Frequency Of Anti-inflammatory Related Cutaneous Manifestation In Patients With Aspirin-exacerbated Respiratory Disease (AERD)
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Mayra Coutinho Andrade, MD, Rosilane dos Reis Pacheco, MD, Mila Almeida, MD, Priscila Takejima, MD, Jorge Elias Kalil Filho, MD, PhD, Pedro Giavina-Bianchi, MD PhD FAAAAI, Rosana C. Agondi, MD, PhD
RATIONALE: Aspirin-exacerbated respiratory disease (AERD) is characterized by acute respiratory reactions after ingestion of aspirin. Cutaneous symptoms are not usually associated to AERD. The aim of this study was to assess cutaneous symptoms in AERD patients.

METHODS: A retrospective study of AERD patients in a tertiary center for Allergy and Clinical Immunology was performed. The inclusion criteria were as follows: (1) adults older than 18 years; (2) asthma gathered by a physician; (3) nasal polyps confirmed by computed tomography scan of the paranasal sinuses and/or nasal endoscopy; (4) aspirin/nonsteroidal anti-inflammatory drug (NSAID) sensitivity. We reviewed the medical record of those patients to assess which reported a history of an NSAID cutaneous reaction.

RESULTS: A total of 72 patients were assessed of those 77.8% were women, with a mean age of 55 years (SD 14 years) and the onset of symptoms, 30.4 years (SD 17.3 years). Twenty-four patients (33%) developed cutaneous manifestation. Of these, four patients (16.7%) had chronic urticaria (CU) and 75.0%, acute urticaria (AU). Two patients (8,3%) developed delayed cutaneous reaction after NSAID intake, that were Stevens-Johnson syndrome and exanthema. Most patients (75%) reacted with two or more different NSAIDs. The drugs most commonly involved with cutaneous reactions were pyrazolones (31.4%) and aspirin (27.5%).

CONCLUSIONS: This study showed that cutaneous symptoms were a frequent manifestation in AERD patients. The most common was AU and the drugs most commonly involved were pyrazolones and aspirin. Whether these are a part of the AERD spectrum or part of an anaphylactoid reaction needs clarifying and better definition.