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Introduction: Patients of Chronic Urticaria (CU) suffer from the morbidity that arise from irritable itch and wheals and it also shows a poor response to drug treatment. Treatment options which increase the duration of remission and those which address the key factors involved in the disease pathogenesis are the need of the hour. Aim: To assess the efficacy of injection histaglobulin a complex of histamine and human immunoglobulin in producing relief in patients with CU. Secondary objective was to compare effect of histaglobulin in between Autologous Serum Skin Test (ASST) positive and ASST negative group of CU patients. Materials and Methods: The present study was a prospective clinical study in which 40 patients with CU were enrolled. Patients were administered injection histaglobulin as a weekly dose of 1 mL subcutaneously for eight consecutive weeks. Patients were permitted to take Tab Levocetirizine 5 mg as and when required not exceeding the recommended permitted dose. The efficacy of the drug was assessed using Urticaria Activity Score (UAS 7) a unified, validated and simple scoring system. The assessment was done at every weekly visit and the final assessment was done after 24 weeks. Results: Out of 40 patients enrolled, 32 patients had completed the entire schedule of dosage of eight weeks and final follow-up at 24th week. The mean basal UAS 7 was 12.6 at the time of enrolment to the study and it reduced to 2.57 at the end of 8th week which marginally increased to 2.8 at the end of 24 weeks, the antihistamine pill burden also reduced. No adverse effects were observed in the study group. Conclusion: Histaglobulin was found to be effective in producing long term remission and it reduced the antihistamine need as well. Thus, it can be an effective alternative to existing treatment modalities.

Generalised pustular psoriasis (GPP) is an uncommon, severe, life-threatening variant of psoriasis requiring careful therapeutic approach. Conventional treatment modalities have unsatisfactory outcomes, poor side effect profiles and toxicities that have led to an emerging use of biological therapies. Itolizumab, an anti-CD-6 humanised monoclonal IgG1 antibody, is approved for the management of chronic plaque psoriasis in India. We share our experience of using this drug in three cases of GPP that were failing conventional therapies. Its upstream effect on co-stimulatory pathway in disease pathogenesis is the postulated mechanism. Our experience warrants further large-scale exploration of the role of itolizumab in the management of GPP, which would benefit this severely affected population of patients. Although the definite pathogenesis of GPP is unknown fully, molecules blocking CD-6, which plays a role in the interaction between T cells and antigen-presenting cells (APCs), are expected as new promising treatment options for GPP.