Urticaria Questions & Answers

1. Frigas E, Park MA. Acute urticaria and angioedema: diagnostic and treatment considerations. Am J Clin Dermatol. 2009. 10(4):239-50. [QxMD MEDLINE Link].

2. Poonawalla T, Kelly B. Urticaria : a review. Am J Clin Dermatol. 2009. 10(1):9-21. [QxMD MEDLINE Link].

3. Ribeiro F, Sousa N, Carrapatoso I, Segorbe Luís A. Urticaria after ingestion of alcoholic beverages. J Investig Allergol Clin Immunol. 2014. 24(2):122-3. [QxMD MEDLINE Link].

4. Irinyi B, Szeles G, Gyimesi E, Tumpek J, Heredi E, Dimitrios G, et al. Clinical and laboratory examinations in the subgroups of chronic urticaria. Int Arch Allergy Immunol. 2007. 144(3):217-25. [QxMD MEDLINE Link].

5. Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2010 Feb. 125(2 Suppl 2):S161-81. [QxMD MEDLINE Link].

6. [Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009 Oct. 64(10):1427-43. [QxMD MEDLINE Link].

7. Sharma M, Bennett C, Carter B, Cohen SN. H1-antihistamines for chronic spontaneous urticaria: An abridged Cochrane Systematic Review. J Am Acad Dermatol. 2015 Aug 4. [QxMD MEDLINE Link].

8. Bernstein JA, Lang DM, Khan DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. 2014 May. 133(5):1270-7. [QxMD MEDLINE Link].

9. Brown NA, Carter JD. Urticarial vasculitis. Curr Rheumatol Rep. 2007 Aug. 9(4):312-9. [QxMD MEDLINE Link].

10. Najib U, Sheikh J. An update on acute and chronic urticaria for the primary care provider. Postgrad Med. 2009 Jan. 121(1):141-51. [QxMD MEDLINE Link].

11. Viegas LP, Ferreira MB, Kaplan AP. The maddening itch: an approach to chronic urticaria. J Investig Allergol Clin Immunol. 2014. 24(1):1-5. [QxMD MEDLINE Link].

12. Darlenski R, Kazandjieva J, Zuberbier T, Tsankov N. Chronic urticaria as a systemic disease. Clin Dermatol. 2014 May-Jun. 32(3):420-3. [QxMD MEDLINE Link].

13. Bolognia JL, Jorizzo JL, Shaffer JV. Dermatology. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2012.

14. Zuberbier T, Maurer M. Urticaria: current opinions about etiology, diagnosis and therapy. Acta Derm Venereol. 2007. 87(3):196-205. [QxMD MEDLINE Link].

15. Kaplan AP, Joseph K, Maykut RJ, Geba GP, Zeldin RK. Treatment of chronic autoimmune urticaria with omalizumab. J Allergy Clin Immunol. 2008 Sep. 122(3):569-73. [QxMD MEDLINE Link].

16. Rather S, Keen A, Sajad P. Serum Levels of 25-hydroxyvitamin D in Chronic Urticaria and its Association with Disease Activity: A Case Control Study. Indian Dermatol Online J. 2018 May-Jun. 9 (3):170-174. [QxMD MEDLINE Link].

17. Viola M, Quaratino D, Gaeta F, Rumi G, Caruso C, Romano A. Cross-reactive reactions to nonsteroidal anti-inflammatory drugs. Curr Pharm Des. 2008. 14(27):2826-32. [QxMD MEDLINE Link].

18. [Guideline] Magerl M, Borzova E, Gimrnez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias--EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy. 2009 Dec. 64(12):1715-21. [QxMD MEDLINE Link].

19. Kasperska-Zajac A, Jasinska T, Grzanka A, Kowalik-Sztylc A. Markers of systemic inflammation in delayed pressure urticaria. Int J Dermatol. 2012 Nov 1. [QxMD MEDLINE Link].

20. Tong LJ, Balakrishnan G, Kochan JP, Kinét JP, Kaplan AP. Assessment of autoimmunity in patients with chronic urticaria. J Allergy Clin Immunol. 1997 Apr. 99(4):461-5. [QxMD MEDLINE Link].

21. Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy. 2009 Sep. 64(9):1256-68. [QxMD MEDLINE Link].

22. Philpott H, Kette F, Hissaria P, Gillis D, Smith W. Chronic urticaria: the autoimmune paradigm. Intern Med J. 2008 Nov. 38(11):852-7. [QxMD MEDLINE Link].

23. Konstantinou GN, Asero R, Ferrer M, Knol EF, Maurer M, Raap U, et al. EAACI taskforce position paper: evidence for autoimmune urticaria and proposal for defining diagnostic criteria. Allergy. 2012 Nov 15. [QxMD MEDLINE Link].

24. Hossler EW. Caterpillars and moths: Part I. Dermatologic manifestations of encounters with Lepidoptera. J Am Acad Dermatol. 2010 Jan. 62(1):1-10; quiz 11-2. [QxMD MEDLINE Link].

25. Kaplan AP, Greaves M. Pathogenesis of chronic urticaria. Clin Exp Allergy. 2009 Jun. 39(6):777-87. [QxMD MEDLINE Link].

26. Vonakis BM, Saini SS. New concepts in chronic urticaria. Curr Opin Immunol. 2008 Dec. 20(6):709-16. [QxMD MEDLINE Link].

27. Guldbakke KK, Khachemoune A. Etiology, classification, and treatment of urticaria. Cutis. 2007 Jan. 79(1):41-9. [QxMD MEDLINE Link].

28. Bains SN, Hsieh FH. Current approaches to the diagnosis and treatment of systemic mastocytosis. Ann Allergy Asthma Immunol. 2010 Jan. 104(1):1-10; quiz 10-2, 41. [QxMD MEDLINE Link].

29. Goldfinger S. The inherited autoinflammatory syndrome: a decade of discovery. Trans Am Clin Climatol Assoc. 2009. 120:413-8. [QxMD MEDLINE Link]. [Full Text].

30. Nichols KM, Cook-Bolden FE. Allergic skin disease: major highlights and recent advances. Med Clin North Am. 2009 Nov. 93(6):1211-24. [QxMD MEDLINE Link].

31. Brodell LA, Beck LA. Differential diagnosis of chronic urticaria. Ann Allergy Asthma Immunol. 2008 Mar. 100(3):181-8; quiz 188-90, 215. [QxMD MEDLINE Link].

32. Sánchez-Borges M, Asero R, Ansotegui IJ, Baiardini I, Bernstein JA, Canonica GW, et al. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Organ J. 2012 Nov. 5 (11):125-47. [QxMD MEDLINE Link].

33. Sathishkumar D, Al-Abadi E, Nicklaus-Wollenteit I, Moss C, Hawkins PN, Gach JE. Early-onset urticaria: a marker of cryopyrin-associated periodic syndrome. Clin Exp Dermatol. 2017 May 17. [QxMD MEDLINE Link].

34. Casale TB. Biologics and biomarkers for asthma, urticaria, and nasal polyposis. J Allergy Clin Immunol. 2017 May. 139 (5):1411-1421. [QxMD MEDLINE Link].

35. Botto NC, Warshaw EM. Solar urticaria. J Am Acad Dermatol. 2008 Dec. 59(6):909-20; quiz 921-2. [QxMD MEDLINE Link].

36. [Guideline] Powell RJ, Leech SC, Till S, Huber PA, Nasser SM, Clark AT. BSACI guideline for the management of chronic urticaria and angioedema. Clin Exp Allergy. 2015 Mar. 45 (3):547-65. [QxMD MEDLINE Link].

37. Ozceker D, Dilek F, Yucel E, Tamay Z, Ozkaya E, Guler N. Can allergy patch tests with food additives help to diagnose the cause in childhood chronic spontaneous urticaria?. Postepy Dermatol Alergol. 2020 Jun. 37 (3):384-389. [QxMD MEDLINE Link].

38. [Guideline] Powell RJ, Du Toit GL, Siddique N, Leech SC, Dixon TA, Clark AT, et al. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007 May. 37 (5):631-50. [QxMD MEDLINE Link].

39. Kaplan AP. Therapy of chronic urticaria: a simple, modern approach. Ann Allergy Asthma Immunol. 2014 May. 112(5):419-425. [QxMD MEDLINE Link].

40. Shahzad Mustafa S, Sánchez-Borges M. Chronic Urticaria: Comparisons of US, European, and Asian Guidelines. Curr Allergy Asthma Rep. 2018 May 24. 18 (7):36. [QxMD MEDLINE Link].

41. Zuberbier T, Bernstein JA. A Comparison of the United States and International Perspective on Chronic Urticaria Guidelines. J Allergy Clin Immunol Pract. 2018 May 18. [QxMD MEDLINE Link].

42. Sype JW, Khan IA. Prolonged QT interval with markedly abnormal ventricular repolarization in diphenhydramine overdose. Int J Cardiol. 2005 Mar 18. 99(2):333-5. [QxMD MEDLINE Link].

43. [Guideline] Fine LM, Bernstein JA. Urticaria Guidelines: Consensus and Controversies in the European and American Guidelines. Curr Allergy Asthma Rep. 2015 Jun. 15 (6):30. [QxMD MEDLINE Link].

44. Sil A, Tripathi SK, Chaudhuri A, Das NK, Hazra A, Bagchi C, et al. Olopatadine versus levocetirizine in chronic urticaria: an observer-blind, randomized, controlled trial of effectiveness and safety. J Dermatolog Treat. 2012 Nov 19. [QxMD MEDLINE Link].

45. Lin RY, Curry A, Pesola GR, Knight RJ, Lee HS, Bakalchuk L, et al. Improved outcomes in patients with acute allergic syndromes who are treated with combined H1 and H2 antagonists. Ann Emerg Med. 2000 Nov. 36(5):462-8. [QxMD MEDLINE Link].

46. Fedorowicz Z, van Zuuren EJ, Hu N. Histamine H2-receptor antagonists for urticaria. Cochrane Database Syst Rev. 2012 Mar 14. 3:CD008596. [QxMD MEDLINE Link].

47. Smith PF, Corelli RL. Doxepin in the management of pruritus associated with allergic cutaneous reactions. Ann Pharmacother. 1997 May. 31(5):633-5. [QxMD MEDLINE Link].

48. Pollack CV Jr, Romano TJ. Outpatient management of acute urticaria: the role of prednisone. Ann Emerg Med. 1995 Nov. 26(5):547-51. [QxMD MEDLINE Link].

49. Bluestein HM, Hoover TA, Banerji AS, Camargo CA Jr, Reshef A, Herscu P. Angiotensin-converting enzyme inhibitor-induced angioedema in a community hospital emergency department. Ann Allergy Asthma Immunol. 2009 Dec. 103(6):502-7. [QxMD MEDLINE Link].

50. Mandel VD, Guanti MB, Liberati S, Demonte A, Pellacani G, Pepe P. Omalizumab in Chronic Spontaneous Urticaria Refractory to Conventional Therapy: An Italian Retrospective Clinical Analysis with Suggestions for Long-Term Maintenance Strategies. Dermatol Ther (Heidelb). 2018 May 16. [QxMD MEDLINE Link].

51. Larenas-Linnemann DES, Parisi CAS, Ritchie C, Cardona-Villa R, Cherrez-Ojeda I, Cherrez A, et al. Update on Omalizumab for Urticaria: What's New in the Literature from Mechanisms to Clinic. Curr Allergy Asthma Rep. 2018 May 9. 18 (5):33. [QxMD MEDLINE Link].

52. Ozbagcivan O, Akarsu S, Ilknur T, Fetil E. Urticaria and angioedema as possible reactions of omalizumab. An Bras Dermatol. 2018 Mar. 93 (2):304-305. [QxMD MEDLINE Link].

53. Patil AD, Bingewar G, Goldust M. Efficacy of methotrexate as add on therapy to H1 antihistamine in difficult to treat chronic urticaria: A systematic review and meta-analysis of randomized clinical trials. Dermatol Ther. 2020 Jul 26. e14077. [QxMD MEDLINE Link].

54. Su O, Bahali AG, Onsun N. The effect of at least 1-year use of omalizumab without interruption on relapse in patients with chronic spontaneous urticaria. Dermatol Ther. 2020 Aug 13. e14192. [QxMD MEDLINE Link].

55. Maoz-Segal R, Levy T, Haj-Yahia S, Offengenden I, Iancovich-Kidon M, Agmon-Levin N. Combination therapy with omalizumab and an immune-suppressive agent for resistant chronic spontaneous rrticaria - A real-life experience. World Allergy Organ J. 2020 Aug. 13 (8):100448. [QxMD MEDLINE Link].

56. Dabija D, Tadi P. Chronic Urticaria. StatPearls [Internet]. 2020 Jan. [QxMD MEDLINE Link]. [Full Text].

57. Agache I, Rocha C, Pereira A, et al. Efficacy and safety of treatment with omalizumab for chronic spontaneous urticaria: A systematic review for the EAACI Biologicals Guidelines. Allergy. 2020 Aug 7. [QxMD MEDLINE Link].

58. Sarti L, Barni S, Giovannini M, Liccioli G, Novembre E, Mori F. Efficacy and tolerability of the updosing of second-generation non-sedating H1 antihistamines in children with chronic spontaneous urticaria. Pediatr Allergy Immunol. 2020 Aug 3. [QxMD MEDLINE Link].

59. Rajan JP, Simon RA, Bosso JV. Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria. J Allergy Clin Immunol Pract. 2014 Mar-Apr. 2(2):168-71. [QxMD MEDLINE Link].

60. Simons FE. H1-Antihistamines: more relevant than ever in the treatment of allergic disorders. J Allergy Clin Immunol. 2003 Oct. 112(4 Suppl):S42-52. [QxMD MEDLINE Link].

61. Balaraman B, Bergstrom KG. Beyond antihistamines: treating chronic urticaria. J Drugs Dermatol. 2009 Nov. 8(11):1043-8. [QxMD MEDLINE Link].

62. Sicherer SH, Leung DY. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2009. J Allergy Clin Immunol. 2010 Jan. 125(1):85-97. [QxMD MEDLINE Link].

63. Okubo Y, Shigoka Y, Yamazaki M, Tsuboi R. Double dose of cetirizine hydrochloride is effective for patients with urticaria resistant: a prospective, randomized, non-blinded, comparative clinical study and assessment of quality of life. J Dermatolog Treat. 2013 Apr. 24(2):153-60. [QxMD MEDLINE Link].

64. Maurer M, Rosén K, Hsieh HJ, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. 2013 Mar 7. 368(10):924-35. [QxMD MEDLINE Link].

65. Kai AC, Flohr C, Grattan CE. Improvement in quality of life impairment followed by relapse with 6-monthly periodic administration of omalizumab for severe treatment-refractory chronic urticaria and urticarial vasculitis. Clin Exp Dermatol. 2014 Apr 23. [QxMD MEDLINE Link].

66. Lang DM. Omalizumab is efficacious for management of recalcitrant, antihistamine-resistant chronic urticaria. Drugs Today (Barc). 2015 Jun. 51 (6):367-74. [QxMD MEDLINE Link].

67. Wan KS. Efficacy of leukotriene receptor antagonist with an anti-H1 receptor antagonist for treatment of chronic idiopathic urticaria. J Dermatolog Treat. 2009. 20(4):194-7. [QxMD MEDLINE Link].

68. Serhat Inaloz H, Ozturk S, Akcali C, Kirtak N, Tarakcioglu M. Low-dose and short-term cyclosporine treatment in patients with chronic idiopathic urticaria: a clinical and immunological evaluation. J Dermatol. 2008 May. 35(5):276-82. [QxMD MEDLINE Link].

69. Kessel A, Toubi E. Low-dose cyclosporine is a good option for severe chronic urticaria. J Allergy Clin Immunol. 2009 Apr. 123(4):970; author reply 970-1. [QxMD MEDLINE Link].

70. Holm JG, Ivyanskiy I, Thomsen SF. Use of nonbiologic treatments in antihistamine-refractory chronic urticaria: a review of published evidence. J Dermatolog Treat. 2017 May 31. 1-18. [QxMD MEDLINE Link].

71. Akenroye AT, McEwan C, Saini SS. Montelukast reduces symptom severity and frequency in patients with angioedema-predominant chronic spontaneous urticaria. J Allergy Clin Immunol Pract. 2018 May 5. [QxMD MEDLINE Link].

Henry K Wong, MD, PhD Professor and Chairman, Department of Dermatology, University of Arkansas for Medical Sciences College of Medicine

Henry K Wong, MD, PhD is a member of the following medical societies: American Academy of Dermatology, International Society for Cutaneous Lymphomas, Medical Dermatology Society, Society for Investigative Dermatology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Seattle Genetics, Actillion, Celgene, Kyowa-Kirin<br/>Serve(d) as a speaker or a member of a speakers bureau for: Amgen<br/>Received income in an amount equal to or greater than $250 from: Celgene<br/>Received honoraria from Amgen for speaking and teaching; Received grant/ Received grant/research funds from Celgene for none; Received grant/research funds from Abbott Labs for independent contractor; Received grant/research funds from Amgen for none; Received honoraria from Seattle Genetics for consulting. for: Actelion-Advisory board, grants;Seattle Genetics - Advisory board.

Mallory Shiver, MD Resident Physician, Department of Dermatology, University of Arkansas for Medical Sciences College of Medicine

Mallory Shiver, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Arkansas Foundation for Skin Cancer, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Steven A Conrad, MD, PhD Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center

Steven A Conrad, MD, PhD is a member of the following medical societies: American College of Chest Physicians, American College of Critical Care Medicine, American College of Emergency Physicians, American College of Physicians, International Society for Heart and Lung Transplantation, Louisiana State Medical Society, Shock Society, Society for Academic Emergency Medicine, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Mark W Fourre, MD Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine; Program Director, Department of Emergency Medicine, Maine Medical Center

Disclosure: Nothing to disclose.

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