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Chronic Urticaria

Practical Recommendations for Management

  • Disease Management
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Summary

The management of chronic urticaria begins with the taking of a thorough history. Nondrug management also plays a significant part; discussion and patient education are mandatory.

The symptoms of urticaria can usually be improved with drug treatment, with the newer, second-generation antihistamines being the mainstay of therapy. In patients with more refractory disease, it may be necessary to combine different classes of antihistamines, including the first- and second-generation antihistamines. Other therapeutic strategies that may be adopted include the use of tricyclic antidepressants such as doxepin.

The recent identification of functionally significant, histamine-releasing autoantibodies in some patients with chronic ‘idiopathic’ urticaria is an exciting advance and has opened new therapeutic possibilities. The presence of a serum histamine-releasing factor may be predicted by a positive autologous intradermal serum test. Patients with recalcitrant, chronic urticaria of probable autoimmune aetiology may be offered novel therapy with cyclosporin or intravenous immunoglobulin.

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Authors and Affiliations

  1. St John’s Institute of Dermatology, United Medical and Dental School, St Thomas’ Hospital, Lambeth Palace Road, London, England

    Brigid F. O’Donnell & Frances Lawlor

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  1. Brigid F. O’Donnell
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  2. Frances Lawlor
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O’Donnell, B.F., Lawlor, F. Chronic Urticaria. Clin. Immunother. 6, 341–351 (1996). https://doi.org/10.1007/BF03259355

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