title: [Argentine guidelines for urticaria and angioedema].
abstract: This interdisciplinary paper summarizes the news in the diagnosis and treatment of chronic urticaria (CU), and provides concepts, definitions and evidence-based suggestions for its management. Urticaria occurs in at least 20% of the population at some point in their lives. Acute urticaria (less than 6 weeks' duration), differs from CU in its etiology, but the onset of this disease is always acute. CU may occur as spontaneous (SCU) or induced (ICU). The diagnosis is simple, although a careful evaluation is necessary for differential diagnosis. ICU's diagnosis is mainly clinical, even if provocation tests can be useful. Supplementary studies should be limited and based on the clinical suspicion. Treatment may be divided into three approaches: avoidance, elimination or treatment of the cause, and pharmacological treatment. Recently treatment has been modified with the use of second-generation antihistamines as first-line and increased doses of nonsedating H1 antihistamines, up to 4 times, as second line. Antihistamines are essential to treat CU; however, 40% of patients do not achieve good control despite increased doses and require additional treatment. The most recent evidence indicates a group of drugs to be used as third line in these cases, to improve quality of life and to limit toxicity from frequent or chronic use of systemic steroids. Only 3 drugs are recommended as third line: omalizumab, cyclosporin A or anti-leukotrienes.
authors.affiliation: 1Fundación CIDEA, Buenos Aires, 2 3 4 5 6 789, 1011Argentina.
authors.forename: Jorge
authors.initials: J
authors.lastname: Máspero
authors.affiliation: Cátedra de Dermatología, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
authors.forename: Hugo
authors.initials: H
authors.lastname: Cabrera
authors.affiliation: Facultad de Ciencias Médicas, Universidad Nacional de Rosario y Hospital Provincial del Centenario, Rosario, Santa Fe, Argentina.
authors.forename: Ledit
authors.initials: L
authors.lastname: Ardusso
authors.affiliation: Fundación CIDEA, Buenos Aires, Argentina.
authors.forename: Mónica
authors.initials: M
authors.lastname: De Gennaro
authors.affiliation: Cátedra de Dermatología, Universidad Nacional de Rosario y Hospital Provincial del Centenario, Rosario, Santa Fe, Argentina.
authors.forename: Ramón
authors.initials: R
authors.lastname: Fernández Bussy
authors.affiliation: Sanatorio Británico de Rosario, Santa Fe, Argentina.
authors.forename: José
authors.initials: J
authors.lastname: Galimany
authors.affiliation: Hospital Italiano de Buenos Aires, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Galimberti
authors.affiliation: Hospital Ramos Mejía, Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Label
authors.affiliation: Hospital Dr. J. M. Penna, Buenos Aires, Argentina.
authors.forename: Marta
authors.initials: M
authors.lastname: La Forgia
authors.affiliation: Especialista consultor en Alergia e Inmunología Clínica.
authors.forename: Iris
authors.initials: I
authors.lastname: Medina
authors.affiliation: Hospital de Niños Orlando Alassia, Santa Fe, Argentina.
authors.forename: Hugo
authors.initials: H
authors.lastname: Neffen
authors.affiliation: Facultad de Medicina, Universidad de Buenos Aires, Argentina.
authors.forename: Patricia
authors.initials: P
authors.lastname: Troielli
mesh_terms: D000465:Algorithms; D000799:Angioedema / Q000188:drug therapy / Q000473:pathology; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001118:Argentina; D001327:Autoimmune Diseases / Q000150:complications; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D016572:Cyclosporine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine / Q000191:economics; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D007073:Immunoglobulin E / Q000378:metabolism; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D000069444:Omalizumab; D011788:Quality of Life; D014581:Urticaria / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D006633:Histamine Antagonists; D020024:Leukotriene Antagonists; D000069444:Omalizumab; D007073:Immunoglobulin E; D016572:Cyclosporine
keywords: angioedema; chronic urticaria; induced chronic urticaria; omalizumab; spontaneous chronic urticaria