Chronic Urticaria: Special Considerations

Introduction

Chronic urticaria is a distressing dermatological condition characterized by recurrent hives persisting for more than six weeks. It significantly impacts patients' quality of life and requires careful diagnosis and management.

Causes and Pathophysiology

• Idiopathic Chronic Urticaria: No identifiable cause, but immune dysfunction suspected.
• Autoimmune Urticaria: Often associated with autoantibodies targeting FcεRI or IgE.
• Physical Urticaria: Triggered by environmental factors like pressure, heat, or cold.

Symptoms and Diagnosis

Patients present with wheals, pruritus, and occasionally angioedema. Diagnosis involves:

• Clinical evaluation based on symptom duration and frequency.
• Laboratory tests for autoimmune markers.
• Exclusion of underlying systemic disorders.

Treatment and Management

Management is patient-specific and includes:

• Antihistamines: Non-sedating H1 blockers as first-line therapy.
• Omalizumab: Effective in refractory cases.
• Immunosuppressants: Considered in autoimmune urticaria.
• Avoidance Strategies: Identifying and minimizing triggers.

Conclusion

Chronic urticaria is a challenging condition requiring a multi-faceted approach. With proper diagnosis and personalized treatment, patients can achieve significant relief.