To the Editor.—
In answer to a question requesting clarification of the relationship between chronic urticaria and thyroid disease, MacKechnie1 described a case report and mentioned other cases of urticaria in thyrotoxicosis, emphasizing the rarity of the association. He did not point out that urticaria or pruritus may be so severe as to be the presenting complaint in patients with thyrotoxicosis.In 1971, Isaacs and I2 described six patients who presented because of chronic urticaria (four patients) or severe pruritus (two patients). The case of a 12-year-old girl, treated on several occasions with methimazole, was particularly instructive in that on several occasions she discontinued use of medication and each time had a recurrence of urticaria along with an exacerbation of hyperthyroidism; with the effective treatment of the thyrotoxicosis, the urticaria disappeared. A 61-year-old woman complained of weight loss, weakness, and mild pruritus for 24 months and consulted a
Ertel NH. Hyperthyroidism and Urticaria. JAMA. 1985;254(18):2553–2554. doi:10.1001/jama.1985.03360180051011
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