Urticarial dermatitis: clinical features, diagnostic evaluation, and etiologic associations in a series of 146 patients at Mayo Clinic (2006-2012).

BACKGROUND

Few studies have examined patients initially presenting with clinical features of urticarial dermatitis (UD).

OBJECTIVE

We sought to examine clinical and laboratory evaluations and final diagnoses of patients with clinical features of UD.

METHODS

This was a retrospective review of patients with UD seen at Mayo Clinic between 2006 and 2012, and formal review of available skin biopsy specimens to identify any patients who also met microscopic criteria for UD.

RESULTS

Of 146 patients with clinical features of UD (mean age at onset, 60 years), 88 (60%) were female. The most common final diagnoses were: UD (70 patients [48%]); dermatitis not otherwise specified (24 [16%]); urticaria (14 [10%]); drug reaction (9 [6%]); bullous pemphigoid (6 [4%]); atopic dermatitis (5 [3%]); and contact dermatitis (4 [3%]). Of 40 patients with clinical and microscopic features of UD, 46% (16 of 35) had no response to treatment, whereas 10% (4 of 40) had a newly diagnosed concurrent malignancy (within 4 months of UD onset).

LIMITATIONS: This was a retrospective study.

CONCLUSION

Clinical features of UD occur in various dermatologic diseases. Some patients with clinical and microscopic features of UD have associated malignancies. Further studies should assess optimal evaluation and management of UD.