scholarly journals Chronic inducible urticaria: classification and prominent features of physical and non-physical types

2020 ◽  
Vol 29 (3) ◽  
Author(s):  
Iva Pozderac ◽  
Liborija Lugović-Mihić ◽  
Marinko Artuković ◽  
Asja Stipić-Marković ◽  
Matea Kuna ◽  
...  
Keyword(s):  
Chronic Inducible Urticaria ◽  
Inducible Urticaria

Effectiveness and tolerability of personalized omalizumab treatment in patients with chronic inducible urticaria

2021 ◽  
Author(s):  
Thomas P. Buters ◽  
Willemijn A.C. van der Velden ◽  
Ismahaan Abdisalaam ◽  
Maurits S. van Maaren ◽  
Martijn B.A. van Doorn
Keyword(s):  
Chronic Inducible Urticaria ◽  
Inducible Urticaria

scholarly journals Cholinergic urticaria: novel aspects of pathogenesis, diagnosis and management

2021 ◽  
Vol 24 (3) ◽  
pp. 211-226
Author(s):  
Elena Yu. Borzova ◽  
Christina Yu. Popova ◽  
Marcin Kurowski ◽  
Maia T. Rukhadze ◽  
Razvigor Darlenski ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Main Research ◽  
Cholinergic Urticaria ◽  
Chronic Inducible Urticaria ◽  
H1 Antihistamines ◽  
Inducible Urticaria ◽  
Diagnostic Approaches ◽  
Challenge Tests ◽  
Pathophysiologic Mechanisms

Cholinergic urticaria (CholU) is a chronic inducible urticaria, characterised by itchy pinpoint wheals up to 3 mm in diameter, surrounded by a prominent flare, that occur following an exposure to characteristic triggers such as active or passive heating, physical exercise, emotions, hot or spicy foods. Key pathophysiologic mechanisms include immediate hypersensitivity to autologous sweat antigens, functional sweating disorders, impaired acethylcholine metabolism, abnormal skin vascular permeability and disturbed skin innervation. Clinical manifestations of CholU may vary from typical itchy pinpoint urticarial lesions, angioedema to anaphylaxis. Atypical CholU forms include cholinergic pruritus, cholinergic dermographism, cold cholinergic urticaria and persistent cholinergic erythema. The diagnosis of cholinergic urticaria relies on patients history, сlinical manifestations and challenge tests. Treatment options include nonsedating H1 antihistamines in standard or increased doses. The evidence is accumulating for the use of biological treatment with omalizumab in cholinergic urticaria. The prospect of personalized treatment of cholinergic urticaria include autologous sweat desensitization. The main research efforts in ColdU are directed at optimizing diagnostic approaches and developing innovative therapeutic options.

Management of chronic inducible urticaria according to the guidelines: A prospective controlled study

2017 ◽  
Vol 87 (1) ◽  
pp. 60-69 ◽  
Author(s):  
Emek Kocatürk ◽  
Pelin Kuteyla Can ◽  
Pırıl Etikan Akbas ◽  
Mehmet Copur ◽  
Ece Nur Degirmentepe ◽  
...  
Keyword(s):  
Controlled Study ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
Prospective Controlled Study

scholarly journals Urticaria and Angioedema – More than just Skin Deep!

2016 ◽  
Vol 59 (2) ◽  
pp. 32-36
Author(s):  
Jeanette Holtzhausen
Keyword(s):  
Food Allergy ◽  
Response Patterns ◽  
Trigger Factors ◽  
Acute Urticaria ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
Ige Mediated ◽  
Provocation Testing ◽  
Systemic Symptoms ◽  
Work Up

Urticaria and angioedema are characterized by pruritic hives and sometimes swelling of deeper mucocutaneous layers. Urticaria is caused by release of histamine and other mediators from mast cells. A cut-off of six weeks distinguishes acute and chronic forms, as these seem to differ regarding etiological and response patterns. Angioedema may be histaminergic or due to factors involving the bradykinin pathway. Medications such as ACE-Inhibitors or conditions affecting the C1-esterase inhibitor enzyme are potential causes. Acute urticaria may be related to triggers such as infections, medications or food allergy. When occurring with systemic symptoms and a temporal relationship to food or drug ingestion, IgE mediated allergy could be considered. Chronic Inducible Urticaria (CInd) is suspected on history and may be confirmed by provocation testing where physical and other specific trigger factors elicit the wheals. The term Chronic Spontaneous Urticaria (CSU) is used when symptoms persist for more than six weeks in the absence of inducible factors. A single cause is seldom found but a thorough history and clinical evaluation may elicit trigger factors and associated medical conditions such as auto-immune or thyroid disorders. Indiscriminate food allergy testing is unhelpful, but additive intolerance may be implicated in some cases. Modern non-sedating antihistamines are the mainstay of treatment, and omalizumab or immunosuppressives may be considered for refractory cases. Emotional support is needed as the condition is associated with psychological distress. If there are unusual features, vasculitis, auto-inflammatory or haematological conditions should be considered and skin biopsy or detailed immunological work-up may be indicated.

scholarly journals Chronic inducible urticaria: Clinical presentation, diagnosis, and management

2022 ◽  
Vol 1 ◽  
pp. 2-6
Author(s):  
Pelin Kuteyla Can ◽  
Daria Fomina ◽  
Emek Kocaturk
Keyword(s):  
Patient Education ◽  
Disease Duration ◽  
Clinical Presentation ◽  
Treatment Approach ◽  
Diagnosis And Management ◽  
Physical Urticaria ◽  
Chronic Inducible Urticaria ◽  
Significant Difference ◽  
Different Types ◽  
Inducible Urticaria

Chronic inducible urticaria (CIndU) is a subtype of chronic urticaria characterized by recurrent itchy wheals and/or angioedema for more than 6 weeks. CIndU has a longer disease duration than chronic spontaneous urticaria (CSU) and wheals are shorter lasting than CSU. CIndU incudes physical and non-physical urticaria. Triggers and diagnosis of subtypes of CIndU differ from each other. Patient education for avoiding triggers is an important aspect of the treatment of CIndU. There is no significant difference in the treatment approach for CIndU and CSU. In this article, we have discussed different types of CIndU, their clinical features, diagnosis, and management.

scholarly journals The Use of Omalizumab in Chronic Urticaria: Available Data and Future Aspects of Anti-IgE Treatment

2021 ◽  
Author(s):  
Young-Min Ye
Keyword(s):  
Chronic Urticaria ◽  
Efficacy And Safety ◽  
Chronic Inducible Urticaria ◽  
First Choice ◽  
H1 Antihistamines ◽  
Choice Of Treatment ◽  
Inducible Urticaria ◽  
Disease Modifying ◽  
Impaired Quality

Chronic urticaria (CU) defined as repeatedly occurred itchy wheals and/or angioedema for at least 6 weeks. Due to the unpredictability, recurrent and disabling symptoms, and a considerably impaired quality of life, effective and tolerable treatment for CU patients is crucial. Almost a half of patients with CU are refractory to H1-antihistamines, even though the dose of antihistamines is increased up to 4-fold. Recently treatment modulating IgE levels and activities provides an efficient therapeutic approach. Omalizumab, the only approved anti-IgE treatment for chronic spontaneous urticaria (CSU) patients until now, with a strong evidence of the efficacy and safety, opened a new horizon in the care of the patients whose urticaria is not controlled with antihistamines. Recent international guidelines recommend omalizumab as the first choice of treatment for antihistamine-refractory CSU. However, as it is not curative neither disease-modifying agent, there is a subpopulation of CSU patients responding partly or never to omalizumab. The other things to be solved in the treatment of CU is that clinical evidence is still limited on chronic inducible urticaria (CIndU) and special populations. Thus, a new anti-IgE treatment, ligelizumab is actively evaluated in the efficacy compared with both placebo and omalizumab. Further understandings on the pathogenesis of CU can lead to the development of new mechanism-based therapeutics for CU patients.

scholarly journals Advances in Understanding and Managing Chronic Urticaria

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 177 ◽  
Author(s):  
Yasmin Moolani ◽  
Charles Lynde ◽  
Gordon Sussman
Keyword(s):  
Chronic Urticaria ◽  
Immunoglobulin E ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Fold Increase ◽  
Line Treatment ◽  
Physical Urticaria ◽  
Chronic Inducible Urticaria ◽  
Autoimmune Urticaria ◽  
Inducible Urticaria

There have been recent advances in the classification and management of chronic urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic inducible urticaria (CINDU) has replaced physical urticaria and includes other forms of inducible urticaria, such as cholinergic and aquagenic urticaria. Furthermore, novel research has resulted in a new understanding with guidelines being revised in the past year by both the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA2LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There are some differences in the recommendations, which will be discussed, but the core updates are common to both groups. The basic treatment for chronic urticaria involves second-generation non-sedating non-impairing H1 antihistamines as first-line treatment. This is followed by up to a 4-fold increase in the licensed dose of these H1 antihistamines. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor. Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab for CSU. There are also some small studies showing efficacy of omalizumab in CINDU. While there were previously many treatment options which were lacking in strong evidence, we are moving into an era where the treatment algorithm for chronic urticaria is simplified and contains more evidence-based, effective, and less toxic treatment options.

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