[Mexican guidelines on the diagnosis and treatment of urticaria].
BACKGROUND
Urticaria is a disease that a fifth of the population shallsuffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups -both specialists and primary health care workers-, necessary in Mexico.


METHODS
Internationally recognized tools for guidelinedevelopment were used. An interdisciplinary group of clinical experts (some of them knowledgeable in methodology of guideline development) determined the objectives and scope of the Evidence Based Clinical Practice Guideline with SCOPE. It was decided to adapt and transculturize international guidelines on the diagnosis and treatment of urticaria. With AGREE-II three high-quality guidelines (Zuberbier 2014, Sánchez-Borges 2012, Powell 2007) were selected to function as basic guidelines (BG). A set of Clinical Questions was formulated that lead to recommendations/suggestions, based on these BG, taking into account the cultural and economic background of Mexico, according to GRADE recommendation development.


RESULTS
By a formal process of discussion and voting during several working-sessions, experts and first level healthcare physicians determined the wording of the final guideline, taking particularly care of developing a document, adjusted to the reality, values and preferences of the Mexican patients. The use of oral second generation, non-sedating antihistamines as first line treatment is emphasized.


CONCLUSIONS
This document is an Evidence Based Clinical Practice Guideline for the diagnosis and treatment of acute and chronic urticaria, based on three, high quality, international guidelines. It was developed by a multidisciplinary group. Tables and algorithms make the guideline user-friendly for both, first line health care physicians and specialists.
Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, México, DF.
Désirée
D
Larenas-Linnemann
Miguel Alejandro
MA
Medina-Ávalos
José Antonio
JA
Ortega-Martell
Angélica María
AM
Beirana-Palencia
María Isabel
MI
Rojo-Gutiérrez
Martha Alejandra
MA
Morales-Sánchez
Héctor
H
Solorio-Gómez
María Lourdes
ML
Alonzo-Romero Pareyón
Jorge Bernardo
JB
Vargas-Correa
Carlos
C
Baez-Loyola
Roberto
R
Blancas-Espinosa
Joaquín
J
Esquer-Flores
Javier
J
Gómez-Vera
María Graciela
MG
Guzmán-Perea
Alejandra
A
Macías-Weinmann
César Alfonso
CA
Maldonado-García
José Darío
JD
Martínez-Villarreal
Juan José
JJ
Matta-Campos
Elías
E
Medina-Segura
Blanca
B
Del Río-Navarro
Juan Ignacio
JI
Salgado-Gama
Héctor
H
Stone-Aguilar
Juan José Luis
JJ
Sienra-Monge
Sandra Nora
SN
González-Díaz
Enrique
E
Mendoza-López
Mario
M
Amaya-Guerra
Alicia
A
Lemini-López
Andrés
A
Blanco-Montero
María Teresa
MT
Chavarría-Jiménez
Martha Graciela
MG
Guerrero-Michaus
Albina
A
Martínez-Pérez
Ruth Ivonne Mireya
RI
Ramírez-Segura
Gabriel
G
Montes-Narváez
Jorge
J
Olvera-Salinas
Ana Beatriz
AB
Rosas-Sumano
Angioedema; Antihistamine; Chronic urticaria; Clinical practice guideline; Corticosteroid; Cyclosporin; Omalizumab; Urticaria; Wheals