title: Urticarial dermatitis: clinical features, diagnostic evaluation, and etiologic associations in a series of 146 patients at Mayo Clinic (2006-2012).
abstract: 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).
  
  
  CONCLUSIONS
  This was a retrospective study.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Hannon
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota. Electronic address: wetter.david@mayo.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Wetter
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Division of Dermatopathology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Gibson
mesh_terms: D000046:Academic Medical Centers; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D015331:Cohort Studies; D015897:Comorbidity; D003872:Dermatitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D010328:Patch Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014581:Urticaria / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*
chemical_list: D000305:Adrenal Cortex Hormones; D006633:Histamine Antagonists
keywords: BP; DIF; UD; bullous pemphigoid; dermal hypersensitivity; dermatitis; direct immunofluorescence; eczema; hypersensitivity; malignancy; urticarial; urticarial dermatitis