Chronic Urticaria – From Diagnose to Treatment

  • Ana Célia Costa Assistente Hospitalar Graduada de Imunoalergologia/Graduated Consultant of Immunoallergology ; Serviço de Imunoalergologia do Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Clínica Universitária de Imunoalergologia, Faculdade de Medicina de Lisboa, Portugal
  • Sofia Campina Assistente Hospitalar de Imunoalergologia/Consultant of Immunoallergology; Unidade de Imunoalergologia do Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal
  • Pedro Andrade Assistente Hospitalar de Dermatologia/ Consultant of Dermatology; Serviço de Dermatologia Hospital Pedro Hispano, ULS Matosinhos, Portugal
  • Paulo Filipe Assistente Hospitalar Graduado de Dermatologia/Graduated Consultant of Dermatology; Serviço de Dermatologia do Hospital de Santa Maria, Professor de Dermatologia e Venereologia da Clínica Universitária de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Portugal
  • Arminda Guilherme Assistente Hospitalar Graduada de Imunoalergologia/Graduated Consultant of Immunoallergology; Serviço de Imunoalergologiado Centro Hospitalar de Vila Nova de Gaia e Espinho, Portugal
  • Margarida Gonçalo Assistente Hospitalar Graduada Senior de Dermatologia/Consultant Chief of Dermatology; Serviço de Dermatologia, Centro Hospitalar e Universitário de Coimbra e Professora Auxiliar de Dermatologia/Assistant Professor of Dermatology da Faculdade de Medicina da Universidade de Coimbra, Portugal
Keywords: Chronic Disease, Cyclosporine, Histamine H1 Antagonists, Pruritus, Omalizumab, Urticaria

Abstract

Around 20% of the population suffers at least one urticaria episode, with 0.5 to 1% suffering from chronic urticaria. This disease has a mean duration of 1 to 5 years, and it has a higher incidence in women between 20 and 40 years old. Due to the publication in 2014 of the European guidelines for the management of urticaria, the authors performed a revision covering different aspects of chronic urticaria. Chronic urticaria is manly driven by the release of pro-inflammatory mediators from mast cells. It is characterized by the daily or almost daily appearance of transient itchy wheals and/or angioedema for more than 6 consecutive weeks. It is classified as either chronic spontaneous or inducible urticaria. Complementary diagnostic tests based on clinical history are recommended. An evidence-based symptomatic treatment includes as 1st line non-sedating 2nd generation anti- -histamines H1, which can be up dosed up to 4 times. Omalizumab and cyclosporine are 3rd line therapeutic options. Due to the highly negative impact on patients’ quality of life together with the costs associated with this disease, it is highly important to raise awareness within the medical community. A correct and early diagnosis, along with the appropriate and timely referral to specialized centers has the main purpose of total symptom control in the safest possible way.

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Published
2016-12-26
How to Cite
Costa, A. C., Campina, S., Andrade, P., Filipe, P., Guilherme, A., & Gonçalo, M. (2016). Chronic Urticaria – From Diagnose to Treatment. Journal of the Portuguese Society of Dermatology and Venereology, 74(4), 315-325. https://doi.org/10.29021/spdv.74.4.670
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Continuous Medica Education