (CSU) is more common in adults, especially middle-aged women. The condition resolves spontaneously within 6 months in 30 to 55% of patients but can persist for years in others. It has a devastating effect on the quality of life of those who experience it. Although the mechanisms are not fully elucidated, anti IgE recombinant humanized monoclonal (Omalizumab) has been recommended, according to the latest guidelines EAACI/GA2LEN/EDF & WAO, with encouraging results in management of refractory CSU as opposed to the usual and alternative therapies.

Short-term prophylaxis (STP) with plasma derived human C1 inhibitor concentrate (pdhC1-INH) in two pregnant women with hereditary angioedema (HAE): an experience in Rio de Janeiro – Brazil Solange Oliveira Rodrigues Valle, Maria Luiza Oliva Alonso, Sergio Duarte Dortas Junior, Soloni Afra Pires Levy, Ana Paula Ferracciu Coutinho Millet, Alfeu Tavares Franca, Alfeu Tavares Franca, Ana Luiza Ribeiro Bard De Carvalho