Aquagenic urticaria associated with anaphylaxis, urticarial vasculitis, skin ulcerations, and systemic lupus erythematosus: A rare case study

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
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Abstract

Aquagenic urticaria is a very rare form of physical urticaria with less than 50 cases reported in the medical literature. The condition causes itchy and potentially painful hives to break out whenever the sufferer comes into contact with water, sweat, or tears. A relationship between chronic urticaria and systemic lupus erythematosus (SLE) has been suggested in the literature. However, aquagenic urticaria has rarely been reported in association with other systemic conditions and is not typically a life-threatening condition. There are no documented cases of aquagenic urticaria occurring together with SLE or small vessel vasculitis, or presenting with cutaneous lesions more serious than urticaric wheals. This report presents a rare case of a 43-year-old African-American woman with aquagenic urticaria, who developed unusually painful skin ulcerations and life-threatening wheezing after contact with water, remained misdiagnosed for over five years, and, subsequently developed several serious comorbidities, including SLE. The case seems to suggest that aquagenic urticaria, urticarial vasculitis, and SLE may be related disorders that potentially developed along one spectrum of disease. As diagnosis of the condition is challenging and the use of water intraorally is essential to performing most dental procedures, the article aims to raise awareness of the condition among dentists and physicians and provides tips and suggestions to help manage patients with aquagenic urticaria more effectively.

伴有过敏性休克、荨麻疹性血管炎、皮肤溃疡和系统性红斑狼疮的水源性荨麻疹:罕见病例研究
水源性荨麻疹是一种非常罕见的物理性荨麻疹,医学文献中报道的病例不到 50 例。只要患者接触到水、汗液或泪液,就会出现瘙痒和潜在疼痛的荨麻疹。有文献认为慢性荨麻疹与系统性红斑狼疮(SLE)有关。不过,水源性荨麻疹与其他系统性疾病相关的报道很少,而且通常不会危及生命。目前还没有水原性荨麻疹与系统性红斑狼疮或小血管炎同时发生,或出现比荨麻疹性喘鸣更严重的皮肤损害的病例记录。本报告介绍了一例罕见病例,患者是一名 43 岁的非裔美国妇女,患有水原性荨麻疹,在接触水后出现异常疼痛的皮肤溃疡和危及生命的喘息,被误诊五年多,随后发展为包括系统性红斑狼疮在内的多种严重并发症。该病例似乎表明,水源性荨麻疹、荨麻疹性血管炎和系统性红斑狼疮可能是相关疾病,有可能沿着一个疾病谱发展。由于该病的诊断具有挑战性,而口腔内用水是进行大多数牙科手术的必要条件,因此这篇文章旨在提高牙医和医生对该病的认识,并提供提示和建议,以帮助更有效地管理水源性荨麻疹患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.80
自引率
0.00%
发文量
129
审稿时长
83 days
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