urticaria pelo calor

04/27-05/231

Rev. bras. alerg. imunopatol.
Copyright © 2004 by SBAI

RELATO DE CASO

Urticária pelo calor localizada associada à doença de Grover
Localized heat urticaria associated with Grover’s disease
Mario Geller*
Abstract
Objective: Physical urticarias are dermatosis with mast cell dysfunction, with decreased threshold for the release of the cytoplasmatic mediators of anaphylaxis, specially histamine. Localized heat urticaria is a very rare form of the physical urticarias. Grover’s disease is an uncommon modality of acantholysis. Both conditions are triggered by heat exposure and consequently may become associated with excessive sweating.
The quality of life impairment of patients with these atypical and infrequent disorders should be stressed.
Methods: We are reporting the first Brazilian case of localized heat urticaria and also the medical literature’s first description of its association with Grover’s disease. Immunopathologic and clinical diagnostic features are discussed.
Results: Localized heat urticaria in this patient was successfully controlled with the combination of antihistamines with heat induced tolerance in an incremental desensitization program. Grover’s disease improved but did not disappear with the use of oral and topical corticosteroids.
Conclusions: Localized heat urticaria can be well managed with the association of antihistamines and induced gradative thermal tolerance.

Resumo
Objetivo: As urticárias físicas são dermatoses com disfunção mastocitária, nas quais ocorre a diminuição do limiar para a liberação de mediadores citoplasmáticos da anafilaxia e, em especial a histamina. A urticária pelo calor localizada é uma urticária física muito rara. A doença de Grover é um exemplo incomum de dermatose acantolítica. Ambas entidades nosológicas estão associadas à exposição ao calor e potencialmente com maior sudorese. Há necessidade de se divulgar o comprometimento da qualidade de vida dos portadores