Search

Background: cold urticaria (ColdU), that is, the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. Methods: an international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest(R) performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Results: of 551 ColdU patients, 75% (n = 412) had a positive CST and ColdA occurred in 37% (n = 151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n = 40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs. 39%, p = .003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. Conclusion: coldA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector., GA(2)LEN UCARE Network

BACKGROUND:Urticaria is one of the most common dermatoses and affects 1525% of the population; chronic spontaneous urticaria occur in 1.8% of adults and in 0.13% of children. Second generation antihistamines are effective only in 4577% of patients. The next steps of treatment include increase antihistamines dose and their combination with omalizumab. AIM:To analyze own clinical experience and assess effectiveness of omalizumab in severe chronic spontaneous urticaria. MATERIALS AND METHODS:Effectiveness of biological treatment with omalizumab was analyzed in 14 patients with severe chronic spontaneous urticaria. RESULTS:The prescription of omalizumab in the basic therapy of patients with severe chronic spontaneous urticaria (CSU) allowed to reduce significantly the severity of clinical symptoms in 78.6% of patients, to abandon the use of systemicglucocorticosteroids and to achieve partial or complete control of the disease. It should be noted, that 28.5% of patients during the immunobiological therapy stopped taking second-generation antihistamines and the dosage was reduced to therapeutic in 35.7% of patients. CONCLUSION:Omalizumab is a highly effective in patients with severe chronic spontaneous urticaria.