Skip to content

Chronic idiopathic urticaria/chronic spontaneous urticaria

June 7, 2017

Acute urticaria (hives) is often caused by viruses or allergy. Chronic urticaria (hives) lasts longer than  6 weeks and is thought to be autoimmune. Urticaria is itchy, comes and goes, and can move around. The eruptions are spontaneous or inducible by exercise (exercise-induced anaphylaxis and cholinergic urticaria), water (aquagenic urticaria), coldness (cold urticaria), or sunlight (solar urticaria). One-third to two-thirds of cases are associated with angioedema (swelling beneath the skin). If a patient is on an ACEI drug, this must be stopped. Urticaria usually resolves in 24 hours and angioedema in 72 hours. Severity is measured by the weekly urticaria activity score (UAS7). If individual lesions last over 24 hours, a skin biopsy may be required.

The treatment algorithm starts with a second generation antihistamine like cetirizine (10-40mg/day), desloratadine (5-20mg/day), fexofenadine (120-480mg/day), or loratadine (10-40mg/day). These drugs can be increased up to four times the standard dose. Montelukast can be added and exacerbations may be treated with an oral steroid.

Omalizumab and cyclosporine are third-line therapies initiated at the specialist level.

Resources:

www.itchingforanswers.ca

www.skintolivein.com

www.optionsinciu.ca

CIU Tracker App on App store and Google play

Advertisements

From → Uncategorized

Leave a Comment

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s

%d bloggers like this: