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    1 OF 10

    Long-term management of chronic spontaneous urticaria with omalizumab.
    Clin Exp Dermatol 2017 Jun 25. Epub 2017 Jun 25.
    Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
    Background: Clinical trials have shown the efficacy of omalizumabs efficacy in refractory chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), but real-life management strategies are lacking.

    Aim: To assess the long-term efficacy and safety of omalizumab, and to identify predictive factors and optimum dosage regimens.

    Methods: This was a prospective study of 13 patients (11 women, 2 men) with severe CSU [weekly urticaria activity score (UAS7) > 28] resistant to anti-H1 antihistamines. Read More

    Review of Physical Urticarias and Testing Methods.
    Curr Allergy Asthma Rep 2017 Aug;17(8):51
    Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela.
    Purpose Of Review: This review aims to update the information available on the prevalence, clinical picture, diagnostic methods, and treatment of urticarias induced by external physical stimuli.

    Recent Findings: Physical urticarias are present in up to 5% of the general population, and in 10 to 50% of patients with chronic urticaria. Recent investigations have provided evidence that the presence of physical urticaria alone or when comorbid with chronic spontaneous urticaria is associated with a worse prognosis and duration. Read More

    Anaphylaxis following intralesional triamcinolone acetonide (Kenacort) injection.
    Asia Pac Allergy 2017 Apr 6;7(2):115-118. Epub 2017 Apr 6.
    Division of Allergy, Immunology and Rheumatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
    Intralesional triamcinolone acetonide injection is indicated for multiple skin conditions such as keloid scars, alopecia areata, and hypertrophic lichen planus. Immediate hypersensitivity reaction remains uncommon. We report on a 24-year-old woman who had received multiple intralesional injections with triamcinolone acetonide (Kenacort) plus lidocaine for keloid scar treatment without any reaction for the previous 10 years. Read More

    Follicular traction urticaria.
    An Bras Dermatol 2016 Sep-Oct;91(5 suppl 1):64-65
    Okmeydani Training and Research Hospital - Istanbul, Turkey.
    Inducible urticaria is a heterogeneous subgroup of chronic urticarias caused by a wide variety of environmental stimuli, such as exercise, cold, heat, pressure, sunlight, vibration, and water. A new term, follicular traction urticaria, was suggested as an unusual form of inducible urticarias. We report a patient who was diagnosed with follicular traction urticaria. Read More

    Delayed effort-induced swelling with myofasciitis and systemic manifestations: A so far unrecognized type of pressure-induced urticaria.
    Medicine (Baltimore) 2017 Feb;96(7):e6112
    Department of Dermatology, University Hospital of Strasbourg, Strasbourg, France.
    Diseases characterized by recurrent symptoms with prolonged intervals without any clinical manifestations can pose diagnostic difficulties. Some diagnoses will be obvious but other situations can be very challenging.To nosologically delineate a new entity characterized by recurrent flares of induration of the forearms and legs with swelling of the extremities accompanied by intense fatigue and variable other symptoms. Read More

    Cutaneous exposure to vesicant phosgene oxime: Acute effects on the skin and systemic toxicity.
    Toxicol Appl Pharmacol 2017 Feb 11;317:25-32. Epub 2017 Jan 11.
    Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
    Phosgene Oxime (CX), an urticant or nettle agent categorized as a vesicant, is a potential chemical warfare and terrorist weapon. Its exposure can result in widespread and devastating effects including high mortality due to its fast penetration and ability to cause immediate severe cutaneous injury. It is one of the least studied chemical warfare agents with no effective therapy available. Read More

    Acrally distributed dermatoses: Vascular dermatoses (purpura and vasculitis).
    Clin Dermatol 2017 Jan - Feb;35(1):68-80. Epub 2016 Sep 10.
    Department of Dermatology and Venereology, Tokuda Hospital Sofia, Sofia, Bulgaria.
    Purpuric lesions appear in acral distribution in a variety of conditions and often provide clues to the clinical diagnosis. Purpuric means "hemorrhagic"-that is, the lesions do not blanch from pressure. This review focuses on dermatoses that produce hemorrhagic lesions in acral distribution from the large groups of the vasculitic diseases and their mimics. Read More

    Prevalence of Inducible Urticaria in Patients with Chronic Spontaneous Urticaria: Associated Risk Factors.
    J Allergy Clin Immunol Pract 2017 Mar - Apr;5(2):464-470. Epub 2016 Nov 9.
    Group of Experimental and Clinical Allergy, IPS Universitaria, University of Antioquia, Medellín, Colombia.
    Background: Information on the prevalence of inducible urticaria (IU) in patients with chronic spontaneous urticaria (CSU) and the factors affecting this prevalence is scarce in the literature.

    Objectives: To estimate the frequency of IU in patients with CSU and to explore possible factors associated with CSU.

    Methods: Patients older than 12 years diagnosed with CSU and a control group with no history of urticaria were recruited from 2 different cities. Read More

    Comprehensive technical and patient-care optimization in the management of pediatric apheresis for peripheral blood stem cell harvesting.
    Transfus Apher Sci 2016 Dec 30;55(3):338-343. Epub 2016 Sep 30.
    Department of Pediatric Oncology, Fukushima Medical University, Fukushima, Japan.
    Background: Pediatric apheresis for peripheral blood stem cell transplantation should be carried out with due concern for low corporeal blood volume and vulnerability to hypocalcemia-related complications, hypovolemic shock, and hypervolemic cardiac overload.

    Study Design And Methods: We retrospectively investigated a total of 267 apheresis procedures from 1990 to 2013 on 93 children between 0 and 10 years old, including 89 patients and 4 healthy donors, with body weights of 6.3 to 44. Read More

    Omalizumab in the Treatment of Chronic Inducible Urticaria.
    Actas Dermosifiliogr 2017 Jun 5;108(5):423-431. Epub 2016 Oct 5.
    Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España.
    Omalizumab is a recombinant humanized monoclonal antibody that inhibits immunoglobulin E. It has been approved for the treatment of severe asthma and chronic spontaneous urticaria refractory to other treatments. Its use in the management of chronic inducible urticaria (a type triggered by certain stimuli) is still considered off-label, although this use has been discussed in some consensus papers. Read More

    Inducible urticaria: Case series and literature review.
    Biomedica 2016 Mar 3;36(1):10-21. Epub 2016 Mar 3.
    Grupo de Alergología Clínica y Experimental (GACE), IPS Universitaria, Universidad de Antioquia, Medellín, Colombia.
    Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. Read More

    Diagnostic utility of challenge procedures for physical urticaria/angioedema syndromes: a systematic review.
    Curr Opin Allergy Clin Immunol 2016 Oct;16(5):511-5
    aDepartment of Internal MedicinebDepartment of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA.
    Purpose Of Review: Physical urticaria/angioedema syndromes (PUAs) are commonly encountered. They are identified by a history of physical factors provoking cutaneous symptoms, and confirmed by provocation testing. Recent guidelines have recommended use of challenge procedures for diagnosis; however, their positive/negative likelihood ratios have not been established. Read More

    Autoreactive IgE in Chronic Spontaneous/Idiopathic Urticaria and Basophil/Mastocyte Priming Phenomenon, as a Feature of Autoimmune Nature of the Syndrome.
    Arch Immunol Ther Exp (Warsz) 2017 Apr 31;65(2):137-143. Epub 2016 Aug 31.
    Department of Internal Medicine and Allergy, Wroclaw Medical University, Curie-Skłodowskiej 66, 50-367, Wrocław, Poland.
    Recent years of research have shed a new light on the role of IgE in immune reactions. It seems to be more than just a contribution to immediate type of allergic response. It appears that monomeric IgE may enhance mast cell activity without cross-linking of FcεRI by IgE specific allergen or autoreactive IgG anti-IgE antibodies. Read More

    A regional approach to unmet needs in anaphylaxis.
    Eur Ann Allergy Clin Immunol 2016 May;48(3):88-93
    Emergency Department, Saint Paul Hospital, Savona, Italy.
    Allergic diseases are under-diagnosed and undertreated despite their wide prevalence, and particularly anaphylaxis is often under-estimated. Evidence-based anaphylaxis guidelines developed by principal allergy organizations agree on increased prevalence of anaphylaxis, especially in patients younger than 18 years (18-27,30): this trend highlights the need for actions on anaphylaxis management and prevention (3,4). Lack of prompt connection between emergency department and allergy unit after discharge, and of a dedicated ICD-9th identification code (18-26), can delay diagnosis and treatment of anaphylaxis (28,29). Read More

    Delayed pressure urticaria treated with the selective serotonin reuptake inhibitor escitalopram.
    Clin Exp Dermatol 2016 Jul 2;41(5):526-8. Epub 2016 Apr 2.
    Department of Psychiatry, Lovisenberg Diakonale Hospital, Oslo, Norway.
    There is increasing evidence of platelet activation and systemic inflammation in chronic spontaneous urticaria and delayed pressure urticaria (DPU). Inflammation may be central to understanding the high comorbidity of depression and anxiety in patients with chronic urticaria (CU). We report a case of DPU and depression in a patient, which responded favourably to treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram. Read More

    Combined Angiotensin Receptor Antagonism and Neprilysin Inhibition.
    Circulation 2016 Mar;133(11):1115-24
    From Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
    Heart failure affects ≈5.7 million people in the United States alone. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone antagonists have improved mortality in patients with heart failure and reduced ejection fraction, but mortality remains high. Read More

    Effective treatment of different phenotypes of chronic urticaria with omalizumab: Case reports and review of literature.
    Int J Immunopathol Pharmacol 2016 Jun 4;29(2):320-8. Epub 2016 Jan 4.
    Department of Internal Diseases, Dermatology and Allergology in Zabrze, SMDZ in Zabrze, Medical University of Silesia in Katowice, Poland.
    Despite the excellent efficacy and safety profile of omalizumab in chronic spontaneous urticaria (CSU), there are scarce data concerning its role in the treatment of refractory cases with different phenotypes of urticaria. We describe our experience with the therapy of nine patients with CSU co-existing with delayed pressure urticaria (DPU) or angioedema or both and refractory to treatment with high-dose antihistamines. The first patient, with severe CSU and recurrent angioedema, did not respond well to cyclosporine A or corticosteroids and suffered from numerous side effects of long-term corticosteroid therapy. Read More

    Cetirizine Quantification by High-Performance Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS).
    Methods Mol Biol 2016 ;1383:115-20
    Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA.
    A multiple reaction monitoring (MRM), positive ion electrospray ionization, LC/MS/MS method is described for the quantification of cetirizine. The compound was isolated from human plasma by protein precipitation using acetonitrile. Cetirizine d4 was used as an internal standard. Read More

    An Unusual Allergic Response to Orthodontic Treatment.
    Dent Update 2015 Jul-Aug;42(6):580-2
    This paper describes a case of a 13-year-old patient with a systemic hypersensitivity reaction to orthodontic treatment. Her allergy was investigated resulting in a provisional diagnosis of pressure urticaria. The aetiology, diagnosis and clinical management of allergic reactions to dental procedures are discussed. Read More

    The effects of the El Niño Southern Oscillation on skin and skin-related diseases: a message from the International Society of Dermatology Climate Change Task Force.
    Int J Dermatol 2015 Dec 15;54(12):1343-51. Epub 2015 Oct 15.
    Division of Clinical Dermatology, Mayo Clinic, Rochester, MN, USA.
    The El Niño Southern Oscillation (ENSO) is a complex climate phenomenon occurring in the Pacific Ocean at intervals of 2-7 years. The term refers to fluctuations in ocean temperatures in the tropical eastern Pacific Ocean (El Niño [the warm phase of ENSO] and La Niña [the cool phase of ENSO]) and in atmospheric pressure across the Pacific basin (Southern Oscillation). This weather pattern is attributed with causing climate change in certain parts of the world and is associated with disease outbreaks. Read More

    Snoring-Induced Vibratory Angioedema.
    Am J Case Rep 2015 Oct 1;16:700-2. Epub 2015 Oct 1.
    Department of Internal Medicine, MidMichigan Medical Center, University of Michigan Health System, Midland, MI, USA.
    Background: Vibratory angioedema (VA) is a rare physical urticaria, with symptoms of itching and swelling of the skin or mucosa when it is exposed to vibration. Avoidance of vibration is the best way to manage this condition. This case report will assist physicians to diagnose this rare condition. Read More

    Neutrophilic Epitheliotropism is a Histopathological Clue to Neutrophilic Urticarial Dermatosis.
    Am J Dermatopathol 2016 Jan;38(1):39-49
    *Department of Dermatology, University of Münster, Münster, Germany; †Dermatopathology Laboratory, Dermatologikum, Hamburg, Germany; ‡Department of Dermatology, University of Zürich, Zürich, Switzerland; and §Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
    Background: Neutrophilic urticarial dermatosis (NUD) comprises a particular autoinflammatory condition within the spectrum of aseptic neutrophilic dermatoses characterized by a distinct urticarial eruption clinically and a neutrophilic dermatosis histopathologically.

    Objective: In this study, we reviewed skin biopsies of lesional skin of patients seen in our outpatient clinic for autoimmune dermatoses and in allergy department from 1982 to 2014 that fulfilled these criteria.

    Methods: A total of 77 biopsies from 50 patients were analyzed histopathologically. Read More

    Deep Hypothermic Circulatory Arrest in a Patient With Cold-Induced Urticaria.
    Ann Thorac Surg 2015 Aug;100(2):722-3
    Department of Pathology, Clinical Immunology Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
    Acquired cold urticaria is a condition characterized by the onset of pruritic hives, swelling, and occasional severe systemic reactions, during the rewarming phase, after cold exposure. Pulmonary thromboendarterectomy (PTE) is a cardiac surgical procedure where organized thrombus is excised from the pulmonary vasculature in order to improve pulmonary blood flow and relieve pressure on the right ventricle. A PTE requires institution of deep hypothermic circulatory arrest (DHCA) in order to reduce blood flow from collateral vessels during thrombus excision. Read More

    Delayed pressure urticaria: response to treatment with sulfasalazine in a case series of seventeen patients.
    Dermatol Ther 2015 Sep-Oct;28(5):318-22. Epub 2015 Jul 2.
    Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines.
    We retrospectively identified 17 patients with delayed pressure urticaria (DPU), diagnosed by history and confirmed with provocative pressure testing. The average age in the cohort was 42.6 years with 10 women and seven men. Read More

    Management and treatment of chronic urticaria (CU).
    J Eur Acad Dermatol Venereol 2015 Jun;29 Suppl 3:16-32
    Allergy and Clinical Immunology Department, Centro Médico-Docente La Trinidad, Caracas, Venezuela.
    Developments increasing our understanding of chronic urticaria have resulted in the simplification and improvement of available treatments. Currently, many treatments target mast cell mediators, but we can now disrupt mast cell activation with the anti-IgE antibody omalizumab, which has markedly advanced the treatment landscape for patients with difficult-to-treat urticaria. Current guidelines provide a framework for the management and treatment of patients with CU but, as each patient is different, knowledge and experience of specialist dermatologists and allergists are key to effective pharmacotherapy. Read More

    Mast-cell interleukin-1β, neutrophil interleukin-17 and epidermal antimicrobial proteins in the neutrophilic urticarial dermatosis in Schnitzler's syndrome.
    Br J Dermatol 2015 Aug 20;173(2):448-56. Epub 2015 Jul 20.
    Department of Dermatology, Radboud University Medical Center, 6500 HB, Nijmegen, the Netherlands.
    Background: Schnitzler's syndrome (SchS) is an autoinflammatory disease characterized by a chronic urticarial rash, a monoclonal component and signs of systemic inflammation. Interleukin (IL)-1β is pivotal in the pathophysiology.

    Objectives: Here we investigated the cellular source of proinflammatory mediators in the skin of patients with SchS. Read More

    Analysis of circulating vascular endothelial growth factor and its soluble receptors in patients with different forms of chronic urticaria.
    Biomed Res Int 2015 10;2015:578383. Epub 2015 Feb 10.
    Chair and Clinical Department of Internal Diseases, Dermatology and Allergology, Ulica M. Curie-Skłodowskiej 10, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland.
    Background: Vascular endothelial growth factor (VEGF) is a powerful enhancer of vascular permeability and inflammatory response; however its significance in chronic urticaria is poorly recognised.

    Aim: To compare free circulating levels of VEGF and its soluble receptors (sVEGFR1 and VEGFR2) in patients with different forms of chronic urticaria.

    Methods: The concentrations of VEGF and its receptors in plateletpoor plasma (PPP)/plasma were measured using enzyme-linked immunosorbent assay in chronic urticaria: (1) chronic spontaneous urticaria (CSU) with positive autologous serum skin test (ASST), (2) CSU with negative response to ASST, (3) CSU with concomitant euthyroid Hashimoto's thyroiditis (CSU/Hashimoto), (4) delayed pressure urticaria (DPU), and the healthy subjects. Read More

    [Unilateral periocular angioedema after application of contrast agent].
    Ophthalmologe 2015 Oct;112(10):854-6
    Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
    This article presents a case report of unilateral, periocular angioedema after intravenous application of a contrast agent with a temporary increase of intraocular pressure in an eye in which trabeculectomy had been carried out 5 weeks previously. Read More

    [An uncommon cause of delayed walking: idiopathic palmoplantar hidradenitis].
    Arch Pediatr 2015 Mar 27;22(3):306-8. Epub 2015 Jan 27.
    Service de pédiatrie, CHU Mohamed VI, Marrakech, Maroc.
    Introduction: Idiopathic palmoplantar hidradenitis is an uncommon neutrophilic dermatosis, occurring in children and young adults. Its pathogenesis is incompletely understood. It is characterized by spontaneous resolution, but it can relapse in 50% of cases. Read More

    [Angioedema and urticaria].
    Ann Dermatol Venereol 2014 Nov;141 Suppl 3:S586-95
    Centre national de référence des angioedèmes (CREAK), CHU de Grenoble, Hôpital Nord, Boulevard de la Chantourne, 38700 La Tronche, France; Clinique universitaire de médecine interne, Pôle pluridisciplinaire de médecine, CHU de Grenoble - Hôpital Albert Michallon, BP 217, Boulevard de la Chantourne, 38043 Grenoble cedex 9, France.
    Angiœdema (AE) is the clinical expression of urticaria (U) which occurs when urticaria is located within the subcutis. It is a syndrome characterized by a sudden and limited subcutaneous and/or submucous swelling. The updated classification of urticaria distinguishes acute and chronic urticaria. Read More

    Validation of a simplified provocation instrument for diagnosis and threshold testing of symptomatic dermographism.
    Clin Exp Dermatol 2015 Jun 18;40(4):399-403. Epub 2014 Dec 18.
    Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    Background: Symptomatic dermographism is a common urticarial condition, which requires determination of provocation thresholds to confirm diagnosis and allow physicians to individualize management and therapy for optimal control of symptoms. To determine provocation thresholds, we have developed a provocation test device, the FricTest(®) 4.0. Read More

    Dissociation between history and challenge in patients with physical urticaria.
    J Allergy Clin Immunol Pract 2014 Nov-Dec;2(6):786-90. Epub 2014 Sep 8.
    Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
    Background: Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus.

    Objective: To evaluate the consistency between a history of physical urticaria and results of challenge testing.

    Methods: Seventy-six subjects, ages 3 to 77 years old, were referred with the diagnosis of a physical urticaria and were evaluated by using challenge testing directed toward the presenting diagnosis, yet included other stimuli based on history. Read More

    [Exercise-induced urticaria and angioedema - case report].
    Pneumonol Alergol Pol 2014 ;82(5):467-71
    Oddział Kliniczny Interny Dziecięcej i Alergologii, Wojewódzki Szpital Specjalistyczny im. Mikołaja Kopernika w Łodzi.
    Urticaria is a heterogeneous group of disorders, with various clinical manifestations and intensity of symptoms. Urticaria can be induced with a wide variety of environmental stimuli, such as cold, pressure, vibration, sunlight, exercise, temperature changes, heat, and water. In a select group of patients, exercise can induce a spectrum of urticaria symptoms, ranging from cutaneous pruritus and warmth, generalised urticaria, angioedema, and the appearance of such additional manifestations as collapse, upper respiratory distress, and anaphylaxis. Read More

    Angiotensin-converting enzyme inhibitor-induced angioedema.
    Am J Med 2015 Feb 21;128(2):120-5. Epub 2014 Jul 21.
    Departments of Medicine B, Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel. Electronic address:
    Angiotensin-converting enzyme inhibitors (ACE-I) are widely used, effective, and well-tolerated antihypertensive agents. The mechanisms by which those agents act can cause side effects such as decreased blood pressure, hyperkalemia, and impaired renal function. ACE-I can induce cough in 5%-35% and angioedema in up to 0. Read More

    [Suspected allergy to a local anaesthetic: how often is allergy proven?].
    Ned Tijdschr Geneeskd 2014 ;158:A7556
    St. Antonius Ziekenhuis, afd. Dermatologie, Nieuwegein.
    Objective: To determine the percentage of proven allergy for local anaesthetics (LA) in patients who were tested because of a clinical suspicion of LA allergy.

    Design: Retrospective multicentre case series.

    Method: All patients from two hospitals who were seen from 2004 through 2013 for a possible allergy to local anaesthetics. Read More

    Spontaneous giant splenic hydatid cyst rupture causing fatal anaphylactic shock: a case report and brief literature review.
    Turk J Gastroenterol 2014 Feb;25(1):88-91
    Department of General Surgery, Diyarbakır Education and Research Hospital, Diyarbakır, Turkey.
    Hydatid disease is a parasitic infection characterized by cyst formation in any organ, although the liver and lungs are most commonly involved. Hydatid disease of the spleen is uncommon, representing <8% of all human hydatid diseases. Splenic hydatid cysts usually coexist with liver hydatid cysts (secondary form), although the spleen is the primary location (primary form) in some cases. Read More

    [Urticaria in children attending allergy services].
    Rev Alerg Mex 2014 Apr-Jun;61(2):90-8
    Departamento de Alergología e Inmunología Clínica, Clínica El Ávila, 6a. transversal Urb. Altamira, piso 8, consultorio 803, Caracas 1060, Venezuela.
    Background: There is little information on urticaria occurring in children, especially in limited resource countries.

    Objective: To determine the demographic and clinical features of urticaria in children living in a developing country.

    Patients And Method: A prospective study was done in children from two allergy outpatient clinics were prospectively studied. Read More

    Therapy of chronic urticaria: a simple, modern approach.
    Ann Allergy Asthma Immunol 2014 May 20;112(5):419-25. Epub 2014 Mar 20.
    Division of Pulmonary, Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, South Carolina. Electronic address:
    Objective: To examine the available treatment choices for chronic spontaneous urticaria (CSU) and discuss a new paradigm for treating such patients.

    Data Sources: The literature regarding treatment is reviewed, including considerations of published guidelines. Attention is focused on the most recent evidence indicating particular efficacy of omalizumab. Read More

    [Omalizumab: therapeutic option in chronic spontaneous urticaria difficult to control with associated vasculitis, report of three cases].
    Biomedica 2013 Oct-Dec;33(4):503-12
    Cátedra de Alergología Clínica, Universidad de Antioquia, Medellín, Colombia.
    Introduction: Approximately 50% of chronic urticaria cases do not respond adequately to conventional doses of antihistamines, so a number of other therapeutic options have been suggested. Among these, omalizumab is an innovative tool, which now has high-quality evidence that supports its use in difficult cases, rapidly improving the symptom index and the use of medications with a good safety profile.

    Objective: To report three cases of adult women with spontaneous chronic urticaria with an evolution of more than eight years, which did not improve with high doses of antihistamines and leukotriene receptor blockers, associated with immunomodulatory therapy in which several etiologic mechanisms were combined: chronic spontaneous urticaria with autoimmune and pressure components, and vasculitis. Read More

    ACE inhibitor-induced angioedema.
    J Allergy Clin Immunol Pract 2013 Sep-Oct;1(5):442-5. Epub 2013 Aug 30.
    Department of Medicine, Thomas Jefferson University, Philadelphia, Pa.
    Angiotensin-converting enzyme inhibitors (ACEI) are commonly prescribed for blood pressure control and renal protection. ACEI angioedema is a common problem in patients who are taking ACEI, although, in most cases, the disorder is self-limited, and spontaneous episodes of apparently unprovoked angioedema stop with the discontinuation of the medication. In a subset of patients, hospitalization and even intubation are required for airway protection. Read More

    Retreatment with omalizumab results in rapid remission in chronic spontaneous and inducible urticaria.
    JAMA Dermatol 2014 Mar;150(3):288-90
    Department of Dermatology, Venerology, and Allergology, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    Importance: Omalizumab has emerged as a novel and effective treatment option for patients with antihistamine-resistant chronic urticaria. It is unclear whether patients with recurrent urticaria symptoms after discontinuation of omalizumab treatment can benefit from retreatment.

    Objective: To assess the response of patients with chronic urticaria who receive omalizumab retreatment. Read More

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