Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system...Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution—SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the out-patient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.展开更多
Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is t...Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine展开更多
In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase cha...In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase chain reactions with sequence-specific primers (PCR-SSP) in 42 patients with CU (19 men and 23 women, mean age 30.67±12.45 y old as well as 193 racially matched healthy persons in ethnic Han from Hubei provinece. Gene frequencies of HLA-DRB1*12, *0901 (RR=3.11, χ2=7.579, P=0.006; RR=2.47, χ2=5.684, P=0.017) were significantly increased in CU patients as compared with that in healthy people. Gene frequencies of HLA-DQB1*05 (RR=0.26, χ2=6.683, P=0.01) were significantly decreased in CU patients. It was suggested that CU was found strongly associated with HLA-DRB1*12, *0901 and HLA-DQB1*05, the former might be the genetic markers for susceptibility to CU, but the latter might play a resistive role.展开更多
Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, ...Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, tailored to the severity of the condition, which can enhance overall quality of life. Aim: In this article, we outline a systematic approach to managing chronic urticaria, while also elucidating the available treatment strategies for cases that prove resistant to conventional therapies. To illustrate our points, we present a clinical case as a practical example. Case Presentation: Here, we present a patient with CSU since childhood who presented in the context of refractory hives and generalized arthralgia that responded well to omalizumab therapy with no further relapse. Conclusion: Omalizumab is a biological agent that offers a potential treatment option for CSU. It is available for individuals twelve years and older who have not responded well to conventional treatments. It has demonstrated good efficacy with a relatively low rate of clinically significant adverse effects. Nonetheless, there is a dearth of research regarding the optimal method for tapering the dosage and determining the duration of treatment.展开更多
Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including sys...Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.展开更多
Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to eval...Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to evaluate the clinical and therapeutic socio-demographic profile and quality of live of patients followed for urticaria in the dermatology-venereology department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Methodology: We conducted a descriptive cross-sectional study over a 5-year period from 1 January 2015 to 31 December 2019. The data were collected retrospectively by analysing the files and prospectively by evaluating the quality of life with DLQI. All the records of patients treated for urticaria at the Dermatology-Venerology Department of the Yalgado Ouédraogo University Hospital during the period were included. Results: Urticarial frequency is 1.91%. There were 36 men (25.71%) and 104 women (74.28%), i.e. a sex ratio of 0.34. The median age was 31 years with extremes of 4 to 70 years. The 30 - 45 age group accounted for 51.42%, followed by the 16 - 29 age group (31.42%), then the 46 - 65 age group (9.28%), the 4 - 15 age group (5.71%) and the over 66 age group (2.14%). In terms of occupation, pupils/students accounted for 37.1%, housewives for 18.6% and workers for 44.3%. As for the residence of the patients, 88.57% lived in Ouagadougou Personal history of atopy, it concerned 19.26% of patients, with precisely 9.28% having asthma history, 7.14% having rhino-sinusitis history, 1.42% of atopic dermatitis and allergic conjunctivitis respectively. For clinical aspects, 97.14% of the patients had superficial urticaria, and 2.86% had facial angioedema. There were 35% (49) patients with acute urticaria and 65% (91) with chronic urticaria. Chronic urticaria was spontaneous in 55% (50) and physically inducible in 10% (9) (sweating, pressure or friction). 97.14% of patients received antihistamines associated with systemic corticoids in 2.86%. For Quality of life, the mean DLQI score was 7.51, indicating a moderate effect of urticaria on patients’ quality of life. The quality of life of women was more affected than that of men, especially in the professional and social spheres. Conclusion: In hospital frequency of urticaria is low in Ouagadougou, a predominance of chronic spontaneous urticaria whose management involves the use of second generation antihistamines at a dosage and duration that do not meet international recommendations. The patients’ quality of life was moderately impaired.展开更多
Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or a...Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or almost daily symptoms a type I allergy could be the underlying cause. We present one adult patient with chronic urticaria who was finally diagnosed as a non-occupational case of IgE-mediated wheat allergy manifested following exposure by 3 different routes: inhalation (rhinitis and bronchial asthma), dermal absorption (contact urticaria) and ingestion (systemic chronic urticaria). We were able to detect the culprit proteins by immunoblotting. Serum IgE binds mainly to alpha-amylase/trypsin inhibitors and, to a lesser extent, to other proteins associated with food allergy to grains (e.g. beta-glucanase, serpin, peroxidase). In our opinion, skin prick tests with a food standard battery could help in the etiological diagnosis of chronic urticaria. The identification of responsible allergens could be difficult because only a few complex in vitro techniques allow detecting the allergy to several proteins.展开更多
Objective:To study the effect of Jumihaidokuto(Shi-Wei-Bai-Du-Tang,十味败毒汤)in the management of chronic spontaneous urticaria.Methods:A randomized two-arm,parallel group study was conducted to compare the effect of...Objective:To study the effect of Jumihaidokuto(Shi-Wei-Bai-Du-Tang,十味败毒汤)in the management of chronic spontaneous urticaria.Methods:A randomized two-arm,parallel group study was conducted to compare the effect of Jumihaidokuto(6 g daily)with a control for 8 weeks.Concomitant therapy(e.g.,antihistamines)was continued.Twenty?one subjects with severe chronic urticaria were enrolled in this study.The primary treatment outcome was the severity score proposed by the Japanese Dermatological Association.Secondary outcomes were quality of life(Skindex-16),itch intensity(Visual Analogue Scale),and patients'subjective disability due to wheal or itch.After the subjects were randomly assigned to groups by block randomization,10 received Jumihaidokuto,and 11 did not.All subjects had already taken antihistamines.Results:Improvement was significant when comparing the severity score of the Jumihaidokuto group with that of the control group(P<0.01).Skindex-16 values for both groups gradually decreased in the same fashion.Conclusion:Concomitant use of Jumihaidokuto with antihistamine was more effective than antihistamine alone in the management of chronic idiopathic urticaria.展开更多
Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate ...Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate the relationship between elevated serum levels of tlgE in patients with CU and the sensitivity of these patients to antihistamine treatments.Methods:Blood samples of 302 patients with CU were collected,and their levels of serum tlgE were measured.The patients were divided into two groups according to their serum tlgE level:High serum tlgE level group (>150 U/mL)and Low serum tlgE level group (< 150 U/mL).The correlations between the serum tlgE end disease severity as well as the sensitivity of patients to antihistamine treatments were assessed.Data were statistically analyzed using t-tasts and Chi-square tests.Results:Higher rates of positive autologous serum skin test results (X2=5.707,P=0.017) and skin scratch test results (x2 =5.878,P=0.015),higher CU scores (average:2.88±0.73 vs.2.18±0.59,t =6.377,P< 0.001),and longer disease course durations (median:8.5 vs.14.6,z=5.525,P<0.001) were observed in patients with high levels of serum tlgE compared with those with low levels of serum tlgE;moreover,patients with higher levels of serum tlgE were less sensitive to antihistamine therapies compared with those with lower levels of serum tlgE (x2=16.783,P < 0.001).Conclusion:Our study indicates that the high serum tlgE level is associated with the disease severity as well as with low sensitivity to antihistamine treatment of patients.展开更多
Chronic urticaria(CU)is characterized by repeated occurrence of wheals or itching for more than 6 weeks.When urticaria symptoms repeatedly occur despite taking Western medicines such as antihistamines,Chinese medicine...Chronic urticaria(CU)is characterized by repeated occurrence of wheals or itching for more than 6 weeks.When urticaria symptoms repeatedly occur despite taking Western medicines such as antihistamines,Chinese medicine(CM)has been shown to relieve symptoms and prevent recurrence.However,the lack of robust evidence from the evidence-based medicine perspective is hindering acceptance of CM by the Western medicine community.In recent years,more and more evidence-based studies of CU treatment by CM were report in English literatures,including acupuncture,herbs,and food,although some of evidence is still with low quality.These progress in CM treatment of CU will inspire high quality evidences via randomized,controlled trials assessing efficacy and safety of CM treatment of CU.展开更多
文摘Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution—SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the out-patient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.
文摘Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine
文摘In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase chain reactions with sequence-specific primers (PCR-SSP) in 42 patients with CU (19 men and 23 women, mean age 30.67±12.45 y old as well as 193 racially matched healthy persons in ethnic Han from Hubei provinece. Gene frequencies of HLA-DRB1*12, *0901 (RR=3.11, χ2=7.579, P=0.006; RR=2.47, χ2=5.684, P=0.017) were significantly increased in CU patients as compared with that in healthy people. Gene frequencies of HLA-DQB1*05 (RR=0.26, χ2=6.683, P=0.01) were significantly decreased in CU patients. It was suggested that CU was found strongly associated with HLA-DRB1*12, *0901 and HLA-DQB1*05, the former might be the genetic markers for susceptibility to CU, but the latter might play a resistive role.
文摘Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, tailored to the severity of the condition, which can enhance overall quality of life. Aim: In this article, we outline a systematic approach to managing chronic urticaria, while also elucidating the available treatment strategies for cases that prove resistant to conventional therapies. To illustrate our points, we present a clinical case as a practical example. Case Presentation: Here, we present a patient with CSU since childhood who presented in the context of refractory hives and generalized arthralgia that responded well to omalizumab therapy with no further relapse. Conclusion: Omalizumab is a biological agent that offers a potential treatment option for CSU. It is available for individuals twelve years and older who have not responded well to conventional treatments. It has demonstrated good efficacy with a relatively low rate of clinically significant adverse effects. Nonetheless, there is a dearth of research regarding the optimal method for tapering the dosage and determining the duration of treatment.
文摘Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.
文摘Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to evaluate the clinical and therapeutic socio-demographic profile and quality of live of patients followed for urticaria in the dermatology-venereology department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Methodology: We conducted a descriptive cross-sectional study over a 5-year period from 1 January 2015 to 31 December 2019. The data were collected retrospectively by analysing the files and prospectively by evaluating the quality of life with DLQI. All the records of patients treated for urticaria at the Dermatology-Venerology Department of the Yalgado Ouédraogo University Hospital during the period were included. Results: Urticarial frequency is 1.91%. There were 36 men (25.71%) and 104 women (74.28%), i.e. a sex ratio of 0.34. The median age was 31 years with extremes of 4 to 70 years. The 30 - 45 age group accounted for 51.42%, followed by the 16 - 29 age group (31.42%), then the 46 - 65 age group (9.28%), the 4 - 15 age group (5.71%) and the over 66 age group (2.14%). In terms of occupation, pupils/students accounted for 37.1%, housewives for 18.6% and workers for 44.3%. As for the residence of the patients, 88.57% lived in Ouagadougou Personal history of atopy, it concerned 19.26% of patients, with precisely 9.28% having asthma history, 7.14% having rhino-sinusitis history, 1.42% of atopic dermatitis and allergic conjunctivitis respectively. For clinical aspects, 97.14% of the patients had superficial urticaria, and 2.86% had facial angioedema. There were 35% (49) patients with acute urticaria and 65% (91) with chronic urticaria. Chronic urticaria was spontaneous in 55% (50) and physically inducible in 10% (9) (sweating, pressure or friction). 97.14% of patients received antihistamines associated with systemic corticoids in 2.86%. For Quality of life, the mean DLQI score was 7.51, indicating a moderate effect of urticaria on patients’ quality of life. The quality of life of women was more affected than that of men, especially in the professional and social spheres. Conclusion: In hospital frequency of urticaria is low in Ouagadougou, a predominance of chronic spontaneous urticaria whose management involves the use of second generation antihistamines at a dosage and duration that do not meet international recommendations. The patients’ quality of life was moderately impaired.
文摘Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or almost daily symptoms a type I allergy could be the underlying cause. We present one adult patient with chronic urticaria who was finally diagnosed as a non-occupational case of IgE-mediated wheat allergy manifested following exposure by 3 different routes: inhalation (rhinitis and bronchial asthma), dermal absorption (contact urticaria) and ingestion (systemic chronic urticaria). We were able to detect the culprit proteins by immunoblotting. Serum IgE binds mainly to alpha-amylase/trypsin inhibitors and, to a lesser extent, to other proteins associated with food allergy to grains (e.g. beta-glucanase, serpin, peroxidase). In our opinion, skin prick tests with a food standard battery could help in the etiological diagnosis of chronic urticaria. The identification of responsible allergens could be difficult because only a few complex in vitro techniques allow detecting the allergy to several proteins.
文摘Objective:To study the effect of Jumihaidokuto(Shi-Wei-Bai-Du-Tang,十味败毒汤)in the management of chronic spontaneous urticaria.Methods:A randomized two-arm,parallel group study was conducted to compare the effect of Jumihaidokuto(6 g daily)with a control for 8 weeks.Concomitant therapy(e.g.,antihistamines)was continued.Twenty?one subjects with severe chronic urticaria were enrolled in this study.The primary treatment outcome was the severity score proposed by the Japanese Dermatological Association.Secondary outcomes were quality of life(Skindex-16),itch intensity(Visual Analogue Scale),and patients'subjective disability due to wheal or itch.After the subjects were randomly assigned to groups by block randomization,10 received Jumihaidokuto,and 11 did not.All subjects had already taken antihistamines.Results:Improvement was significant when comparing the severity score of the Jumihaidokuto group with that of the control group(P<0.01).Skindex-16 values for both groups gradually decreased in the same fashion.Conclusion:Concomitant use of Jumihaidokuto with antihistamine was more effective than antihistamine alone in the management of chronic idiopathic urticaria.
文摘Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate the relationship between elevated serum levels of tlgE in patients with CU and the sensitivity of these patients to antihistamine treatments.Methods:Blood samples of 302 patients with CU were collected,and their levels of serum tlgE were measured.The patients were divided into two groups according to their serum tlgE level:High serum tlgE level group (>150 U/mL)and Low serum tlgE level group (< 150 U/mL).The correlations between the serum tlgE end disease severity as well as the sensitivity of patients to antihistamine treatments were assessed.Data were statistically analyzed using t-tasts and Chi-square tests.Results:Higher rates of positive autologous serum skin test results (X2=5.707,P=0.017) and skin scratch test results (x2 =5.878,P=0.015),higher CU scores (average:2.88±0.73 vs.2.18±0.59,t =6.377,P< 0.001),and longer disease course durations (median:8.5 vs.14.6,z=5.525,P<0.001) were observed in patients with high levels of serum tlgE compared with those with low levels of serum tlgE;moreover,patients with higher levels of serum tlgE were less sensitive to antihistamine therapies compared with those with lower levels of serum tlgE (x2=16.783,P < 0.001).Conclusion:Our study indicates that the high serum tlgE level is associated with the disease severity as well as with low sensitivity to antihistamine treatment of patients.
文摘Chronic urticaria(CU)is characterized by repeated occurrence of wheals or itching for more than 6 weeks.When urticaria symptoms repeatedly occur despite taking Western medicines such as antihistamines,Chinese medicine(CM)has been shown to relieve symptoms and prevent recurrence.However,the lack of robust evidence from the evidence-based medicine perspective is hindering acceptance of CM by the Western medicine community.In recent years,more and more evidence-based studies of CU treatment by CM were report in English literatures,including acupuncture,herbs,and food,although some of evidence is still with low quality.These progress in CM treatment of CU will inspire high quality evidences via randomized,controlled trials assessing efficacy and safety of CM treatment of CU.
