Zusammenfassung
Mechanische und thermische Reize sowie elektromagnetische Wellen sind die Auslöser der verschiedenen Formen der physikalischen Urtikaria, die sich lokalisiert an Haut und Schleimhäuten oder auch generalisiert mit verschiedenen Begleitsymptomen manifestiert. Sie tritt überwiegend sporadisch, nur sehr selten familiär auf. Die physikalische Urtikaria kommt zwar als isolierte Erkrankung, häufig aber assoziiert mit der chronischen Urtikaria vor. Vielfach ist den Betroffenen der zeitliche und kausale Zusammenhang zwischen Auslöser und Reaktion geläufig, Formen mit stark verzögertem Auftreten werden aber manchmal erst durch entsprechende Provokationstestungen erkannt. Die klinische Bedeutung der physikalischen Urtikaria ergibt sich aus Untersuchungen, nach denen die Lebensqualität der Patienten deutlich stärker gemindert ist als bei anderen Formen der Urtikaria. Bei den meisten Formen der physikalischen Urtikaria besitzen wir nur lückenhafte Kenntnisse über die Pathophysiologie: Entzündungsreaktionen mit Beteiligung verschiedener Leukozytenarten, der Gefäße und Nerven spielen wohl eine wichtige Rolle.
Abstract
The different types of physical urticaria are triggered by mechanical and thermal stimuli, as well as electromagnetic waves. Localized forms restricted to the skin and mucous membranes are most common, but generalized urticaria with variable extracutaneous manifestations can also occur. Physical urticaria is usually sporadic but may rarely have a familial form; it is often associated with chronic urticaria. In most instances, the short time interval between the physical stimulus and reaction points to a causal relationship, but in delayed types the exact diagnosis may be missed without provocation tests. The clinical implication of physical urticaria is demonstrated by investigations showing a greater degree of disability in affected patients as compared to other types of urticaria. There is still an incomplete understanding of the crucial pathophysiological aspects; most likely inflammatory reactions involving leukocytes, endothelial cells and nerves stimulated by various mediators play an important role in this form of urticaria.
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Fleischer, M., Grabbe, J. Physikalische Urtikaria. Hautarzt 55, 344–349 (2004). https://doi.org/10.1007/s00105-004-0691-x
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DOI: https://doi.org/10.1007/s00105-004-0691-x