| Objective: Factitious urticaria namely dermatographism. Its cause isn't clearly identified. It was concerned with drugs, fungus and its metabolic product, sarcoptic mite, and systemic disease, such as thyroid disfunction. Some study discovered that psychological factor was important in the development of factitial urticaria. The objective of this study was to reveal the relations between the psychological factors and the cause of factitious urticaria by investigating life event scale and comparing with health adult. The course of subject was within half a year. Meanwhile, this study also tried to find out the relations between the allergy and the cause of factitious urticaria by detecting allergen and comparing with eczema, health adult.Methods:Test 1: The case group involved 78 factitious urticaria patients who were outpatients in the department of dermatology of the second hospital, Hebei Medical University, from January, 2006 to December, 2007. The course of the case was within half a year. The control group was 78 healthy persons. The case group was compared with the control groups in the life event scale. The case group and the control groups were strictly selected according to the diagnoses standards. The control groups matched the case group in gender, age, address, education level and so on. Persons with other dermatosises, chronic disease, nervous system and mental disorder were not included in the case groups and control groups. The investigation content included: 1. Ordinary circumstances: gender, age, occupation, education level, address and medical data including complaint, course of diseases and suffered from other diseases whether or not. 2. The two groups were surveyed by using the life event scale (LES) compiled by Yang De-sen and Zhang Ya-lin. The case group and the control groups were investigated by the same specialist with the uniform guiding words. The testees were requested to complete the scale on one's own. Then the two group's investigation results were calculated, compared and analysed. The investigation data were analysed by means of statistical methods as test of normality, ANOVA, t-test with SPSS 11.5 software. The statistics results were expressed by average±standard deviation( x±s).Test 2: The case group involved 30 factitious urticaria patients who were outpatients in the department of dermatology of the second hospital, Hebei Medical University, from January, 2007 to December, 2007. The control groups involved 20 eczema patients and 20 healthy persons. The case group was compared with the two-control groups in allergen detection by QD allergen detection kit, which is produced by Kuike medical equipment limited company in Zhejiang. 30 allergens, such as dirt mites, fish, willow and so on, were tested in this study. The case group and the control groups were strictly selected according to the diagnoses standards. The standard of case group was same as above. The eczema group was consistent with diagnostic criteria. Persons with other dermatosises, chronic disease, nervous system and mental disorder were not included in the case groups and the two-control groups. The case group and the control groups were detected by the same specialist according to the operation standard. The investigation data were analysed by means of statistical methods as test of normality,χ~2-test.Results:Test 1:1 The positive life events stimulus quantity average score in one year in the case group and health adult groups were 3.50±4.726,2.47±5.119 respectively, showed no statistical difference (P>0.05). The negative life events stimulus quantity average score and the total stimulus quantity average score in one year were 16.01±12.179 and 19.58±12.781 in the case group respectively, they were higher than those of the healthy persons group (3.53±7.243 and 5.95±8.148).The differences showed statistical significance (P<0.05).And there was analysis in 47 factitious urticaria patients whose course was within 3 months. The positive, negative, total life events stimulus quantity average score in one year were 3.68±6.738,18.11±12.795,20.94±12.684 in the case group respectively, they were higher than those of health person group, The differences showed statistical significance.2 Positive, negative and total life events stimulus quantity average score in one year were compared between the male patients group and the female patients group, and showed no statistical difference (P>0.05). So did it at different educational level among primary school, secondary school and university or above (P>0.05).3 The factitious urticaria patients were divided into urban dweller and country dweller by where they living. The negative and total life events stimulus quantity average score in the urban dweller were higher than those in the country dweller. The differences showed statistical significance (P<0.05).4 The more frequent negative life events in the case group were in following order : great change of living pattern (bad sleep) (29.49%,23/78 cases); heavy pressures in work and study (20.51%,16/78 cases).Test 2:Investigation results of allergen detection by QD allergen detection kit: The positive rate in the factitial urticaria group was 46.7%. The positive rate in the eczema group was 85.0%. It was 0.0% in health adult group. The positive rate in the factitial urticaria group and the eczema group were obviously higher than that in the health adult group. The differences showed statistical significance (P<0.05). And the positive rate in the eczema group was obviously higher than that in the factitial urticaria group. The differences showed statistical significance (P<0.05). The dirt mites,flour mite were most common allergen in the factitial urticaria group.Conclusion:1 The negative life events stimulus quantity average score and the total stimulus quantity average score in one year in the case group were higher than those of the healthy persons, which suggested that the factitious urticaria patients endured greater psychological pressure and they were in a higher psychological and societal stress level condition. The higher psychological and societal stress level in factitious urticaria patients were likely to have something to do with this disease. Moreover, the problem of family was the most common in negative life events. The rest was the problem of work and study, social intercourse and other problem by turns. That suggested that the case group was affected abviously by the problem of family.2 The course of subjects was within half a year, and the life events within one year were surveyed. The negative and total life events stimulus quantity average score of patiens group were higher than those of health adults group. Furthermore, the result by comparing the patiens group, whose course was within 3 months, with health adults group was same as above. This further indicated that the psychological factors do had a certain relationship with the pathogenesis of factitious urticaria.3 Some definite allergenes could be found in factitial urticaria group, such as mites, fish and so on. Which suggested allergic factors were likely to have something to do with pathogenesis of this disease, and pathogenesis of some patients with factitial urticaria were likely related to allergy.Eventually, it can't be excluded probability that pathogenesis was contacting allergen such as dirt mites and so on, while it based on the disorder of immunological regulation, which caused by higher psychological and social stress level. |
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