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Background Vasculitic urticaria (UV) is a condition characterized by hives lasting more than 24 hours, itchy and burning with residual hyperpigmentation. Histopathology is characterized by leukocytoclastic vasculitis, perivascular infiltrate and fibrin deposits. The incidence is approximately 2%, prevalence in women (5:1). The treatment includes steroids, immunosuppressants, and has suggested the use of monoclonal antibodies. We report a patient treated with omalizumab. Methods Female 51 years old, his mother died of complications from Lupus Erythematosus (SLE). 10 years ago was diagnosed with SLE by criteria haematological and immunological joints treated with azathioprine, chloroquine and deflazacort, with control of lupus, immunosuppressive suspended and continuing low-dose steroids. Have hives as secondary reaction to netilmicin and penicillin. Two years ago shows like lesions papules and burning and itching rash on chest and limbs, with no peeling hyperpigmented macules, managed with systemic steroids (prednisone) and antihistamines, with a decrease of the same but has l month after similar injuries, and macula, adjust the dose of steroid 1 mg/kg with a decrease in events with exacerbations and remissions, until 3 months course again with increasing symptoms with erythematous, violaceous, painful to the touch did not disappear in extremities lower, upper abdomen and chest, with no improvement after systemic steroids, antihistamines, and immunosuppressants, laboratories report 4.600 leukocytes, eosinophils 100/mcl, 90.1 mgU/dl C3, C4 8.6 mg/dL of 169 I U IgE/mL, leukocytoclastic vasculitis biopsy reports, deciding Omalizumab use was calculated based on weight and IgE, showing significant improvement with disappearance of the lesions, without pain or itching with hives. Results Gradual decrease was observed of Score of 6 to 1 and score-related quality of of life with a 84.37 to 42.36 CUQ2oL after 3 applications, with a significant P by comparing the results and statistical analysis. Conclusions We conclude that Omalizumab may be useful in the treatment of vasculitic urticaria, although it requires clinical trials that include a greater number of patients and be compared with conventional treatment.

Background Chronic urticaria (CU) is a common disorder characterized by recurrent episodes of urticaria pruritic erythematous lesions, associated with angioedema1. It affects 0.1% of the population, it is estimated that approximately 15 to 25% of the population will have hives at some point in their lives.2 About 80% of UC patients are diagnosed as idiopathic chronic urticaria and that no cause is identified, 3 experiencing deterioration in their quality of life affecting your work, social relationships, schemes requiring multiple medications and doses higher than usual. This study proposes Omalizumab (anti-IgE humanized antibody) as a treatment for Refractory Chronic Urticaria (RCU) Object Demonstrate Omalizumab's effectiveness in the treatment of Refractory Chronic Urticaria. Methods A clinical study, was carried out to evaluate the effectiveness of the Omalizumab's treatment on RCU diagnosed patient, including male and female patients ages 12 to 50 diagnosed with RCU, with Scorad higher tan 30 points. We made a questionnaire to know about the patient's family background, skin symptoms beginning, administration of drugs such sistemic steroids, inmunosupresors, calceurine inhibitors, presence of inmunotherapy and age of start. Omalizumab was administered on doses according patient's weight and IgE levels, bimonthly or monthly according to treatment guides. Severeness level was calculated with scorad every 1 month, with IgE seric level measurement and life quality questionnaire. Results 5 patients diagnosed with RCU were included in the group of Omalizumab and 5 patients in the control group (placebo). All patients were female. A gradual decrease on the life quality score and in Score, with a significant P under 0.05 was observed on all patients treated with omalizumab compared with patient in the group with placebo. Conclusions Treatment with Omalizumab progressively decreases the severeness level on RCU, with a significant improvement on the patient's life quality.

Background Near-fatal asthma treated with Omalizumab. The near-fatal asthma is a severe form of asthma that threatens the life of patients and is associated with poorly controlled chronic asthma, accounting for limitations in the quality of life. Presents with ongoing chronic inflammation and irreversible changes in the airway. Treatment is difficult, however with the use of omalizumab can decrease the risk of mortality in these patients. Objective Evaluating clinical improvement, spirometric and income to the emergency hospitalization and intensive care unit, as well as near-fatal asthma episodes in patients with uncontrolled asthma in treatment with con Omalizumab. Methods We evaluated 4 patients with poorly controlled asthma and near-fatal episodes of asthma who were administered doses of omalizumab and IgE established according to weight, evaluating clinical, spirometric well as income to the emergency room and hospital intensive care unit. Results There was a significant clinical improvement in 4 patients after treatment with omalizumab with improved daytime symptoms by 75% and 68% nocturnal P ≤ 0.001, as well as 100% improvement in revenue and hospitalizations to floor, well as income to the ICU with P ≤ 0.001. No further episodes of near-fatal asthma. In addition to decreased use of systemic steroids 90% (P 0.003) and inhaled steroids 60% (P 0.005). Conclusions Omalizumab is a good treatment option in patients with poorly controlled asthma with near-fatal asthma episodes.