title: Approach to therapy in chronic urticaria: when benadryl is not enough.
abstract: Chronic urticaria is a relatively common disorder in which its management often presents a difficult clinical challenge. Histamine antagonists are the mainstays of therapy, and the second-generation antihistamines offer an attractive combination of efficacy, convenience, and lack of side effects. For patients whose symptoms are not controlled by once daily second-generation antihistamines, adjunct therapy with first generation H1-antihistamines, H2-antihistamines, doxepin, or leukotriene modifiers may be effective. Short-term systemic corticosteroids are useful for acute symptom flares but should not be used chronically. For chronically unremitting disease, immunomodulatory agents such as low-dose oral cyclosporine often are useful.
authors.affiliation: University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Tilles
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002908:Chronic Disease; D004155:Diphenhydramine / Q000627:therapeutic use*; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D014581:Urticaria / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000929:Antidepressive Agents, Tricyclic; D006634:Histamine H1 Antagonists; D007155:Immunologic Factors; D004155:Diphenhydramine