关键词: 荨麻疹, 流行病学研究, 物理性荨麻疹, 组胺H1拮抗剂, 皮肤划痕症

Abstract: 【Abstract】 Objective To investigate clinical features and current treatment status of patients with physical urticaria （PU） in China. Methods A questionnaire survey was carried out in patients diagnosed with PU at the first visit at the Department of Dermatology of 12 tertiary hospitals in China from January to December 2019. Physicians filled out the survey questionnaires, which included demographic characteristics, pruritus intensity, the number of wheals, concomitant symptoms （such as pain in skin rashes, arthralgia, and fever）, subtypes of PU, treatment regimens, etc. Differences between groups were analyzed using one-way analysis of variance, Kruskal-Wallis test or chi-square test. Results Overall, 612 PU outpatients were enrolled, including 268 males and 344 females; they were aged 37.4 ± 16.4 years, their age at the onset was 35.1 ± 16.4 years, and the disease duration （M ［Q1, Q3］） was 0.50 （0.25, 2.00） years. Of these patients, 500 were diagnosed with symptomatic dermographism （SD）, 54 with heat contact urticaria （HCU）, 43 with cold contact urticaria （CCU）, and 15 with delayed pressure urticaria （DPU）. There were no significant differences in the gender distribution, age, age at onset, or disease duration among the 4 subtypes of PU patients （all P > 0.05）, but the proportions of patients with arthralgia, with eczema/dermatitis, and with elevated total serum IgE levels significantly differed among the 4 subtypes （all P < 0.05）. Concretely, the proportion of patients with arthralgia was significantly higher in the DPU group （4/15, 26.7%） than in the SD group （64/500, 12.8%）, HCU group （1/54, 1.9%）, and CCU group （5/43, 11.6%） （all P < 0.05）; the proportion of patients with eczema/dermatitis was significantly lower in the HCU group （2/54, 3.7%） than in the SD group （96/500, 19.2%）, CCU group （7/43, 16.3%）, and DPU group （3/15, 20.0%） （all P < 0.05）; the proportion of patients with elevated total serum IgE levels was significantly higher in the SD group （185/500, 37.0%） than in the HCU group （9/54, 16.7%）, CCU group （11/43,25.6%）, and DPU group （4/15, 26.7%） （all P < 0.05）. Among the PU patients, 307 （50.3%） chose dietary avoidance, and only 95 （15.5%）considered that the dietary avoidance was effective for the treatment of PU. At the initial visit, a single second-generation H1 antihistamine （sgAH） was prescribed in 271 cases （44.3%）, two or more sgAHs in combination were prescribed in 258 cases （42.2%）, and sgAHs were administered at double doses in 17 cases （2.7%）. Conclusion The PU patients were predominantly young and middle-aged adults, and PU frequently occurred in females; the clinical characteristics varied among the subtypes of PU.

Key words: Urticaria, Epidemiologic studies, Physical urticaria, Histamine H1 antagonists, Symptomatic dermatographism