Indian Journal of Dermatology
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CORRESPONDENCE COLUMN
Year : 2006  |  Volume : 51  |  Issue : 2  |  Page : 153-154
Can worms cause chronic urticaria?


Shree Skin Centre, 22, L Market, Sector 8, Nerul, Navi Mumbai - 400 706, India

Correspondence Address:
K V Godse
Shree Skin Centre, 22, L Market, Sector 8, Nerul, Navi Mumbai - 400 706
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.26947

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How to cite this article:
Godse K V. Can worms cause chronic urticaria?. Indian J Dermatol 2006;51:153-4

How to cite this URL:
Godse K V. Can worms cause chronic urticaria?. Indian J Dermatol [serial online] 2006 [cited 2019 Dec 11];51:153-4. Available from: http://www.e-ijd.org/text.asp?2006/51/2/153/26947


Worms are often said to be associated with urticaria. This study was done to find whether this association is present or not. This study was done in Navi Mumbai township which is a new township near Mumbai. A complete blood cell count can be used as a baseline screening investigation in more severe urticaria. Blood eosinophilia should prompt stool examination for parasitic infestations, although this is a rare cause of chronic urticaria in developed countries.[1]

Fifty patients (30 females and 20 males) in the age group of 10 to 50 years with chronic urticaria of more than six weeks duration were included in this study. Patients with physical urticaria were not included in this study. Pregnant and lactating mothers were not included. Routine investigations like complete blood count, random blood sugar, urine and stool examination was done to find out presence of eosinophilia and worms in stool. Eosinophilia was found in twelve out of fifty patients. Stool examination showed eggs of Enterobius vermicularis in two and Ancylostoma duodenale in two and Giardia lamblia in one patient. Those patients having eosinophilia were asked to do repeat stool examination after two days. Repeat examination did not reveal positive findings. Wormicidal treatment in the form of 400mg of albendazole was offered to four patients with worms in stool. Giardia lamblia infestation was treated with metronidazole. Eosinophilia patients were advised 21 days of Diethyl carbamazine 300mg daily. All patients were on Cetirizine 10 to 20 mg daily for control of symptoms. Patients were followed for 4 weeks for symptoms score. Anti worm treatment did not improve urticaria in any patient. No patient could stop antihistaminics after completion of anti worm treatment.

A study from Italy found that a set of patients with allergic cutaneous diseases in whom the presence of intestinal parasites may not be incidental.[2] A wide variety of parasites, almost exclusively helminths, elicit eosinophilia; however, eosinophilia is not a constant feature of parasitic infections, and the absence of eosinophilia does not exclude the presence of a parasite.[3] Strongyloides stercoralis has been reported to cause urticarial like eruption of 65 years duration from Canada.[4]

Summarizing worms are not important cause of chronic urticaria in developing country like developed countries. Larger studies are required to confirm above findings.

 
   References Top

1.Grattan CE, Sabroe RA, Greaves MW. Chronic urticaria. J Am Acad Dermatol 2002;46:645-57.   Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Giacometti A, Cirioni O, Antonicelli L, D'Amato G, Silvestri C, Del Prete MS, et al . Prevalence of intestinal parasites among individuals with allergic skin diseases. J Parasitol 2003;89:490-2.  Back to cited text no. 2    
3.Fryatt RJ, Teng J, Harries AD, Siorvanes L, Hall AP. Intestinal helminthiasis in expatriates returning to Britain from the tropics: A controlled study. Trop Geogr Med 1990;42:119-22.   Back to cited text no. 3  [PUBMED]  
4.Leighton PM. Strongyloides stercoralis. The cause of an urticarial-like eruption of 65 years' duration. Arch Intern Med 1990;150:1747-8.  Back to cited text no. 4    



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