Clinical evaluation and treatment of chronic urticaria.
Chronic urticaria is a common disease characterized by recurrent pruritic wheals with surrounding erythema for >6 weeks. It is associated with a significant health care burden and affects patient quality of life. The etiology of chronic urticaria is often difficult to elucidate; however, known etiologies include autoimmune urticaria, physical urticarias (eg, cold, cholinergic, and delayed pressure urticaria), and idiopathic urticaria. The etiology is unknown in many patients, leading to a diagnosis of chronic idiopathic urticaria. The diagnosis of chronic idiopathic urticaria can be challenging for the primary care physician because of the disease's chronic symptoms. Diagnosis requires a detailed patient history and comprehensive physical examination, with additional testing tailored to the patient's history. Effective treatments include antihistamines, leukotriene receptor antagonists in combination with antihistamines, and oral immunomodulatory drugs, including corticosteroids, cyclosporine, dapsone, hydroxychloroquine, and sulfasalazine. Newer experimental therapies include intravenous immunoglobulin and omalizumab. This article reviews the pathophysiology, diagnosis, and treatment of chronic urticaria.
Fonacier
Luz
L
Winthrop University Hospital, Mineola, NY 11501, USA. LFonacier@Winthrop.org
Aquino
Marcella
M
Kim
Bora
B
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D012307:Risk Factors; D014581:Urticaria / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology
D000305:Adrenal Cortex Hormones; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D020024:Leukotriene Antagonists