Fibrinolysis in Chronic Urticaria

Adrenergic Urticaria: An Updated Review

“…AU is considered to be a rare form of urticaria [ 1 - 2 , 4 - 5 , 7 ], although there is not enough information available in the literature to ensure it is a rare occurrence. AU may be misdiagnosed, potentially contributing to a percentage of idiopathic chronic urticarial eruption diagnoses.…”

“…The classic clinical cutaneous manifestations of AU are transient and disseminated and include its characteristic white halo of vasoconstriction surrounding erythematous papules, wheals, macules, and plaques in severe cases [ 1 - 6 , 8 ]. Pruritus can be present with cutaneous findings (Figure 1 ) [ 5 , 7 , 9 ]. Systemically, some manifestations have been associated with AU, including heart palpitations, tachypnea, paresthesias, malaise, wheezing, postural orthostatic tachycardia syndrome, increased heart rate, and increased blood pressure (Figure 1 ) [ 1 , 4 , 9 ].…”

“…Additionally, there has been one reported case of dupilumab, an IL4 receptor antagonist, used successfully to treat AU [ 4 ]. The standard treatment for AU is propranolol 10-60 mg orally two to three times daily, depending on severity [ 1 - 5 , 7 - 8 ]. Allergic reactions to propranolol causing urticarial eruptions are rare but have been reported and are something to be aware of [ 17 ].…”

“…It is clinically defined by transient disseminated episodes of papules, wheals, macules, and plaques in severe cases that are characteristically surrounded by a white halo of vasoconstriction [ 1 - 6 , 8 ]. AU is described as a rare form of urticaria [ 1 - 2 , 4 - 5 , 7 ]. It was first described in 1985 by Shelly and Shelly as an “autonomic-system-dependent urticaria” with associated increases in plasma epinephrine and norepinephrine during the time of flare [ 8 ].…”