Exaggerated neurophysiological responses to stressor in patients with chronic spontaneous urticaria.

To the Editor, Chronic spontaneous urticaria (CSU) has detrimental effects on patients' quality of life (QoL) and emotional well-being.1 Patients with CSU have increased levels of emotional distress, anxiety, depression and somatoform disorders, and their elevated stress correlates with CSU activity.2,3 Mechanisms of stress-induced CSU exacerbation suggest that patients with CSU may be vulnerable to stressors and have altered and exaggerated stress responses. CSU patients had stronger skin vasculature responses as assessed by laser speckle measurements of cutaneous perfusion, both after the first startle (58.6 ± 13.5 vs. 46.4 ± 14.1, I p i = .021) and at the end of the stress exposure session (59.5 ± 38.0 vs. 42.9 ± 20.5, I p i = .007). The increased reactivity of CSU patients to startle stimuli and impaired PPI in CSU patients suggests a disrupted activity of their nervous system. [Extracted from the article]