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Writer's pictureAziz Ghafoor

Chronic Urticaria: Diagnosis and Management

In this blog, we will explore how chronic urticaria is diagnosed as well as management strategies that can bring relief to those that are affected by this skin condition.


Diagnosis: How is Chronic Urticaria Identified?


The diagnosis of chronic urticaria typically begins with a visit to a dermatologist or allergist. The diagnosis is primarily a clinical diagnosis, which means that it is based on the appearance of hives on the skin that last for more than six weeks. While allergy tests may be done to rule out allergens, it is important to note that most chronic urticaria cases are not allergy-related. Therefore, extensive allergy testing is rarely required unless specific triggers like food or medications are suspected.

A thorough medical history is essential in determining the type of chronic urticaria. For patients with chronic spontaneous urticaria (CSU), additional tests might be conducted to rule out underlying conditions like thyroid disease or infections that could contribute to symptoms.


Management of Chronic Urticaria: What Can You Do?


The good news is that chronic urticaria is not a life-threatening condition; it is typically limited in time and for most patients it will go away. However, it can still have a significant negative impact on the quality of life of those who are living with this condition. Fortunately, there are several treatments to help provide relief from the symptoms:


  1. Antihistamines: This is the first-line treatment option, and often provides relief from the itch and hives. Second-generation antihistamines like cetirizine or loratadine are preferred as they cause fewer side effects than older medications. In certain cases, antihistamines can be given up to four times the typical daily dose.


  1. Omalizumab: In cases where antihistamines fail to provide relief, omalizumab, a biologic that targets the antibody immunoglobulin E (IgE), has been highly effective in treating CSU. Studies show that a majority of patients experience a reduction in symptoms with this treatment.


  1. Corticosteroids: Corticosteroids may be prescribed for short-term relief in severe cases of chronic urticaria; however, they are not recommended for long-term use due to potential side effects.


  2. Lifestyle Modifications: Some patients may have a type of chronic urticaria known as chronic inducible urticaria. For these patients, avoiding triggers, such as extreme temperatures or tight clothing, can help prevent flare-ups. Stress management techniques such as meditation and yoga can also help with reducing the severity of symptoms in some patients.


Several new treatments for chronic urticaria are soon to be available, we will keep you informed!


Living with Chronic Urticaria


Although there is currently no cure available for chronic urticaria, the condition can be effectively managed with appropriate treatment. The goal of current therapeutics for chronic urticaria is to provide complete symptom relief for patients. Working closely with a healthcare provider to tailor your medication and monitor symptoms can help individuals regain control over their daily lives. Keeping up to date about new treatments and self-care strategies can empower those affected to navigate the challenges of chronic urticaria more effectively.


References:

  1. Zuberbier T, Abdul Latiff AH, Abuzakouk M, et al. (2022). "The international EAACI/GA²LEN/ EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria." Allergy. 77, 734–766. doi:10.1111/all.15090

  2. Kaplan, A.P. (2018). "Chronic urticaria: Pathogenesis and treatment." Journal of Allergy and Clinical Immunology, 141(2), 425-431.

  3. Dabija, D., Tadi, P., & Danosos, G. N. (n.d. 2023). Chronic Urticaria. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK555910/

  4. Kolkhir, P. et al. (2021). “Autoimmune comorbidities in chronic spontaneous urticaria: A systematic review.” Allergy, 76(4), 1282-1303.

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Aziz
Ghafoor

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Aziz Abdul Ghafoor is a second-year medical student at UBC with a passion for dermatology and patient advocacy. Originally from Afghanistan and raised in Canada, Aziz Is dedicated to improving health outcomes for marginalized communities.

 

His work with Chronic Urticaria Canadian Chronic Urticaria Society) reflects his commitment to supporting patients who face chronic skin conditions. Through this partnership, he aims to raise awareness, foster support networks, and provide educational resources to empower individuals affected by chronic urticaria across Canada.

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