PATHOGENESIS OF URTICARIA

Abstract

The association of urticaria with stressful life situations has been observed by numerous authors,¹but there are few available data concerning the mechanisms involved. Grant, Pearson and Comeau,^1bwho studied the urticaria that occurs with exercise, warming of the body and "emotion," found that parasympathomimetic drugs produced urticaria in susceptible persons. Hopkins, Kesten and Hazel^1cconfirmed these observations. They inferred that urticaria in their patients represented an allergic reaction to acetylcholine released at nerve endings during the resulting vasodilatation. Lewis²demonstrated the importance of cutaneous vascular changes in the production of wheals. Accordingly, in our investigation measurements of blood vessel function were correlated with changes in the life situation, attitude and feeling state in 30 patients with chronic urticaria. Three procedures were employed: Life history material was correlated with the appearance and subsidence of symptoms; material thought to be symptom provoking was deliberately introduced during interviews