Treatment of Chronic Spontaneous Urticaria

April 2015 | Volume 14 | Issue 4 | Features | 332 | Copyright © April 2015

Nicholas A. Soter MD

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY

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Episodes of urticaria that recur more than six weeks are considered chronic. Chronic urticaria may be divided into chronic spontaneous urticaria with chronic idiopathic and autoimmune subtypes and chronic inducible or physical urticaria. More than one type of chronic urticaria may occur in the same individual. Consensus conferences and various organizations have recommended guidelines for the management of chronic spontaneous urticaria based on high levels of evidence and suggest the initial use of H1 antihistamines followed by montelukast, cyclosporine, and omalizumab. 1,2 However, there are other therapeutic agents with low levels of evidence that may be of value, and their use is offlabel. Therapeutic agents approved for chronic spontaneous urticaria by the Food and Drug Administration include certain H1 antihistamines and omalizumab.

H1 Antihistamines