URTICARIA AND MECHANICAL ANGIONEUROTIC-ED EMA

Urticaria and mechanical angioneurotic oedema correspond to three enti ties among the physical urticarias : dermographism in its various clin ical forms, delayed pressure-induced urticaria, vibratory angioneuroti c oedema. The authors propose a review of the literature of the variou s manifestations of this disease, discussing its clinical, histologica l, pathogenic and therapeutic aspects, in the light of their own perso nal experience. Simple dermographism contrasts with pathological pruri ginous dermographism. but the two conditions are often difficult to di stinguish. The diagnosis of dermographism is generally easy to establi sh on the basis of the clinical interview and a stimulation test by sc ratching the skin with a blunt stylet or dermographometer. Delayed pre ssure-induced urticaria is more difficult to diagnose, particularly wh en physical stimulation tests are net systematically performed in the investigation of chronic urticaria. Its pathogenesis has not yet been clearly elucidated despite current research in the field cytokines and adhesion molecules. No treatment has been demonstrated to be clearly effective (antihistaminics, topical or systemic corticosteroids, non-s teroidal anti-inflammatory drugs). Vibratory angioneurotic oedema rema ins an exceptional entity which resembles delayed pressure-induced urt icaria in many ways.