Office-based management of urticaria.
Urticaria is a common pruritic skin disorder that is often seen in the office and varies in severity and chronicity. The etiologic cause is frequently not identifiable. Urticaria may be associated with physical factors and triggers, including foods or medications. A significant percentage of patients with chronic urticaria have circulating autoantibodies directed toward immunoglobulin-E or the high-affinity receptor for immunoglobulin-E (FcepsilonRI), or have antithyroid antibodies that might play a role in the activation of the final common pathway in urticaria: mast cell activation and degranulation. Management begins with a careful investigation and elimination of eliciting factors when identified, followed by treatment of underlying disease. Antihistamines are the current mainstay of pharmacotherapy for urticaria, which provide symptomatic relief in most cases. In severe cases, corticosteroids, hydroxychloroquine sulfate (Plaquenil; Sanofi-Synthelabo, New York, NY), and immunosuppressive agents, including cyclosporin, are sometimes used by specialists.
Komarow
Hirsh D
HD
Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-1894, USA. komarowh@niaid.nih.gov
Metcalfe
Dean D
DD
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D004342:Drug Hypersensitivity; D005512:Food Hypersensitivity; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D014581:Urticaria / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D006634:Histamine H1 Antagonists; D007166:Immunosuppressive Agents; D020024:Leukotriene Antagonists