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Clinical Report

Chronic Urticaria is Usually Associated with Fibromyalgia Syndrome

doi: 10.2340/00015555-0653

Abstract:

Although the pathophysiology of chronic urticaria is not fully understood, it is possible that dysfunctioning of peripheral cutaneous nerve fibres may be involved. It has also been suggested that fibromyalgia syndrome, a multi-symptomatic chronic pain condition, may be associated with alterations and dysfunctioning of peripheral cutaneous nerve fibres. The aim of this study was to determine whether patients with chronic urticaria are also affected by fibromyalgia syndrome. A total of 126 patients with chronic urticaria were investigated for fibromyalgia syndrome. An unexpectedly high proportion (over 70%) had fibromyalgia syndrome. The corresponding proportion for 50 control dermatological patients was 16%, which is higher than previously published data for the Italian general population (2.2%). It is possible that dysfunctional cutaneous nerve fibres of patients with fibromyalgia syndrome may release neuropeptides, which, in turn, may induce dermal microvessel dilatation and plasma extravasation. Furthermore, some neuropeptides may favour mast cell degranulation, which stimulates nerve endings, thus providing positive feedback. Chronic urticaria may thus be viewed in many patients, as a consequence of fibromyalgia syndrome; in fact, skin neuropathy (fibromyalgia syndrome) may trigger neurogenic skin inflammation (chronic urticaria).

Authors:

Claudio Torresani, Salvatore Bellafiore and Giuseppe De Panfilis

References

  • Soter NA, Kaplan AP. Urticaria and angioedema. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick’s dermatology in general medicine, 6th edn. New York: McGraw-Hill; 2003, p. 1129–1139.
  • Szolcsányi J. Capsaicin-sensitive sensory nerve terminals with local and systemic efferent functions: facts and scopes of an unorthodox neuroregulatory mechanism. Prog Brain Res 1996; 113: 343–359.
  • Steinhoff M, Ständer S, Seeliger S, Ansel JC, Schmelz M, Luger T. Modern aspects of cutaneous neurogenic inflammation. Arch Dermatol 2003; 139: 1479–1488.
  • Raap U, Kapp A. Neuroimmunological findings in allergic skin diseases. Curr Opin Allergy Clin Immunol 2005; 5: 419–424.
  • Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33: 160–172.
  • Clauw DJ. The pathogenesis of chronic pain and fatigue syndromes, with special reference to fibromyalgia. Med Hypotheses 1995; 44: 369–378.
  • Kim SH. Skin biopsy findings: Implications for the pathophysiology of fibromyalgia. Med Hypotheses 2007; 69: 141–144.
  • Martinez-Lavin M. Fibromyalgia is a neuropathic pain syndrome. J Rheumatol 2006; 33: 827–828.
  • Dworkin RH, Fields HL. Fibromyalgia from the perspective of neuropathic pain. J Rheumatol Suppl 2005; 75: 1–5.
  • Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. In: Merskey H, Bogduk N, editors. Task force on taxonomy of the IASP. 2nd edn. Seattle: IASP Press; 1994, p. 209–214.
  • Maggi CA. Tachykinins and calcitonin gene-related peptide (CGRP) as co-transmitters released from peripheral endings of sensory nerves. Prog Neurobiol 1995; 45: 1–98.
  • Littlejohn GO, Weinstein C, Helme RD. Increased neurogenic inflammation in fibrositis syndrome. J Reumathol 1987; 14: 1022–1025.
  • Enestrom S, Bengtsson A, Frodin T. Dermal IgG deposits and increase of mast cells in patients with fibromyalgia-relevant findings or epiphenomena? Scand J Rheumatol 1997; 26: 308–313.
  • Salemi S, Rethage J, Wollina U, Michel BA, Gay RE, Gay S, et al. Detection of interleukin 1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha in skin of patients with fibromyalgia. J Rheumatol 2003; 30: 146–150.
  • Kim SH, Kim D, Oh D. Characteristic changes of unmyelinated nerve fibers in the skin of patients with fibromyalgia. Arthritis Rheum 2006; 54: 126.
  • Salaffi F, De Angelis R, Grassi W. Marche Pain Prevalence; Investigation Group (MAPPING) study. Prevalence of musculoskeletal conditions in an Italian population sample: results of a regional community-based study. I. Clin Exp Rheumatol 2005; 23: 819–828.
  • Thune PO. The prevalence of fibromyalgia among patients with psoriasis. Acta Derm Venereol 2005; 85: 33–37.
  • Gräfe A, Wollina U, Tebbe B, Sprott H, Uhlemann C, Hein G. Fibromyalgia in lupus erythematosus. Acta Derm Venereol 1999; 79: 62–64.
  • Leznoff A, Josse RG, Denburg J, Dolovich J. Association of chronic urticaria and angioedema with thyroid autoimmunity. Arch Dermatol 1983; 119: 636–640.
  • Tong LJ, Balakrishnan G, Kochan JP, Kinet JP, Kaplan AP. Assesment of autoimmunity in patients with chronic urticaria. J Allergy Clin Immunol 1997; 99: 461–465.
  • Bazzichi L, Rossi A, Giuliano T, De Feo F, Giacomelli C, Consensi A, et al. Association between thyroid autoimmunity and fibromyalgic disease severity. Clin Rheumatol 2007; 26: 2115–2120.
  • Steinhoff M, Bienenstock J, Schmelz M, Maurer M, Wei E, Bíró T. Neurophysiological, neuroimmunological, and neuroendocrine basis of pruritus. J Invest Dermatol 2006; 126: 1705–1718.
  • Kim SH, Kim DH, Oh DH, Clauw DJ. Characteristic electron microscopic findings in the skin of patients with fibromyalgia: preliminary study. Clin Rheumatol 2008; 27: 219–223.
  • Wiesner-Menzel L, Schulz B, Vakilzadeh F, Czarnetzki BM. Electron microscopical evidence for a direct contact between nerve fibres and mast cells. Acta Derm Venereol 1981; 61: 465–469.
  • Furuno T, Ito A, Koma Y, Watabe K, Yokozaki H, Bienenstock J, et al. The spermatogenic Ig superfamily/synaptic cell adhesion molecule mast-cell adhesion molecule promotes interaction with nerves. J Immunol 2005; 174: 6934–6942.
  • Zuo Y, Perkins NM, Tracey DJ, Geczy CL. Inflammation and hyperalgesia induced by nerve injury in the rat: a key role of mast cells. Pain 2003; 105: 467–479.
  • Ito A, Oonuma J. Direct interaction between nerves and mast cells mediated by the SgIGSF/SynCAM adhesion molecule. J Pharmacol Sci 2006; 102: 1–5.
  • Ständer S, Steinhoff M, Schmelz M, Weisshaar E, Metze D, Luger T. Neurophysiology of pruritus: cutaneous elicitation of itch. Arch Dermatol 2003; 139: 1463–1470.
  • Moalem G, Tracey DJ. Immune and inflammatory mechanisms in neuropathic pain. Brain Res Rev 2006; 51: 240–264.
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    Volume 89, Issue 4

    DOI: 10.2340/00015555-0653

    Pages: 389-392

    View at PubMed