An Observational Study of the Diagnosis and Management of Chronic Urticaria in the UK

Wu, Cheng-Han; Ardern‐Jones, Michael R.; Eren, Erdem; Venter, Carina

doi:10.1159/000430442

Cited by 12 publications

(14 citation statements)

References 17 publications

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“…Chronic urticaria (CU) is defined as the occurrence of daily or almost daily wheals, angioedema, or both, for at least 6 weeks [1,2]. The classification recommended by the updated international guidelines has distinguished CU into spontaneous and inducible forms [1].…”

Section: Definition Of Chronic Urticariamentioning

confidence: 99%

The Role of Platelets in Chronic Urticaria

Veña¹,

Cassano

Marzano

et al. 2016

Int Arch Allergy Immunol

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Background: Platelets are implicated in many pathophysiological processes, including inflammation and immunity. Ever-growing evidence suggests the active involvement of platelets in the pathogenesis of various inflammatory disorders, including cutaneous inflammatory diseases. A limited number of studies have investigated the role of platelets in chronic urticaria (CU). In this review, we summarize the current knowledge regarding the role of platelets in chronic spontaneous and inducible urticarias. Methods: A literature search was performed using PubMed and Google Scholar, and the references of relevant literature were reviewed. Results: Overall, in CU patients, conflicting results have been obtained from the assessment of platelet indices, such as mean platelet volume, platelet count and distribution width, as well as markers of platelet aggregation and activation. Nevertheless, a few studies showed significant changes of such parameters in CU patients compared to controls, in apparent correlation with clinical severity, autoreactivity and/or inflammatory status. Conclusions: In the absence of definitive conclusions, the pathogenic role of platelets in CU needs to be further explored. Platelets might represent a link between inflammation, coagulation and histamine release in the pathophysiological network of CU.

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Section: Definition Of Chronic Urticariamentioning

confidence: 99%

The Role of Platelets in Chronic Urticaria

Veña¹,

Cassano

Marzano

et al. 2016

Int Arch Allergy Immunol

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“…In the German survey, the most common first‐line treatments were also nsAHs in standard or higher doses (Weller et al, ). Similarly, Wu et al found all physicians in their study (dermatologists, allergists, and immunologists) recommended second‐generation antihistamines as first‐line treatment (Wu et al, ). In the available national and international guidelines including European Academy of Allergy and Clinical Immunology, World Allergy Organization, the recommended first‐line treatment is regular‐dose nsAHs, followed by nsAHs in two fold to four fold up‐dosing) in second line (Grattan & Humphreys, ; Zuberbier, Aberer et al, ; Zuberbier et al, ).…”

Section: Discussionmentioning

confidence: 84%

“…Wu et al found differences in the diagnosis and treatment of CU between practitioners of different specialties, which reflected differences among the guidelines used more dermatologists used the BAD guidelines in comparison with allergists and immunologists. On the other hand, the BSACI guidelines and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA 2 LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO) guidelines (2013) were used by more allergists and immunologists compared to dermatologists (Wu et al, ). In our study, majority of dermatologists was familiar with BAD guideline and other international and/ or national guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to C Weller et al study in Germany that reported 81.4% of dermatologist performed serum total IgE for their CU patients, none of dermatologist in our study performed this test (Weller et al, ). In the study by Wu et al, differential blood count, thyroid function, and thyroid‐stimulating hormone (TSH) were the most common tests performed by dermatologists, allergists, and immunologists (Wu et al, ). Differential blood count and ESR/CRP were recommended in the majority of the existing guidelines for CU, whereas the BSACI guidelines and the BAD guidelines only recommended ESR (Grattan & Humphreys, ; Powell, Leech et al, ).…”

Section: Discussionmentioning

confidence: 99%

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Real life management of chronic urticaria: Multicenter and cross sectional study on patients and dermatologists in Iran

Firooz

Akhlaghi

Golbidi³

et al. 2018

Dermatologic Therapy

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Recently, advances in understanding the etiology of urticaria and updates of diagnostic and therapeutic management guidelines have drawn attention to chronic urticaria (CU) morbidity. The present study aimed to evaluate Iranian dermatologists' practice and real life management of CU patients. A total of 35 dermatologists and 443 patients were included in the study. Number of female patients was 321 (72.5%). Mean (standard deviation) age of the study patients was 38 (13) years and the median (inter quartile range) of disease duration was 12 (6–48) months. Severity of patients' symptoms was mild for 32.1%, moderate for 38.7%, severe for 18.8%, and 10.4% of them had no evident signs or symptoms. The most common diagnostic methods were physical examination (96.6%), differential blood count (83.5%), erythrocyte sedimentation rate (77.4%), and C‐reactive protein (62.8%). The number of dermatologists prescribed nonsedating antihistamines (nsAH) in regular dose and high dose mono therapy were 26 (74%) and 6 (17%), respectively. About 66% of dermatologists were familiar with British Association of Dermatologists (BAD) guideline. The most common first‐line treatment for CU by Iranian dermatologists was nonsedating antihistamines in regular or high doses. The real‐life management of patients with CU in Iran was in accordance with the available practice guidelines.

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“…23 O hemograma e doseamento da proteína C reativa/velocidade de sedimentação poderão identificar um estado basal de inflamação que justifique um estudo adicional.…”

Section: Diagnóstico E Diagnóstico Diferencialunclassified

Urticária Crónica - Do Diagnóstico ao Tratamento

Costa¹,

Campina

Andrade

et al. 2016

SPDV

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RESUMO -Cerca de 20 % da população sofre pelo menos um episódio de urticária e 0,5 a 1 % sofre de urticária crónica, com uma duração média entre 1 e 5 anos e uma maior incidência em mulheres entre os 20 e os 40 anos. Dada a publicação, em 2014, de recomendações europeias para a sua orientação diagnóstica e terapêutica, os autores fazem uma revisão dos vários aspetos da urticária crónica. A urticária crónica, resultante da libertação de mediadores pró-inflamatórios do mastócito, caracteriza-se pelo aparecimento diário ou quase diário, de lesões cutâneas maculopapulares, eritematosas, pruriginosas e/ou angioedema, que persistem por um período superior a 6 semanas. Classifica-se em urticária crónica espontânea ou indutível, sendo aconselhável a realização de exames complementares de acordo com a história clínica. O tratamento é sintomático, baseado em evidência, sendo a 1ª linha os anti-histamínicos H1 de 2ª geração, que podem ser aumentados até 4x a dose aprovada e numa 3ª linha, fármacos como o omalizumab ou a ciclosporina. Dado o impacto negativo na qualidade de vida e os custos que esta patologia crónica acarreta, é de extrema importância alertar os clínicos para a necessidade de diagnóstico e tratamento correcto precoces e, se necessário, referenciação atempada para centros especializados, tendo sempre como objetivo o controlo completo dos sintomas, da forma mais segura possível. PALAVRAS-CHAVE -Anti-Histamínicos H1; Ciclosporina; Doença Crónica; Omalizumab; Prurido; Urticária. Chronic Urticaria -From Diagnose to Treatment

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An Observational Study of the Diagnosis and Management of Chronic Urticaria in the UK

Cited by 12 publications

References 17 publications

The Role of Platelets in Chronic Urticaria

The Role of Platelets in Chronic Urticaria

Real life management of chronic urticaria: Multicenter and cross sectional study on patients and dermatologists in Iran

Urticária Crónica - Do Diagnóstico ao Tratamento

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