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Urticaria and Angioedema

Year 2017, Volume: 9 Issue: 2, 117 - 129, 15.03.2017

Abstract

Abstract

Urticaria, having heterogeneous clinical and histopathological characteristics, and more than one concomitant urticaria subtypes in certain cases bring along diagnostic issues. The most important keys the physicians have to identify the etiology and the diagnosis are detailed clinical history and physical examination. Performing routine detailed laboratory analyses in each patient provides no diagnostic improvementand leads to significant health expenses. Although detecting and eliminating the etiologic and triggering factors is the most convenient treatment approach, that is not possible in most patients. The only treatment choice is symptomatic treatment in mostof the patients. Although antihistamines are the corner stone of the treatment, no response could be received in about half of the patients. Also, treatment practices in daily life have considerable differences from guidelines of urticaria treatment.

References

  • Kaynaklar 1.Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsi-eh F, et al. The diagnosis and management of acute and chro-nic urticaria: 2014 update. J Allergy Clin Immunol.2014;133(5):1270-7. 2.Powell RJ, Leech SC, Till S, Huber PA, Nasser SM, Clark AT;British Society for Allergy and Clinical Immunology.. BSA-CI guideline for the management of chronic urticaria and an-gioedema. Clin Exp Allergy. 2015;45(3):547-65. 3.Sánchez-Borges M, Asero R, Ansotegui IJ, Baiardini I, Bernstein JA, Canonica GW, et al; WAO Scientific and Cli-nical Issues Council.. Diagnosis and treatment of urticaria andangioedema: a worldwide perspective. World Allergy OrganJ. 2012;5(11):125-47. 4.Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z,Canonica GW, et al; European Academy of Allergy and Clini-cal Immunology.; Global Allergy and Asthma European Net-work.; European Dermatology Forum.; World Allergy Organi-zation.. The EAACI/GA(2) LEN/EDF/WAO Guideline for the de-finition, classification, diagnosis, and management of urticaria:the 2013 revision and update. Allergy. 2014;69(7):868-87. 5.Saini SS. Urticaria and anjioedema. In:Adkinson NF, BochnerBS, Burks AW, Busse WW, Holgate ST, Lemanske RF, O’He-ir RE. Middleton’s Allergy Principles and Practice. Vol.1, Ch.368th ed. Elsevier Inc. Philedelphia, USA, 2014. p.575-587.6.Zuraw BL. Urticaria and anjioedema. In: Leung DYM, Szef-ler SJ, Bonilla FA, Akdis CA, Sampson HA. Pediatric AllergyPrinciples and Practice. Ch.52 3th ed. Elsevier Inc. New York,USA, 2016. p.458-466. 7.Kaplan AP, Greaves M. Pathogenesis of chronic urticaria. ClinExp Allergy 2009;39:777-87. 8.Maurer M, Bader M, Bas M, Bossi F, Cicardi M, Cugno M,et al. New topics in bradykinin research. Allergy 2011;66 (11):1397-406. 9.Sackesen C, Sekerel BE, Orhan F, Kocabas CN, Tuncer A, Ada-lioglu G. The etiology of different forms of urticaria in child-hood. Pediatr Dermatol 2004;21:102-8. 10.Huang SW. Acute urticaria in children. Pediatr Neonatol2009;50:85-7. 11.Bilbao A, García JM, Pocheville I, Gutiérrez C, Corral JM,Samper A, et al. Round Table: Urticaria in relation to infec-tions. Allergol Immunopathol 1999:27:73-85. 12.Zuberbier T, Maurer M. Urticaria: current opinions about etiology,diagnosis and therapy. Acta Derm Venereol 2007;87:196-205.13.Zuberbier T, Iffländer J, Semmler C, Henz BM. Acute urtica-ria: clinical aspects and therapeutic responsiveness. Acta DermVenereol 1996:76:295-7. 14.Arga M, Harmancı K. Ürtiker ve Anjioödem. Turkiye Klinik-leri J Fam Med-Special Topics 2012;3(3):85-98.15.Maurer M, Weller K, Bindslev-Jensen C, Giménez-Arnau A,Bousquet PJ, Bousquet J, et al. Unmet clinical needs in chro-nic spontaneous urticaria. A GA²LEN task force report. Al-lergy 2011;66:317-30. 16.Delong LK, Culler SD, Saini SS, Beck LA, Chen SC. Annualdirect and indirect health care costs of chronic idiopathic ur-ticaria: a cost analysis of 50 nonimmunosuppressed patients.Arch Dermatol 2008;144:35-9. 17.Kapp A, Demarteau N. Cost effectiveness of levocetirizine inchronic idiopathic urticaria : a pooled analysis of two ran-domised controlled trials. Clin Drug Investig 2006;26:1-11. 18.Wedi B, Kapp A. Helicobacter pylori infection in skin disea-ses: a critical appraisal. Am J Clin Dermatol 2002;3:273-82. 19.Caminiti L, Passalacqua G, Magazzù G, Comisi F, Vita D, Bar-berio G, et al. Chronic urticaria and associated coeliac disea-se in children: a case-control study. Pediatr Allergy Immu-nol 2005;16:428-32. 20.Papadopoulou N, Kalogeromitros D, Staurianeas NG, Tibla-lexi D, Theoharides TC. Corticotropin-releasing hormone re-ceptor-1 and histidine decarboxylase expression in chronic ur-ticaria. J Invest Dermatol 2005;125:952-5. 21.Khan DA. Chronic urticaria: diagnosis and management. Al-lergy Asthma Proc 2008;29:439-46. 22.Kozel MM, Bossuyt PM, Mekkes JR, Bos JD. Laboratory testsand identified diagnoses in patients with physical and chro-nic urticaria and angioedema: A systematic review. J Am AcadDermatol 2003;48:409-16. 23.Fine LM, Bernstein JA. Urticaria Guidelines: Consensus andControversies in the European and American Guidelines. CurrAllergy Asthma Rep. 2015;15(6):30. 24.Maqerl M, Borzova E, Giménez-Arnau A, Grattan CE, Law-lor F, Mathelier-Fusade P, et al. EAACI/GA2LEN/EDF/UNEV.The definition and diagnostic testing of physical and choliner-gic urticarias--EAACI/GA2LEN/EDF/UNEV consensus panelrecommendations. Allergy 2009;64:1715-21. 25.Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task forceconsensus report: the autologous serum skin test in urticaria.Allergy 2009;64:1256-68. 26.Staubach P, Dechene M, Metz M, Magerl M, Siebenhaar F,Weller K, et al. High prevalence of mental disorders and emo-tional distress in patients with chronic spontaneous urticaria.Acta Derm Venereol 2011;91:557-61. 27.Staevska M, Popov TA, Kralimarkova T, Lazarova C, Krae-va S, Popova D, et al. The effectiveness of levocetirizine anddesloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol 2010;125:676-82. 28.Siebenhaar F, Degener F, Zuberbier T, Martus P, Maurer M.High-dose desloratadine decreases wheal volume and impro-ves cold provocation thresholds compared with standard-dosetreatment in patients with acquired cold urticaria: a rando-mized, placebo-controlled, crossover study. J Allergy Clin Im-munol 2009;123:672-9 .29.Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P; Neo-I-30 Study Group. Cyclosporine in chronic idiopathic urtica-ria: a double-blind, randomized, placebo-controlled trial. JAm Acad Dermatol 2006;55:705-9. 30.Grattan CE, O'Donnell BF, Francis DM, Niimi N, Barlow RJ,Seed PT, et al. Randomized double-blind study of cyclospo-rin in chronic 'idiopathic' urticaria. Br J Dermatol.2000;143:365-72. 31.Boubouka CD, Charissi C, Kouimintzis D, Kalogeromitros D,Stavropoulos PG, Katsarou A. Treatment of autoimmune ur-ticaria with low-dose cyclosporin A: A one-year follow-up. ActaDerm Venereol 2011;91:50-4. 32.Saini S, Rosen KE, Hsieh HJ, Wong DA, Conner E, KaplanA, et al. A randomized, placebo-controlled, dose-ranging studyof single-dose omalizumab in patients with H1-antihistami-ne-refractory chronic idiopathic urticaria. J Allergy Clin Im-munol. 2011;128(3):567-73. 33.Maurer M, Rosén K, Hsieh HJ, Saini S, Grattan C, Gimenéz-Arnau A, Agarwal S, et al. Omalizumab for the treatment ofchronic idiopathic or spontaneous urticaria. N Engl J Med.2013;368(10):924-35. 34.Baiardini I, Braido F, Bindslev-Jensen C, Bousquet PJ, Brzo-za Z, Canonica GW, et al. Recommendations for assessing pa-tient-reported outcomes and health-related quality of life inpatients with urticaria: a GA(2) LEN task force position pa-per. Allergy 2011;66:840-4. 35.Church MK, Weller K, Stock P, Maurer M. Chronic sponta-neous urticaria in children: itching for insight. Pediatr AllergyImmunol 2011;22:1-8. 36.Khakoo G, Sofianou-Katsoulis A, Perkin MR, Lack G. Clini-cal features and natural history of physical urticaria in child-ren. Pediatr Allergy Immunol 2008;19:363-6. 37.Sahiner UM, Civelek E, Tuncer A, Yavuz ST, Karabulut E, Sac-kesen C,et al. Chronic urticaria: etiology and natural cour-se in children. Int Arch Allergy Immunol 2011;156:224-30.

Ürtiker ve Anjioödem

Year 2017, Volume: 9 Issue: 2, 117 - 129, 15.03.2017

Abstract

Öz

Ürtikerin heterojen klinik ve histopatolojik özelliklere sahip olması, bazı olgularda birden fazla ürtiker tipinin birlikte görülmesi tanısal sorunları beraberinde getirmektedir. Hekimlerin etiyolojiyi belirleme ve tanıyı koymada sahip olduğu en önemli anahtar doğru ve ayrıntılı klinik öykü ile fiziki muayenedir. Her hastada rutin detaylı laboratuvar incelemelerinin yapılması tanısal bir iyileştirme sağlamamakta veönemli sağlık harcamalarına neden olmaktadır. Etiyolojik nedenlerin ve tetikleyicilerin saptanması ve ortadan kaldırılması en uygun tedavi yaklaşımı olmasına rağmenbu çoğu hastada mümkün olmamaktadır. Hastaların çoğunda tek tedavi seçeneği semptomatik tedavidir. Antihistaminler tedavinin temel taşı olmasına rağmen hastalarınyaklaşık yarısında bu tedaviye yanıt alınamamaktadır. Aynı zamanda pratik hayattaki tedavi uygulamaları ürtiker tedavi rehberlerinden önemli oranda farklılıklar taşımaktadır.

References

  • Kaynaklar 1.Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsi-eh F, et al. The diagnosis and management of acute and chro-nic urticaria: 2014 update. J Allergy Clin Immunol.2014;133(5):1270-7. 2.Powell RJ, Leech SC, Till S, Huber PA, Nasser SM, Clark AT;British Society for Allergy and Clinical Immunology.. BSA-CI guideline for the management of chronic urticaria and an-gioedema. Clin Exp Allergy. 2015;45(3):547-65. 3.Sánchez-Borges M, Asero R, Ansotegui IJ, Baiardini I, Bernstein JA, Canonica GW, et al; WAO Scientific and Cli-nical Issues Council.. Diagnosis and treatment of urticaria andangioedema: a worldwide perspective. World Allergy OrganJ. 2012;5(11):125-47. 4.Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z,Canonica GW, et al; European Academy of Allergy and Clini-cal Immunology.; Global Allergy and Asthma European Net-work.; European Dermatology Forum.; World Allergy Organi-zation.. The EAACI/GA(2) LEN/EDF/WAO Guideline for the de-finition, classification, diagnosis, and management of urticaria:the 2013 revision and update. Allergy. 2014;69(7):868-87. 5.Saini SS. Urticaria and anjioedema. In:Adkinson NF, BochnerBS, Burks AW, Busse WW, Holgate ST, Lemanske RF, O’He-ir RE. Middleton’s Allergy Principles and Practice. Vol.1, Ch.368th ed. Elsevier Inc. Philedelphia, USA, 2014. p.575-587.6.Zuraw BL. Urticaria and anjioedema. In: Leung DYM, Szef-ler SJ, Bonilla FA, Akdis CA, Sampson HA. Pediatric AllergyPrinciples and Practice. Ch.52 3th ed. Elsevier Inc. New York,USA, 2016. p.458-466. 7.Kaplan AP, Greaves M. Pathogenesis of chronic urticaria. ClinExp Allergy 2009;39:777-87. 8.Maurer M, Bader M, Bas M, Bossi F, Cicardi M, Cugno M,et al. New topics in bradykinin research. Allergy 2011;66 (11):1397-406. 9.Sackesen C, Sekerel BE, Orhan F, Kocabas CN, Tuncer A, Ada-lioglu G. The etiology of different forms of urticaria in child-hood. Pediatr Dermatol 2004;21:102-8. 10.Huang SW. Acute urticaria in children. Pediatr Neonatol2009;50:85-7. 11.Bilbao A, García JM, Pocheville I, Gutiérrez C, Corral JM,Samper A, et al. Round Table: Urticaria in relation to infec-tions. Allergol Immunopathol 1999:27:73-85. 12.Zuberbier T, Maurer M. Urticaria: current opinions about etiology,diagnosis and therapy. Acta Derm Venereol 2007;87:196-205.13.Zuberbier T, Iffländer J, Semmler C, Henz BM. Acute urtica-ria: clinical aspects and therapeutic responsiveness. Acta DermVenereol 1996:76:295-7. 14.Arga M, Harmancı K. Ürtiker ve Anjioödem. Turkiye Klinik-leri J Fam Med-Special Topics 2012;3(3):85-98.15.Maurer M, Weller K, Bindslev-Jensen C, Giménez-Arnau A,Bousquet PJ, Bousquet J, et al. Unmet clinical needs in chro-nic spontaneous urticaria. A GA²LEN task force report. Al-lergy 2011;66:317-30. 16.Delong LK, Culler SD, Saini SS, Beck LA, Chen SC. Annualdirect and indirect health care costs of chronic idiopathic ur-ticaria: a cost analysis of 50 nonimmunosuppressed patients.Arch Dermatol 2008;144:35-9. 17.Kapp A, Demarteau N. Cost effectiveness of levocetirizine inchronic idiopathic urticaria : a pooled analysis of two ran-domised controlled trials. Clin Drug Investig 2006;26:1-11. 18.Wedi B, Kapp A. Helicobacter pylori infection in skin disea-ses: a critical appraisal. Am J Clin Dermatol 2002;3:273-82. 19.Caminiti L, Passalacqua G, Magazzù G, Comisi F, Vita D, Bar-berio G, et al. Chronic urticaria and associated coeliac disea-se in children: a case-control study. Pediatr Allergy Immu-nol 2005;16:428-32. 20.Papadopoulou N, Kalogeromitros D, Staurianeas NG, Tibla-lexi D, Theoharides TC. Corticotropin-releasing hormone re-ceptor-1 and histidine decarboxylase expression in chronic ur-ticaria. J Invest Dermatol 2005;125:952-5. 21.Khan DA. Chronic urticaria: diagnosis and management. Al-lergy Asthma Proc 2008;29:439-46. 22.Kozel MM, Bossuyt PM, Mekkes JR, Bos JD. Laboratory testsand identified diagnoses in patients with physical and chro-nic urticaria and angioedema: A systematic review. J Am AcadDermatol 2003;48:409-16. 23.Fine LM, Bernstein JA. Urticaria Guidelines: Consensus andControversies in the European and American Guidelines. CurrAllergy Asthma Rep. 2015;15(6):30. 24.Maqerl M, Borzova E, Giménez-Arnau A, Grattan CE, Law-lor F, Mathelier-Fusade P, et al. EAACI/GA2LEN/EDF/UNEV.The definition and diagnostic testing of physical and choliner-gic urticarias--EAACI/GA2LEN/EDF/UNEV consensus panelrecommendations. Allergy 2009;64:1715-21. 25.Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task forceconsensus report: the autologous serum skin test in urticaria.Allergy 2009;64:1256-68. 26.Staubach P, Dechene M, Metz M, Magerl M, Siebenhaar F,Weller K, et al. High prevalence of mental disorders and emo-tional distress in patients with chronic spontaneous urticaria.Acta Derm Venereol 2011;91:557-61. 27.Staevska M, Popov TA, Kralimarkova T, Lazarova C, Krae-va S, Popova D, et al. The effectiveness of levocetirizine anddesloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol 2010;125:676-82. 28.Siebenhaar F, Degener F, Zuberbier T, Martus P, Maurer M.High-dose desloratadine decreases wheal volume and impro-ves cold provocation thresholds compared with standard-dosetreatment in patients with acquired cold urticaria: a rando-mized, placebo-controlled, crossover study. J Allergy Clin Im-munol 2009;123:672-9 .29.Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P; Neo-I-30 Study Group. Cyclosporine in chronic idiopathic urtica-ria: a double-blind, randomized, placebo-controlled trial. JAm Acad Dermatol 2006;55:705-9. 30.Grattan CE, O'Donnell BF, Francis DM, Niimi N, Barlow RJ,Seed PT, et al. Randomized double-blind study of cyclospo-rin in chronic 'idiopathic' urticaria. Br J Dermatol.2000;143:365-72. 31.Boubouka CD, Charissi C, Kouimintzis D, Kalogeromitros D,Stavropoulos PG, Katsarou A. Treatment of autoimmune ur-ticaria with low-dose cyclosporin A: A one-year follow-up. ActaDerm Venereol 2011;91:50-4. 32.Saini S, Rosen KE, Hsieh HJ, Wong DA, Conner E, KaplanA, et al. A randomized, placebo-controlled, dose-ranging studyof single-dose omalizumab in patients with H1-antihistami-ne-refractory chronic idiopathic urticaria. J Allergy Clin Im-munol. 2011;128(3):567-73. 33.Maurer M, Rosén K, Hsieh HJ, Saini S, Grattan C, Gimenéz-Arnau A, Agarwal S, et al. Omalizumab for the treatment ofchronic idiopathic or spontaneous urticaria. N Engl J Med.2013;368(10):924-35. 34.Baiardini I, Braido F, Bindslev-Jensen C, Bousquet PJ, Brzo-za Z, Canonica GW, et al. Recommendations for assessing pa-tient-reported outcomes and health-related quality of life inpatients with urticaria: a GA(2) LEN task force position pa-per. Allergy 2011;66:840-4. 35.Church MK, Weller K, Stock P, Maurer M. Chronic sponta-neous urticaria in children: itching for insight. Pediatr AllergyImmunol 2011;22:1-8. 36.Khakoo G, Sofianou-Katsoulis A, Perkin MR, Lack G. Clini-cal features and natural history of physical urticaria in child-ren. Pediatr Allergy Immunol 2008;19:363-6. 37.Sahiner UM, Civelek E, Tuncer A, Yavuz ST, Karabulut E, Sac-kesen C,et al. Chronic urticaria: etiology and natural cour-se in children. Int Arch Allergy Immunol 2011;156:224-30.
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Details

Primary Language Turkish
Journal Section makale
Authors

Doç. Dr. Mustafa Arga

Publication Date March 15, 2017
Published in Issue Year 2017 Volume: 9 Issue: 2

Cite

APA Arga, D. D. M. (2017). Ürtiker ve Anjioödem. Klinik Tıp Pediatri Dergisi, 9(2), 117-129.
AMA Arga DDM. Ürtiker ve Anjioödem. Pediatri. March 2017;9(2):117-129.
Chicago Arga, Doç. Dr. Mustafa. “Ürtiker Ve Anjioödem”. Klinik Tıp Pediatri Dergisi 9, no. 2 (March 2017): 117-29.
EndNote Arga DDM (March 1, 2017) Ürtiker ve Anjioödem. Klinik Tıp Pediatri Dergisi 9 2 117–129.
IEEE D. D. M. Arga, “Ürtiker ve Anjioödem”, Pediatri, vol. 9, no. 2, pp. 117–129, 2017.
ISNAD Arga, Doç. Dr. Mustafa. “Ürtiker Ve Anjioödem”. Klinik Tıp Pediatri Dergisi 9/2 (March 2017), 117-129.
JAMA Arga DDM. Ürtiker ve Anjioödem. Pediatri. 2017;9:117–129.
MLA Arga, Doç. Dr. Mustafa. “Ürtiker Ve Anjioödem”. Klinik Tıp Pediatri Dergisi, vol. 9, no. 2, 2017, pp. 117-29.
Vancouver Arga DDM. Ürtiker ve Anjioödem. Pediatri. 2017;9(2):117-29.