Rashad Feddah
Ibraheem Banihameem
Anwar Farhan
Saeed Al-Ahmari
Fayeh Asiri
Hamad AL Fahaad
Wadha Alfarwan
Dr. Anwar Farhan, MD
Consultant dermatologist
King Khalid Hospital, Najran, Saudi Arabia
Tel: (Cell phone) +966 553044333
Email: anwarfarhan@yahoo.com
| Abstract Introduction: Urticaria (or hives) are a kind of skin rash notable for dark red, raised, itchy bumps.Chronic urticaria, defined as urticaria that persists for longer than 6 weeks, it is not a single disease but a reaction pattern that represents cutaneous mast cell degranulation, resulting in extravasation of plasma into the dermis and the patients may not improve or may depend on medication for years to relieve symptoms. chronic urticaria is one of the most common problems facing dermatologists and other specialities. It is the problem which bothers both the patient and the dermatologist. Traditionally, the approach in patients with chronic urticaria (when physical etiology has been excluded) has been to order a panel of laboratory tests to discover an occult medical condition responsible for the skin findings. In many patients, an extensive workup does not discover an etiology. Patients in whom no explanation for his urticaria are said to have chronic idiopathic urticaria. Various infectious agents have been reported as causes of urticaria, including Helicobacter pylori (H. pylori), which is a common worldwide bacterial infection. Its role in inducing allergic conditions, such as chronic urticaria, has been suggested in some reports and ignored in others. Aim : In our research, we want to look for the prevalence of Helicobacter pylori in the serum of patient who presented with chronic urticaria .The patient has endure treatment and is not cured besides partial treatment causes temporary relive of symptoms. So, it is important to make the right decisions regarding the treatment of chronic urticaria by adding triple therapy for those who are H.pylori positive. Subjects and Methods: This study is a non controlled , consecutive interventional study involving 60 patients during the period from November 2012 to April 2013 with history of urticarial lesions of > 6 weeks, to search for the possible cause of their chronic urticaria. Results: Among 60 patients suffering from chronic Urticaria only 40 (66.7%) patients were enrolled in the study with chronic idiopathic urticaria. 25 patients (62.5%) of chronic idiopathic urticaria were infected with H.pylori and 15 patients (37.5%) had negative serology for H.pylori. 80% of patients with positive H.pylori had G.I.T symptoms ,18 patients (72%) were achieved eradication with the first line therapy while 5 patients (20%) required the second line therapy for eradication. In 2 patients (8%) H.pyloripersisted despite two courses of eradication therapy. Response to eradication therapy was evident in 19 patients (76%) in whom H.pylori was eradicated while 4 patients (16%) showed no response despite eradication of H.pylori. Two patients (8%) with persistent H.pylori infection showed no improvement in the urticarial symptoms at the end of study period. Conclusion: The results of our study strongly suggest that H.pylori should be specifically tested in all patients of CIU, to identify subset of patients who are infected and who could benefit from eradication therapy. H.pylori should be included in the diagnostic work up of all patients with CIU. Key words : H.pylori, chronic idiopathic urticaria , chronic urticaria |
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