Ann Dermatol.  2014 Feb;26(1):73-78. 10.5021/ad.2014.26.1.73.

A Case Series Study of Eighty-Five Chronic Spontaneous Urticaria Patients Referred to a Tertiary Care Center

• Kibsgaard
• Lefevre AC
• Deleuran M
• Vestergaard C

• KMID: 2265700
• DOI: http://doi.org/10.5021/ad.2014.26.1.73

Abstract

BACKGROUND
Chronic spontaneous urticaria is a debilitating disease for the patients and often considered by the doctors a very difficult disease to treat. In 2009 the European Academy of Allergy and Clinical Immunology/Global Allergy and Asthma European network/European Dermatology Forum/World Allergy Organization (EAACI/GA2LEN/EDF/WAO) published a revised version of the guidelines for the treatment of urticaria which included an algorithm for the treatment.
OBJECTIVE
The objective of this study was to examine the clinical effect and the practical use of the algorithm.
METHODS
The study was performed as a case-series study of all newly referred patients to our urticaria clinic over a period of 18 months.
RESULTS
Our results show that the single most important and efficient treatment of urticaria patients is up dosing non-sedating antihistamines as recommended by the EAACI/GA2LEN/EDF/WAO guidelines. We did not find any predicting factors for responders to the antihistamine treatment, but about one third of the patients did not respond to the up-dosing of the antihistamines.
CONCLUSION
Antihistamines seems to be the most efficient treatment for urticaria; other treatments such as montelukast, azathioprine, and mycophenolate mofetil may also be used, but only in combination with antihistamines and only in the case of an independent antihistamines treatment failure. The EAACI/GA2LEN/EDF/WAO guideline for the treatment of urticaria offers an efficient and simple guidelines for the treatment of urticaria.

Keyword

Guideline; Treatment; Urticaria

MeSH Terms

Asthma
Azathioprine
Dermatology
Histamine Antagonists
Humans
Hypersensitivity
Tertiary Care Centers*
Tertiary Healthcare*
Treatment Failure
Urticaria*
Azathioprine
Histamine Antagonists

Figure

• 

  Fig. 1 The treatment algorithm for urticaria adapted from the European Academy of Allergy and Clinical Immunology/Global Allergy and Asthma European network/European Dermatology Forum/World Allergy Organization (EAACI/GA2LEN/EDF/WAO) guidelines. The algorithm used in this study did not contain H2 blockers, and azathioprine was added.

• 

  Fig. 2 A flow chart of the patients registered in this study. The patients are subgrouped depending on the number of visits needed to obtain 'good effect'.

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