title: Chronic Urticaria in Returning Travellers: The Role of Anthelmintic Treatment.
abstract: BACKGROUND
  Chronic urticaria often poses a therapeutic challenge. The human immune response to helminths has a high degree of similarity to an allergic response in terms of skin manifestations, eosinophilia, and IgE elevation. Unfortunately, it is often complicated to diagnose such infections.
  
  
  OBJECTIVE
  We sought to assess the effect of empirical anthelmintic treatment among returning travellers diagnosed with chronic urticaria, without clear proof of helminthic infection.
  
  
  METHODS
  This is a retrospective case series of 19 returning travellers with chronic urticaria. All patients were treated with anthelmintic treatment given based on clinical suspicion only. A randomly selected control group of 20 patients with chronic urticaria, with no history of travel, was also enrolled.
  
  
  RESULTS
  A positive clinical response was reported in 68.4% (13 patients) of the travellers' group within 3 months after treatment with anthelmintic therapy compared with 10% (2 patients) of chronic urticaria patients in the control group. No adverse effects from treatment were recorded.
  
  
  CONCLUSIONS
  In patients with chronic urticaria, travel history to developing countries must be obtained. Empiric anthelmintic therapy might be beneficial, even in the absence of findings suggestive of helminthic infection.
authors.affiliation: Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Avishai
authors.initials: A
authors.lastname: Nahshoni
authors.forename: Sharon
authors.initials: S
authors.lastname: Baum
authors.forename: Aviv
authors.initials: A
authors.lastname: Barzilai
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006373:Helminthiasis / Q000150:complications* / Q000188:drug therapy; D006376:Helminths / Q000276:immunology*; D006801:Humans; D007113:Immunity, Innate; D008297:Male; D012189:Retrospective Studies; D014195:Travel; D014581:Urticaria / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology
chemical_list: D000871:Anthelmintics; D015766:Albendazole