This article is developed by the Skin Allergy Research Society of India for an updated evidence-based consensus statement for the management of urticaria, with a special reference to the Indian context. This guideline includes updated definition, causes, classification, and management of urticaria. Urticaria has a profound impact on the quality of life and causes immense distress to patients, necessitating effective treatment. One approach to manage urticaria is by identification and elimination of the underlying cause(s) and/or eliciting trigger(s) while the second one is by treatment for providing symptomatic relief. This guideline recommends the use of second-generation nonsedating H1-antihistamines as the first-line treatment. The dose can be increased up to four times to meet the expected results. In case patients still do not respond, appropriate treatment options can be selected depending on the associated medical condition, severity of the symptoms, affordability of the drugs, and accessibility of modern biologics such as omalizumab.

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Background:Psoriasis may be complicated by contact dermatitis due to an impaired cutaneous barrier. Patch testing helps elucidate sensitizers if any.Aims:To determine the prevalence and relevance of secondary contact dermatitis in subjects with psoriasis.Materials and Methods:Patch testing with Indian Standard Series was done and readings interpreted after 48 and 96 hours.Results:Among 110 subjects 47 (42.7%) showed reactions to at least one antigen. Fifteen (13.6%) reacted to fragrance mix, 10 (9.1%) to nickel sulfate, seven (6.4%) to parthenium, and six (5.5%) to balsam of Peru. Palmoplantar psoriasis was the commonest type of psoriasis patch tested. Fragrance mix was the commonest antigen showing 100% current relevance as an aggravating factor of psoriasis. Cosmetics, beauty preparations, skin and healthcare products followed by topical medications were found to be the most common sources of the patch test positivity.Conclusions:Secondary contact dermatitis is common in patients with psoriasis. Patch testing is necessary to determine the triggering or aggravating antigens in these patients to avoid sensitizers and improve quality of life.

9 of 10 patients who developed dermatitis following contact with Holigarna ferruginea and 5 of 35 asymptomatic volunteers showed a positive patch test reaction to 2% W/V acetone extract of the plant's resinous exudate. 6 albino rats were sensitized following 3 weekly applications of the same extract. Laccol (3-heptadecadienyl catechol) was identified as the active principle in the exudate.