In 2017, omalizumab (Xolair ® ), a monoclonal antibody targeting the high-affinity receptor binding site on human IgE, was approved for the treatment of antihistamine-resistant idiopathic chronic urticaria.This followed its approval in 2009 for the treatment of refractory severe asthma resistant to former therapies in Japan. Albeit only in sporadic cases, omalizumab had also been reported to be beneficial for several types of chronic inducible urticaria such as cholinergic urticaria and solar urticaria, although the underlying mechanism how it exerts its action on these conditions was unclear. 1-3 We herein report a patient with severe cholinergic urticaria, which was unresponsive to various antihistamines with high doses and several other treatments including leukotriene receptor antagonists and H2-antihistamines. Omalizumab showed a rapid, remarkable, and continuous efficacy on the symptoms of the disease without any deleterious events.
| C A S E REP ORTA 27-year-old Japanese woman presented to our department with a 2-year history of pruritic pinpoint wheals with surrounding erythema, which were induced by heat, exercise, hot baths, and emotional upset. She had atopic dermatitis in her infancy. Before her referral, the patient had been treated with fexofenadine 360 mg/d, loratadine 20 mg/d, famotidine 20 mg/d, tranexamic acid 1500 mg/d, and montelukast 20 mg/d without therapeutic effects. She noticed that
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