Open AccessJournal Article
Urticaria: evaluation and treatment.
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TLDR
Treatment includes avoidance of triggers, although these can be identified in only 10 to 20 percent of patients with chronic urticaria, and first-line pharmacotherapy is nonsedating second-generation antihistamines (histamine H1 blockers), which can be titrated to larger than standard doses.Abstract:
Urticaria involves intensely pruritic, raised wheals, with or without edema of the deeper cutis. It is usually a self-limited, benign reaction, but can be chronic. Rarely, it may represent serious systemic disease or a life-threatening allergic reaction. Urticaria has a lifetime prevalence of approximately 20 percent in the general population. It is caused by immunoglobulin E- and nonimmunoglobulin E-mediated mast cell and basophil release of histamine and other inflammatory mediators. Diagnosis is made clinically. Chronic urticaria is usually idiopathic and requires only a simple laboratory workup unless elements of the history or physical examination suggest specific underlying conditions. Treatment includes avoidance of triggers, although these can be identified in only 10 to 20 percent of patients with chronic urticaria. First-line pharmacotherapy for acute and chronic urticaria is nonsedating second-generation antihistamines (histamine H1 blockers), which can be titrated to larger than standard doses. First-generation antihistamines, histamine H2 blockers, leukotriene receptor antagonists, and brief corticosteroid bursts may be used as adjunctive treatment. More than one-half of patients with chronic urticaria will have resolution or improvement of symptoms within one year.read more
Citations
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Resource Use and Costs in an Insured Population of Patients with Chronic Idiopathic/Spontaneous Urticaria
TL;DR: This retrospective cross-sectional cohort study identified patients with CIU/CSU, estimated disease prevalence, comorbidities, and healthcare use (medications, office visits, emergency department visits, and hospitalizations) and costs (urticaria related and all cause).
Journal Article
Acute and Chronic Urticaria: Evaluation and Treatment
TL;DR: The mainstay of treatment is avoidance of triggers, if identified, and the first-line pharmacotherapy is second-generation H1 antihistamines, which can be titrated to greater than standard doses.
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Physical urticaria: Review on classification, triggers and management with special focus on prevalence including a meta-analysis.
TL;DR: The results suggest that PU is an important subset of CU and that physicians should be aware of this important condition in order to manage patients appropriately and to estimate the prevalence of PU in CU patients.
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Management of Pediatric Urticaria with Review of the Literature on Chronic Spontaneous Urticaria in Children
Moshe Ben-Shoshan,Clive Grattan +1 more
TL;DR: A systematic review of articles published in English and French on pediatric CSU management in the last 10 years highlights the efficacy of second-generation antihistamines for the treatment of CSU in children and supports the use of omalizumab for more severe cases.
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Mast Cells in the Skin: Defenders of Integrity or Offenders in Inflammation?
TL;DR: Focusing on the skin as the largest immune organ, both beneficial and detrimental functions of skin MCs are reviewed all the way from skin barrier integrity via host defense mechanisms to MC-driven inflammatory skin disorders and their role in sustained chronic skin inflammation and disease exacerbation.
References
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Journal ArticleDOI
EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria.
T. Zuberbier,Riccardo Asero,Carsten Bindslev-Jensen,G. Walter Canonica,Martin K. Church,Ana Giménez-Arnau,Clive Grattan,Alexander Kapp,Hans F. Merk,Barbara Rogala,Sarbjit S. Saini,Mario Sánchez-Borges,Peter Schmid-Grendelmeier,Holger J. Schünemann,Petra Staubach,Gino A. Vena,Bettina Wedi,Marcus Maurer +17 more
TL;DR: This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors, and pathomechanisms, and outlines evidence‐based diagnostic approaches for different subtypes ofUrticaria.
Journal ArticleDOI
EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria.
Torsten Zuberbier,Riccardo Asero,Carsten Bindslev-Jensen,G. Walter Canonica,Martin K. Church,Ana Giménez-Arnau,Clive Grattan,Alexander Kapp,Marcus Maurer,Hans F. Merk,Barbara Rogala,Sarbjit S. Saini,Mario Sánchez-Borges,Peter Schmid-Grendelmeier,Holger J. Schünemann,Petra Staubach,Gino A. Vena,Bettina Wedi +17 more
TL;DR: This guideline has a profound impact on the quality of life and effective treatment is, therefore, required and the recommended first line treatment is new generation, nonsedating H1‐antihistamines, and second‐line therapies should be added to the antihistamine treatment.
Journal ArticleDOI
EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria.
George N. Konstantinou,Riccardo Asero,Markus Maurer,R. A. Sabroe,Peter Schmid-Grendelmeier,Clive Grattan +5 more
TL;DR: Patients with chronic spontaneous urticaria are more likely to be associated with HLADR4, to have autoimmune thyroid disease, a more prolonged disease course and may be less responsive to H1‐antihistamine treatment than those with a negative ASST (ASST−) although more evidence is needed to confirm these observations conclusively.
Journal ArticleDOI
Natural course of physical and chronic urticaria and angioedema in 220 patients.
TL;DR: In general, the prognosis for spontaneous remission is reasonable, with the exception of the subgroup (33.2%) with physical urticaria.
Journal ArticleDOI
The Etiology of Different Forms of Urticaria in Childhood
TL;DR: Signs were found that infections were frequently associated with urticaria, which suggests that uricaria management should include a survey of certain infectious agents in addition to a detailed history.
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