Chronic Urticaria (For Professionals)

Chronic Urticaria (For Professionals)

Chronic urticaria is a clinical sign of wheals appearing for more than 6 weeks.

Numerous causes are identified and sometimes and auto-immune condition is found.

If no cause is found which ranges from 25% to 75% of cases, autologous serum skin testing can be done, followed by dosing of anti-FCeRI antibodies can be done:

-firstly intradermal injection of autologous serum (ASST) is done as a screening test. This test is positive in 40 to50% of patients with chronic urticaria.

-The more complex tests (ELISA, western blot) are done to detect the antibody.

These tests have two reasons

-they offer a specific pathogenetic explanation…

-…and in the future a specific immunomodulatory inhibitory effect on histamine receptor stimulation could be found.

Treatment is limited in most cases to anti-H1 and anti-H2 antihistaminics but some forms of chronic urticaria can be treated by the following:

-cryptoheptadine for acquired cold urticaria

-steroids and NSAIDS for delayed pressure urticaria

-hydroxychloroquine in some cases of hypocomplementaemic urticarial vasculitis

-attenuated androgens such as stanozol and danazol for hereditary angiodema.

–omalizumab (Xolair) as a subcutaneous injection.

This advice is for informational purposes  only and does not replace therapeutic judgement done by a skin doctor.