A Preliminary Study On The Relationship Between Chronic Urticaria And Superficial Fungal Infection

BackgroundChronic urticaria is one of common Allergic diseases, which is frequent encountered in medical practice. It is usually defined as weekly recurrent attacks of hives over 6-week period and evoked by multiple factors which can be a troublesome dermatologic disorder and had a significant impact on quality of life. Fungi are common allergens. Description of an association between allergic disease and chronic dermatophytosis dates back more than 70 years. A subsequent study including some case reports and small sample researches were conducted to explore the correlation between allergic disease and chronic dermatophytosis, such as asthma, allergic rhinitis and chronic urticaria. This prompted us that dermatophyte antigens may play an important role in the etiology of allergic diseases.ObjectiveThe purposes of this study were to investigate the severity and quality of Life in Chronic Urticaria by using the Urticaria Activity Score(UAS) and Dermatology Life Quality Index (DLQI). And the second part of this study aimed to prepare dermatophyte antigens including Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum and compare the positive rate of dermatophyte antigens in patients with superficial mycoses and patients with chronic urticaria.MethodsOne hundred and fifty-two CU patients were recruited, we design the questionnaire and assess patients with UAS and DLQI to analyze the main factors influencing the quality of life. According to the history of allergy and fungi infection 402 patients were divided into 4 groups:1) atopy plus mycosis; 2) mycosis; 3) atopy; 4) no atopy, no mycosis. And then carried out the Prick Skin Test of dermatophyte antigens and compared the positive rate of SPT of the four groups.ResultsChronic urticaria is a chronic and recurrent skin disease, affect the quality of life widely. The results of this study indicate that the severity of chronic urticaria has nothing to do with sex, age and course of disease. The score of DLQI consists of 6 domains:symptoms and feelings, daily activities, leisure, work/school, personal relationships and treatment, there were significant differences in different areas of the DLQI score, the most affected are the domain of the symptoms and feelings and daily activities. There was statistically significant difference (P< 0.05) in the positive rate of SPT to dermatophyte allergens of the four groups. Patients with active mycosis (groups 1 and 2) demonstrated significantly increased positivity of skin tests compared with patients without fungal infection (groups 3 and 4), There is no significant difference between group 1 and group 2 (P=0.11), We separate analyzed the patients with onychomycosis in group 1 and group 2. There were significant differences in the positive rate of SPT to dermatophyte allergens of group 1 and group 2, and then we found that the course of onychomycosis is longer than other parts of superfical fungi infection, The chronic urticaria patients with the long history of superfical fungi infection seem to be with the higher positive rate of skin prick.