title: Aspirin-exacerbated cutaneous disease (AECD) is a distinct subphenotype of chronic spontaneous urticaria.
abstract: BACKGROUND
  A subset of patients with chronic spontaneous urticaria (CSU) experience disease exacerbations after receiving non-steroidal anti-inflammatory drugs (NSAIDs). This condition has been designated as Aspirin-Exacerbated Cutaneous Disease (AECD).
  
  
  OBJECTIVE
  The purpose of this study was twofold: (i) Investigate the demographic and clinical features of patients affected by AECD; (ii) To compare patients with AECD and NSAID-tolerant CSU patients for those characteristics.
  
  
  METHODS
  Patients with AECD and a group of unselected CSU patients tolerant to NSAIDs were studied. Demographic and clinical data were obtained by direct questioning and physical examination. Laboratory investigations and allergen skin prick tests were performed only in selected patients, as guided by the medical history.
  
  
  RESULTS
  Of 423 CSU patients admitted in the clinics, 52 (12.2%) had AECD. Compared with NSAID-tolerant CSU patients, AECD patients had significantly longer disease duration (57.7 ± 118.4 vs. 24.4 ± 36.6 months, P < 0.05), higher prevalence of angio-oedema (72.7 vs. 30.9%, P < 0.05) and atopy (83.8% vs. 58.4%, P < 0.05) and more frequent involvement of the face and upper respiratory tract (54.5% vs. 29.6%, P < 0.05).
  
  
  CONCLUSIONS
  AECD is a distinct phenotype that should be considered for inclusion as a separate subtype of chronic spontaneous urticaria.
authors.affiliation: Department of Allergy and Clinical Immunology, Clínica El Avila, Caracas, Venezuela; Department of Allergy and Clinical Immunology, Centro Médico Docente La Trinidad, Caracas, Venezuela.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Borges
authors.forename: F
authors.initials: F
authors.lastname: Caballero-Fonseca
authors.forename: A
authors.initials: A
authors.lastname: Capriles-Hulett
authors.forename: L
authors.initials: L
authors.lastname: González-Aveledo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000799:Angioedema / Q000139:chemically induced; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018450:Disease Progression; D003875:Drug Eruptions / Q000209:etiology*; D005148:Facial Dermatoses / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012140:Respiratory Tract Diseases / Q000139:chemically induced; D013997:Time Factors; D014581:Urticaria / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin