Chronic Urticaria: Following Practice Guidelines.
Chronic Urticaria: Following Practice Guidelines. Skin Therapy Lett. 2018 May;23(3):1-4 Authors: Westby EP, Lynde C, Sussman G Abstract Histamine is a key inflammatory player in the pathogenesis of urticaria, a mast-cell-driven disease characterized clinically by the development of wheals, angioedema, or both. Changes to the management of chronic spontaneous urticaria have recently been adopted due to increasing literature surrounding the efficacy and safety of up-dosing modern second-generation H1-antihistamines and the use of omalizamub, a biologic agent, as a third-line treatment. Given the prevalence of chronic urticaria and its impact on quality of life, this editorial aims to provide a summary of the proposed updated guidelines for the management of chronic urticaria as agreed upon at the 5th Consensus Conference on the Update and Revision of the EAACI/GA2LEN/EDF/WAO Guideline for Urticaria in Berlin in December 2016. The chronic urticaria treatment algorithm outlined here reflects the updates and revisions made by 43 international experts representing 40 societies from 25 countries. These guidelines have yet to be published and therefore will require approval by respective national and international boards before adoption. PMID: 29772036 [PubMed - in process]
Authors: Authried G, Prasad SC, Rasmussen ER, Bygum A Abstract Summary: A subset of patients with angioedema (AE) and urticaria has histamine releasing autoantibodies. The histamine release test (HR-test) has been used as a tool in chronic urticaria to define the autoimmune subgroup and may possibly guide the clinician to a more personalized therapy, like omalizumab and cyclosporine. The prevalence and value of positive histamine releasing autoantibodies in monosymptomatic AE is sparsely described in the literature. The purpose of this study was to report the prevalence of positive histamine releasing autoantibodie...
CONCLUSION: The mean annual angioedema admission rate was 72/100 000 and there was airway involvement in 38% of hospitalizations. PMID: 31703184 [PubMed - in process]
Conclusions and Relevance: Overlap in immune signaling pathways between AD and chronic pruritus, eczematous eruption of aging, allergic contact dermatitis, chronic hand eczema, alopecia areata, urticaria, eosinophilic annular erythema, bullous pemphigoid and papuloerythroderma of Ofuji make these conditions candidates for dupilumab therapy when standard treatments have failed or are contraindicated. While promising as a therapeutic option, off-label prescribing of dupilumab requires consideration of challenges in insurance authorization and out-of-pocket cost to the patient. PMID: 31693426 [PubMed - as supplied by publisher]
A 49-year-old Japanese female nursery teacher with no known medical history presented with fever, myalgia, and rash. Six days previously, fever, chill, and moderate pain in the bilateral thighs and lower back had developed, followed 3 days later by exanthema containing urticaria-like wheal, maculopapular rash, and lace-like rash at the bilateral lower limbs and left upper limb. Two days before presentation, the rash expanded to the abdomen. By the next day the rash and fever had alleviated but bilateral swelling of the fingers developed, and pain in the lower limbs and back persisted.
Conclusions: Plasma S100A8, S100A9, and S100A12 levels were elevated in CSU patients. They might be useful biomarkers of CSU, with the potential role in the pathogenesis of CSU.
Publication date: November–December 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 8Author(s): Emmanuelle Amsler, Angèle Soria, Marie-Sylvie Doutre, Urticaria Group (GUS) of French Dermatological Society
Publication date: November–December 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 8Author(s): Reynold M. Karr
Conclusions. Our preliminary findings support the high clinical specificity of BAT for AA diagnosis, suggesting implementing this method in a comprehensive diagnostic algorithm. PMID: 31668056 [PubMed - as supplied by publisher]
A 5-year-old girl with history of significant eczema, severe dog allergy (IgE>100), and anaphylactic allergy to egg and treenuts developed urticaria on her bilateral arms after preparing hamburger patties. No other ingredients, such as egg, were handled. She had previously tolerated cooked beef and had no history of milk allergy.
A 57-year-old female with HIV initially presented for evaluation of lower lip angioedema. Symptoms subjectively waxed and waned over 5-7 day periods but never completely resolved. She denied history of food/medication allergy, urticaria, pruritus, or contact allergy. She had regular HIV follow up and was compliant with antiretroviral therapy (ART). CD4+ lymphocyte counts since presentation ranged from 900-1400 cells/cmm.