Urticaria and Angioedema in Skin of Color

  • Uwe WollinaEmail author
  • Shyam B. Verma
  • Karalikkattil T. Ashique


Urticaria and angioedema are common multifactorial skin reactions. They occur worldwide with all age groups and classes of the population affected. The lifetime prevalence rate for all types of urticaria in Europe was found 8.8%; for chronic urticaria it has been estimated 1.8%, with a predominance of females [1, 2]. Exact data in skin of color are lacking. In Americans with Asian ancestry or Pacific Islanders, urticaria is among the five top dermatological diagnoses [3]. In elderly African-Americans, self-reported urticaria was noted in 4.9% [4]. A nationwide study from China analyzing chronic urticaria (n = 2710) showed that the most frequent was the idiopathic subtype (68.1%), followed by physical urticaria (29.3%). Females were more commonly affected than males [5].


  1. 1.
    Weller K, Altrichter S, Ardelean E, et al. Chronic urticaria. Prevalence, course, prognostic factors and impact. Hautarzt. 2010;61:750–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Zuberbier T, Balke M, Worm M, et al. Epidemiology of urticaria: a representative cross-sectional population survey. Clin Exp Dermatol. 2010;35:869–73.CrossRefPubMedGoogle Scholar
  3. 3.
    Davis SA, Narahari S, Feldman SR, et al. Top dermatologic conditions in patients of color: an analysis of nationally representative data. J Drugs Dermatol. 2012;11:466–73.PubMedGoogle Scholar
  4. 4.
    Caretti KL, Meregan DR, Mehregan DA. A survey of self-reported skin disease in the elderly African-American population. Int J Dermatol. 2015;54:1034–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Zhong H, Song Z, Chen W, et al. Chronic urticaria in Chinese population: a hospital-based multicenter epidemiological study. Allergy. 2014;69:359–64.CrossRefPubMedGoogle Scholar
  6. 6.
    Jo E-J, Yang M-S, Kim Y-J, et al. Food-dependent exercise-induced anaphylaxis occurred only in a warm but not a cold environment. Asia Pac Allergy. 2012;2:161–4.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Thalayasingam M, Allameen NA, Soh JY, et al. Wheat-dependent exercise-induced anaphylaxis: a retrospective case review from a tertiary hospital. Postgrad Med J. 2014;90:488–92.CrossRefPubMedGoogle Scholar
  8. 8.
    Ohsawa I, Honda D, Nagamachi S, et al. Clinical manifestations, diagnosis, and treatment of hereditary angioedema: survey data from 94 physicians in Japan. Ann Allergy Asthma Immunol. 2015;114:492–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Brown NJ, Ray WA, Snowden M, et al. Black Americans have an increased rate of angiotensin converting enzyme inhibitor-associated angioedema. Clin Pharmacol Ther. 1996;60:8–13.CrossRefPubMedGoogle Scholar
  10. 10.
    Pare G, Kubo M, Byrd JB, et al. Genetic variants associated with angiotensin-converting enzyme inhibitor-associated angioedema. Pharmacogenet Genomics. 2013;23:470–8.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Moolani Y, Lynde C, Sussman G. Advances in understanding and managing chronic urticaria. F1000Res. 2016;5. pii: F1000 Faculty Rev-177.Google Scholar
  12. 12.
    Losol P, Yoo H-S, Park H-S. Molecular genetic mechanisms of chronic urticaria. Allergy Asthma Immunol Res. 2014;6:13–21.CrossRefPubMedGoogle Scholar
  13. 13.
    Peacock ME, Park DS, Swiec GD, et al. Perioral angioedema associated with angiotensin-converting enzyme inhibitor. J Peridontol. 2005;76:651–4.CrossRefGoogle Scholar
  14. 14.
    Kupfer Y, Ramachandran K, Tessler S. ACE inhibitor-induced angioedema in elderly African American females requiring tracheostomy. J Natl Med Assoc. 2010;102:529–30.CrossRefPubMedGoogle Scholar
  15. 15.
    Moholisa RR, Rayner BR, Owen EP, et al. Association of B2 receptor polymorphism and ACE activity with ACE inhibitor-induced angioedema in black and mixed-race south Africans. J Clin Hypertens. 2013;15:413–9.CrossRefGoogle Scholar
  16. 16.
    Berhe DF, Juhlin K, Star K, et al. Adverse drug reaction reports for cardiometabolic drugs from sub-Saharan Africa: a study in VigiBase. Tropical Med Int Health. 2015;20:797–806.CrossRefGoogle Scholar
  17. 17.
    Aiavi AAL, Adiqun AQ. Angioedema and cough in Nigerian patients receiving ACE inhibitors. Br J Clin Pharmacol. 2000;50:81–2.Google Scholar
  18. 18.
    Doshi K, Yegnanarayan R, Gokhale N. A retrospective study of drug induced cutaneous adverse reactions (CADR) in patients attending tertiary care hospital. Curr Drug Saf. 2017;12:46–50.Google Scholar
  19. 19.
    Thong BYH, Cheng YK, Leong KP, et al. Immediate food hypersensitivity among adults attending a clinical immunology/allergy centre in Singapore. Singap Med J. 2007;48:236–40.Google Scholar
  20. 20.
    Sheikh F, Amin R, Rehan Khaliq AM, et al. First study of pattern of anaphylaxis in a large tertiary care hospital in Saudi Arabia. Asia Pac Allergy. 2015;5:216–21.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Suwankesawong W, Saokaew S, Permsuwan U, et al. Characterization of hypersensitivity reactions reported among Andrographis paniculata users in Thailand using health Product Vigilance Center (HPVC) database. BMC Complement Altern Med. 2014;14:515.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Ali S, Fisher M, Juckett G. The African eye worm: a case report and review. J Travel Med. 2008;15:50–2.CrossRefPubMedGoogle Scholar
  23. 23.
    Xu YY, Jiang Y, Zhi YX, et al. Clinical features of hereditary angioedema in Chinese patients: new findings and differences from other populations. Eur J Dermatol. 2013;23:500–4.PubMedGoogle Scholar
  24. 24.
    Khieu V, Srey S, Schär F, et al. Strongyloides stercoralis is a cause of abdominal pain, diarrhea and urticaria in rural Cambodia. BMC Res Notes. 2013;6:200.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Olson BG, Domachowske JB. Mazzoti reaction after presumptive treatment for schistosomiasis and stronglyloidiasis in a Liberian refugee. Pediatr Infect Dis. 2006;25:466–8.CrossRefGoogle Scholar
  26. 26.
    Choi S-J, Lee J-C, Kim M-J, et al. The clinical characteristics of Anisakis allergy in Korea. Korean J Intern Med. 2009;24:160–3.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Deshwal R. Clinical and laboratory profile of hospitalized malarial patients: an Agra-based study. J Assoc Physicians India. 2016;64:44–7.PubMedGoogle Scholar
  28. 28.
    Schoepke N, Church MK, Maurer M. The inhibition by levocetirizine and fexofenadine of the histamine-induced wheal and flare response in healthy Caucasians and Japanese volunteers. Acta Derm Venereol. 2013;93:286–93.CrossRefPubMedGoogle Scholar
  29. 29.
    Fine LM, Bernstein JA. Guideline of chronic urticaria. Allergy Asthma Immunol Res. 2016;8:396–403.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Rajesh G, Keerthi S, Karthikeyan K, et al. Weekly injections of histaglobulin produces long-term remission in chronic urticaria: a prospective clinical trial. Indian J Pharm. 2016;48:292–7.CrossRefGoogle Scholar
  31. 31.
    Curtis RM, Felder S, Borici-Mazi R, et al. ACE-I angioedema: accurate diagnosis may prevent epinephrine-induced harm. West J Emerg Med. 2016;17:283–9.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Lei W-T, Shyur S-D, Huang L-H, et al. Type I hereditary angioedema in Taiwan—clinical, biological features and genetic study. Asian Pac J Allergy Immunol. 2011;29:327–31.PubMedGoogle Scholar
  33. 33.
    Craig T, Pürsün EA, Bork K, Bowen T, Boysen H, Farkas H, Grumach A, Katelaris CH, Lockey R, Longhurst H, Lumry W, Magerl M, et al. WAO guideline for the management of hereditary angioedema. Arerugi. 2015;64:1215–41.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Uwe Wollina
    • 1
    Email author
  • Shyam B. Verma
    • 2
  • Karalikkattil T. Ashique
    • 3
  1. 1.Department of Dermatology and AllergologyHospital Dresden-Friedrichstadt, Teaching Hospital of the Technical University of DresdenDresdenGermany
  2. 2.Nirvana Skin ClinicVadodaraIndia
  3. 3.Department of DermatologyKims Alshifa HospitalMalappuramIndia

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