The Classification, Pathogenesis, Diagnostic Workup, and Management of Urticaria: An Update

Maurer, Marcus; Zuberbier, Torsten; Metz, Martin

doi:10.1007/164_2021_506

Cited by 16 publications

(8 citation statements)

References 76 publications

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“…They can also be activated by superallergens (i.e., a group of viral or bacterial proteins) through IgE‐binding at the surface of basal cells nonspecifically. Basophils and eosinophils are also thought to be involved in developing urticarial lesions, but their respective roles are still uncertain 45,46 …”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiology of these lesions is based on a complex interplay of mediators affecting the dermis and Basophils and eosinophils are also thought to be involved in developing urticarial lesions, but their respective roles are still uncertain. 45,46 Since wheals are predominantly known as a manifestation of drug hypersensitivity, urticarial lesions in COVID-19 patients are initially believed to be due to the administered medicines for the disease. 47 However, several studies reported urticarial lesions in pa-…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous manifestations in elderly patients with confirmed coronavirus disease 2019 and the disease outcomes: A systematic review

Yusharyahya

Japranata

Jonlean

et al. 2023

The Journal of Dermatology

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Cutaneous manifestations in coronavirus disease 2019 patients may possess prognostic value for identifying potentially severe cases. This systematic review investigated whether dermatological features are associated with COVID-19 outcomes in elderly patients. Literature retrieval was conducted on May 11, 2022, from databases, hand-searching, and tracing citations. Following selection against eligibility criteria, the remaining records were evaluated utilizing the National Heart, Lung, and Blood Institute Study Quality Assessment Tool or Newcastle-Ottawa Scale. The pooled individual data were subsequently analyzed using the Cochran-Mantel-Haenszel test to calculate the odds ratio (ORs) and confidence intervals (CIs) for the severity and mortality of each skin lesion type. We incorporated 70 articles, including 180 and 117 entries, with information regarding disease severity and mortality. Further analysis revealed that vascular type was the skin lesion most frequently noticed in confirmed COVID-19 elderly patients (46.2%) and was associated with an increased risk of developing advanced disease (OR 7.32,) and the ensuing termination (OR 5.73,). The converse phenomenon was observed in maculopapular type (severity OR 0.27, 95% CI 0.14-0.52; mortality OR 0.10, 95% CI 0.03-0.36). In conclusion, skin manifestations may predict COVID-19 severity and mortality in the senior group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cutaneous manifestations in elderly patients with confirmed coronavirus disease 2019 and the disease outcomes: A systematic review

Yusharyahya

Japranata

Jonlean

et al. 2023

The Journal of Dermatology

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“…According to the latest guidelines, H1 antihistamines (mostly 2nd generation) are primarily used in the treatment of urticaria. The next therapeutic option is omalizumab, an anti-IgE antibody 4 . Chronic spontaneous urticaria lasts on average between 3 and 5 years and monitoring of patients has shown that in approximately 50% of patients spontaneous remission occurs in the first 3 months of the disease.…”

confidence: 99%

The psychosocial burden of urticaria

Jerković¹,

Bešlić²,

Ćesić³

et al. 2021

Rad Hrvatske akademije znanosti i umjetnosti

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Urticaria is one of the most common dermatologic allergic diseases, but also holds a significant psychosocial burden due to possible long duration, frequent relapses, unknown cause or trigger and resistance to applied therapy. Many patients associate the onset and worsening of the disease with stressful experiences indicating it can be a psychosomatic disease within the psychoneuroimmunological approach. Apart from that, urticaria greatly affects the quality of life (QoL) of patients, disrupts their daily lives in all aspects, and is a dermatological disease with one of the highest prevalence of psychiatric comorbidities. Therefore, in this review article we discuss why a multidisciplinary approach, which includes both biological, psychological and social aspects of the disease, must be acknowledged for effective treatment. Finally, we provide suggestions for clinical management of patients suffering from urticaria.

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“…The currently licensed treatment options target either the main MC mediator histamine (second generation H1‐antihistamines, the first line of CSU therapy) or IgE‐FcεRI mediated MC activation (omalizumab, an anti‐IgE monoclonal antibody, the second line of CSU therapy). Many more treatments are currently under investigation, some of which have shown positive outcomes in early trials and will possibly broaden the therapy spectrum in the future 1,3–11 …”

Section: Introductionmentioning

confidence: 99%

“…Many more treatments are currently under investigation, some of which have shown positive outcomes in early trials and will possibly broaden the therapy spectrum in the future. 1,[3][4][5][6][7][8][9][10][11] Omalizumab has proven to be an effective treatment for CSU patients, 1 and pivotal trials showed response rates up to 50%. 12-14 However, some patients require multiple injections and up-dosing to achieve disease…”

mentioning

confidence: 99%

Elevated baseline soluble FcεRI may be linked to early response to omalizumab treatment in chronic spontaneous urticaria

Moñino‐Romero,

Kolkhir,

Ohanyan

et al. 2023

Acad Dermatol Venereol

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BackgroundOmalizumab, an anti‐IgE monoclonal antibody, is an effective treatment in chronic spontaneous urticaria (CSU). Predictors of fast and good response for omalizumab treatment have not yet been identified and characterized.ObjectiveTo evaluate if soluble FcεRI (sFcεRI), a marker of IgE‐mediated mast cell activation, predicts the time of response to omalizumab in CSU.MethodsSera of 67 CSU patients were obtained before omalizumab treatment and analysed for sFcεRI levels by ELISA (2 ng/mL was used as cut‐off for elevated sFcɛRI). Treatment response during the first 4 weeks was assessed with the urticaria activity score (UAS7), urticaria control test (UCT) and the rolling UAS7 (rUAS7).ResultsElevated pre‐treatment sFcɛRI levels were detected in more than 70% of patients with completely controlled disease (UCT = 16) and well controlled disease (UCT = 12‐15) and were significantly associated with disease control (χ2 = 4.94, p < 0.05). More than half of the patients (14/25) with low levels had poor disease control (UCT < 12). Of the patients who achieved complete and marked UAS7 response, respectively, 75% and 63% had elevated baseline sFcɛRI levels. Post‐treatment UAS7 scores were lower in patients with elevated sFcɛRI levels reaching statistical significance at week 3 (p < 0.05). Patients with elevated baseline sFcɛRI levels achieved rUAS7 ≤ 6 and = 0 earlier than those with lower levels (day 9 vs 13 and day 12 vs 14, respectively).ConclusionElevated sFcεRI serum levels predict early and good response to treatment with omalizumab, which may help to better design treatment options for CSU patients.

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The Classification, Pathogenesis, Diagnostic Workup, and Management of Urticaria: An Update

Cited by 16 publications

References 76 publications

Cutaneous manifestations in elderly patients with confirmed coronavirus disease 2019 and the disease outcomes: A systematic review

Cutaneous manifestations in elderly patients with confirmed coronavirus disease 2019 and the disease outcomes: A systematic review

The psychosocial burden of urticaria

Elevated baseline soluble FcεRI may be linked to early response to omalizumab treatment in chronic spontaneous urticaria

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