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[Chronic urticaria--still a vexing problem? Progress in diagnosis and therapy]
1Zentrum für Dermatologie und Andrologie, Justus-Liebig-Universität Giessen.
Zeitschrift Fur Hautkrankheiten
|January 1, 1988
Summary
Chronic urticaria pathogenesis remains unclear, but mast cell membrane instability may play a role. Effective symptomatic treatments, including H1-antihistamines and NSAIDs, offer relief for many patients.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Context:
- Chronic urticaria (CU) pathogenesis is not fully understood, though intolerance reactions and mast cell membrane instability are implicated.
- Provocation testing may indicate underlying instability rather than direct cause of daily rashes.
- Effective symptomatic therapies are available for CU when the cause or trigger is unknown.
Purpose:
- To explore the potential role of intolerance reactions in chronic urticaria pathogenesis.
- To review the efficacy of symptomatic treatments for chronic urticaria.
- To evaluate the effectiveness of H1-antihistamines and non-steroidal anti-inflammatory drugs (NSAIDs) in managing chronic urticaria.
Summary:
- While the exact cause of chronic urticaria is enigmatic, intolerance reactions may indicate mast cell membrane instability.
- Modern non-sedating H1-antihistamines, such as terfenadine and loratadine, are effective symptomatic treatments.
- For refractory cases, combining H1-antihistamines with gradually increasing doses of NSAIDs (e.g., aspirin, indomethacin) can improve symptoms in approximately 50% of patients.
Impact:
- Provides insights into potential mechanisms of chronic urticaria, focusing on mast cell instability.
- Highlights the efficacy of current symptomatic treatments, particularly non-sedating H1-antihistamines.
- Suggests a combined therapeutic approach with H1-antihistamines and NSAIDs for managing difficult-to-treat chronic urticaria cases.