Even Tight Clothes Can Induce Physical Urticaria.

NEW YORK -- Something as simple as wearing tight-fitting clothes may trigger development of uncomfortable wheals in patients with physical urticaria, Dr. Sandra M. Gawchik reported at a conference sponsored by the International Society on Immunorehabilitation.

The physical urticarias comprise several clinically different conditions and account for about 18% of all cases of chronic urticaria, said Dr. Gawchik, who is in private practice in Chester, Pa.

Physical urticarias are classified by the responsible physical stimuli. They can be further classified as either acute or chronic. (See box.)

The discomfort associated with these conditions can be considerable and can have a great impact on the day-to-day life of the patient, Dr. Gawchik said.

Physicians can help patients by offering a clear explanation of the disease process. Understanding the role of the causative stimulus is key in helping patients make the lifestyle modifications necessary to avoid their triggers.

Dr. Gawchik emphasized the importance of taking a comprehensive history, followed by physical examination, rather than ordering a battery of laboratory tests. These are better saved for thoses cases in which underlying systemic disease is suspected.

Skin biopsy may be helpful in both diagnosis and treatment in patients with chronic urticaria, especially if lesions last more than 24 hours, Dr. Gawchik said at the conference also sponsored by the International Society on Immunopharmacology and the Immunology Research Institute of New England.