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Chronic Spontaneous Urticaria: The Devil's Itch.

Sarbjit S Saini1, Allen P Kaplan2

  • 1Department of Medicine, Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Md.

The Journal of Allergy and Clinical Immunology. in Practice
|July 24, 2018
PubMed
Summary
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Chronic urticaria, lasting over six weeks, can be spontaneous or inducible. Current treatments are empirical, not targeted to specific causes, but new guidelines are emerging.

Area of Science:

  • Dermatology
  • Immunology
  • Allergy

Background:

  • Chronic urticaria (CU) is defined as daily hives for over six weeks.
  • It includes chronic spontaneous urticaria (CSU) and chronic inducible urticarias.
  • CSU, formerly idiopathic urticaria, has intrinsic causes, often autoimmune.

Purpose of the Study:

  • To review the current understanding of chronic urticaria pathogenesis.
  • To discuss diagnostic approaches for chronic urticaria.
  • To update treatment strategies based on guidelines and new data.

Main Methods:

  • Literature review of pathogenesis and treatment.
  • Analysis of diagnostic workup.
  • Incorporation of published guidelines and expert experience.
Keywords:
Chronic urticariaPathogenesisTreatment

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Main Results:

  • CSU affects 40% of patients with accompanying angioedema; 10% present with angioedema.
  • Most cases are self-limiting (2-5 years), but 20% persist longer.
  • Current treatments are empirical, lacking targeted pathogenic mechanisms.

Conclusions:

  • Understanding CSU pathogenesis is evolving.
  • A systematic diagnostic approach is crucial.
  • Treatment requires updated, evidence-based guidelines.