Dysmenorrhea in Chronic Spontaneous Urticaria: A Subset of Patients Report Worsening and Partial Antihistamine Benefit: UCARE HURDLE ‐I Study
Makaleler > Tam Makale · 2025
Yazarlar: Murat Türk, Muhammed Burak Yücel, İnsu Yılmaz, Ragıp Ertaş, Ümit Murat Şahiner, Semra Demir, Aslı Gelincik, Derya Ünal, Şule Çelik Kamacı, Merve Hörmet İğde, Pelin Korkmaz, Zafer Türkoğlu, Nazlı Caf, Özge Sevil Karstarlı, Sevda Edis Çınar, Elif Açar, Elif Aktaş Yapıcı, Hatice Eylül Bozkurt Yılmaz, Serpil Köylüce, Özlem Su Küçük, Melisa Özay, Arzu Dilşat Zengin, Neslihan Demirel Öğüt, Simge Ünal, Deniz Özçeker, Güler Yıldırım, Aytül Zerrin Sin, Kasım Okan, Ragıp Fatih Kural, Ebru Damadoğlu, Hazal Kayıkçı, Sevim Bavbek, Erman Gıdık, Esen Özkaya, Yasemin Erdem, Bülent Enis Şekerel, Özge Uysal Soyer, Nadira Nabiyeva Çevik, Öner Özdemir, Ece Tüsüz Önata, Ümmügülsüm Dikici, Murat Borlu, Eda Öksüm Solak, Esra Adışen, Mehmet Gülengül, Rabia Öztaş Kara, Mustafa Tosun, Raif Coşkun, Marcus Maurer, Torsten Zuberbier, Emek Kocatürk
International Journal of Dermatology, Uluslararası, Wos, 2025, cilt 65, ss 1838-1845
DOI: 10.1111/ijd.70252
Özet
BACKGROUND: Histamine plays a central role in CSU pathogenesis and may contribute to extracutaneous symptoms such as dysmenorrhea, but this relationship has not been fully examined. METHODS: In this prospective, cross-sectional multicenter study, 425 female CSU patients and 370 age-matched controls were recruited from 19 UCARE centers in Türkiye. Dysmenorrhea prevalence and severity were assessed using a numerical scale and symptom scores. Histamine skin prick testing (SPT) was performed to evaluate histamine clearance capacity. Associations between dysmenorrhea, CSU phenotype, antihistamine use, and SPT kinetics were analyzed. RESULTS: The prevalence and severity of dysmenorrhea were comparable between CSU patients and controls (81.6% vs. 79.5%, p = 0.244). However, 95/418 (22.7%) of CSU patients reported increased menstrual pain following CSU onset, and 20/95 (21.1%) of these reported partial relief with antihistamines. CSU patients with worsened dysmenorrhea exhibited significantly shorter histamine SPT positivity durations than those without symptom change (35 vs. 45 min; p = 0.015). No correlation was observed between dysmenorrhea severity and total IgE, anti-TPO levels, or urticaria control/activity scores. A moderate negative correlation was found between UAS7 and elapsed time to histamine SPT negativity (r = -0.389, p < 0.001). CONCLUSIONS: Although overall prevalence and severity of dysmenorrhea were similar in CSU patients and healthy controls, about one in five patients with CSU experienced worsening menstrual pain after disease onset, and only a subset of these patients reported partial improvement with antihistamines. A distinct CSU subgroup with heightened menstrual pain may be characterized by altered histamine dynamics. Whether these patients may benefit from more intensive antihistamine treatment remains uncertain and requires confirmation in future studies; further studies should explore neuroimmune and hormonal mechanisms underlying this overlap.