Omalizumab at an initial dosage of 150 mg was effective in the treatment of recalcitrant CSU among Asians. Updosing to 300 mg was required to achieve satisfactory outcomes.

Omalizumab has been approved for the treatment of recalcitrant chronic spontaneous urticaria (CSU). However, it remains unanswered whether omalizumab modifies a CSU course. We aimed to study a course of CSU after omalizumab treatment in an Asian population. Medical records of recalcitrant CSU patients who attended Siriraj Hospital between 2013 and 2017 were reviewed. All patients receiving omalizumab treatment were followed after the first injection for at least 1 year. Of 15 patients receiving omalizumab treatment, 11 patients (73.3%) responded well to 150 mg while the rest required 300 mg. The median follow-up period was 18 months (range, 13.5-25.3). Three patterns of response were proposed and measured: excellent (disease remission over than 6 months) was found in 20%; good (injection interval extended longer than 6 months) was found in 27%; and modest (frequently required injections) was found in 53%. The mean duration of complete remission was 33 weeks (range, 26-38). Two-thirds of patients had disease relapse and required omalizumab injections to control symptoms. The other third did not show relapses for at least 69 weeks of the follow-up period. After 1 year of treatment, Kaplan-Meier curves estimated that a higher percentage (86.7%) of recalcitrant CSU patients receiving omalizumab treatment would be free of symptoms (weekly Urticaria Activity Score = 0) without prednisolone and/ or cyclosporin as compared with 42% of patients not receiving omalizumab treatment. In conclusion, patients seem to be easily and safely manageable with omalizumab. Prednisolone and cyclosporin could be discontinued in all patients. Further studies are needed to conclude whether omalizumab can exactly modify CSU.

Objective: To evaluate the characteristics of post-adolescent male patients with acne in terms of the onset of the condition, its clinical course and severity, and the behaviors associated with its severity. Materials and Methods: A prospective, cross-sectional study was conducted on adult males with acne who visited Siriraj Hospital, Thailand. All male acne patients aged 21 years and older were enrolled. Diagnoses and physical examinations were performed by dermatologists. Results: Seventy-two patients (mean age, 26.9 [± 4.3] years) were included. Persistent acne, relapse acne, and late-onset acne (onset at age ≥ 21 years) were reported in 62.5%, 33.3%, and 4.2% cases, respectively. Persistent acne tended to subside at 26 years of age, whereas late-onset acne tended to start at 28 years of age. The acne severity was mild in most cases. Pimple-picking, followed by frequent face washing, were common habits among male acne patients. Shaving influenced the severity in some adult male with acne. Conclusion: Adult male acne commonly presented as inflammatory lesions and comedones on the cheeks. They commonly had an onset earlier than 21 years old and continued into adulthood, but the post-adolescent severity tended to be mild. While several factors have been reported elsewhere to be involved in the severity of acne, this study found that only shaving influenced severity.