Management and treatment of chronic urticaria (CU)

Developments increasing our understanding of chronic urticaria have resulted in the simplification and improvement of available treatments. Currently, many treatments target mast cell mediators, but we can now disrupt mast cell activation with the anti‐IgE antibody omalizumab, which has markedly advanced the treatment landscape for patients with difficult‐to‐treat urticaria. Current guidelines provide a framework for the management and treatment of patients with CU but, as each patient is different, knowledge and experience of specialist dermatologists and allergists are key to effective pharmacotherapy. This article reviews the different therapeutic options for patients with chronic spontaneous urticaria (also called chronic idiopathic urticaria) or chronic inducible urticaria and discusses management of special populations or special circumstances related to CU.

[1]  R. Body,et al.  Phase 3, Randomized, Double-blind, Placebo-controlled, Multicenter Clinical Study Evaluating the Safety and Efficacy of Icatibant for Angiotensin-converting Enzyme Inhibitor-induced Angioedema in Adults: 8 , 2016 .

[2]  M. Magerl,et al.  Validation of a simplified provocation instrument for diagnosis and threshold testing of symptomatic dermographism , 2015, Clinical and experimental dermatology.

[3]  J. Silvestre,et al.  Effectiveness and safety of omalizumab in a patient with chronic urticaria and hepatitis C , 2015, Journal of the European Academy of Dermatology and Venereology : JEADV.

[4]  R. Colwill,et al.  Effects of embryonic cyclosporine exposures on brain development and behavior , 2015, Behavioural Brain Research.

[5]  M. Maurer,et al.  Symptomatic dermographism: an inadequately described disease , 2015, Journal of the European Academy of Dermatology and Venereology : JEADV.

[6]  M. Sánchez-Borges,et al.  Aspirin‐exacerbated cutaneous disease (AECD) is a distinct subphenotype of chronic spontaneous urticaria , 2015, Journal of the European Academy of Dermatology and Venereology : JEADV.

[7]  M. Maurer,et al.  Successful treatment of cholinergic urticaria with methantheliniumbromide , 2015, The Journal of dermatology.

[8]  C. Lindsell,et al.  Effectiveness of ecallantide in treating angiotensin-converting enzyme inhibitor-induced angioedema in the emergency department. , 2015, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[9]  M. Cabana,et al.  The Xolair Pregnancy Registry (EXPECT): the safety of omalizumab use during pregnancy. , 2015, The Journal of allergy and clinical immunology.

[10]  M. Maurer,et al.  The potential pharmacologic mechanisms of omalizumab in patients with chronic spontaneous urticaria. , 2015, The Journal of allergy and clinical immunology.

[11]  M. Maurer,et al.  Omalizumab Improves Quality of Life (QoL) in Patients with Refractory Chronic Spontaneous/Idiopathic Urticaria (CSU/CIU) As Assessed By the Dermatology Life Quality Index (DLQI): A Post-Hoc Analysis of Percent Change from Baseline to Week 12 , 2015 .

[12]  G. Kojda,et al.  A randomized trial of icatibant in ACE-inhibitor-induced angioedema. , 2015, The New England journal of medicine.

[13]  S. Gilboa,et al.  Antihistamines and birth defects: a systematic review of the literature , 2014, Expert opinion on drug safety.

[14]  M. Sánchez-Borges,et al.  Subtypes of chronic urticaria in patients attending allergy clinics in Venezuela. , 2014, European annals of allergy and clinical immunology.

[15]  P. Vichyanond,et al.  The natural history of chronic urticaria in childhood: a prospective study. , 2014, Journal of the American Academy of Dermatology.

[16]  G. Du Toit,et al.  Antihistamine use in children , 2014, Archives of Disease in Childhood: Education & Practice Edition.

[17]  A. Sheikh,et al.  Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology , 2014, Allergy.

[18]  S. Spector,et al.  Efficacy and Safety of Omalizumab in Patients with Chronic Idiopathic/Spontaneous Urticaria Who Remain Symptomatic on H1 Antihistamines: A Randomized, Placebo-Controlled Study , 2014, The Journal of investigative dermatology.

[19]  M. Weinberger,et al.  Treatment of chronic urticaria in children with antihistamines and cyclosporine. , 2014, The journal of allergy and clinical immunology. In practice.

[20]  T. Zuberbier,et al.  The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. , 2014, Allergy.

[21]  C. Rodrigo,et al.  Leukotriene receptor antagonists for chronic urticaria: a systematic review , 2014, Allergy, Asthma & Clinical Immunology.

[22]  A. Bygum,et al.  Angiotensin-converting enzyme inhibitor-induced angioedema--a dangerous new epidemic. , 2014, Acta dermato-venereologica.

[23]  P. Kuna,et al.  Omalizumab in pregnant women treated due to severe asthma: two case reports of good outcomes of pregnancies , 2014, Postepy dermatologii i alergologii.

[24]  M. Maurer,et al.  Retreatment with omalizumab results in rapid remission in chronic spontaneous and inducible urticaria. , 2014, JAMA dermatology.

[25]  C. Bindslev‐Jensen,et al.  An algorithm for treating chronic urticaria with omalizumab: dose interval should be individualized. , 2014, The Journal of allergy and clinical immunology.

[26]  M. Maurer,et al.  Effects of omalizumab in a patient with three types of chronic urticaria , 2014, The British journal of dermatology.

[27]  J. Hébert,et al.  Real-life experiences with omalizumab for the treatment of chronic urticaria. , 2014, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[28]  T. Zuberbier,et al.  Physical urticarias and cholinergic urticaria. , 2014, Immunology and allergy clinics of North America.

[29]  M. Greaves Pathology and classification of urticaria. , 2014, Immunology and allergy clinics of North America.

[30]  R. Asero Multiple Nonsteroidal Anti-Inflammatory Drug-Induced Cutaneous Disease: What Differentiates Patients with and without Underlying Chronic Spontaneous Urticaria? , 2013, International Archives of Allergy and Immunology.

[31]  A. Bygum,et al.  ACE-inhibitor induced angio-oedema treated with complement C1-inhibitor concentrate , 2013, BMJ Case Reports.

[32]  R. Asero,et al.  Treatment of Refractory Chronic Urticaria: Current and Future Therapeutic Options , 2013, American Journal of Clinical Dermatology.

[33]  E. Nizankowska-Mogilnicka,et al.  Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti‐inflammatory drugs , 2013, Allergy.

[34]  S. Kivity,et al.  Urticaria and Angioedema in Pregnancy , 2013, Current Dermatology Reports.

[35]  J. Bartra,et al.  Efficacy of omalizumab in chronic spontaneous urticaria refractory to conventional therapy: analysis of 110 patients in real-life practice , 2013, Expert opinion on biological therapy.

[36]  P. Kuna,et al.  Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy. , 2013, The Journal of allergy and clinical immunology.

[37]  T. Zuberbier,et al.  Up-dosing with bilastine results in improved effectiveness in cold contact urticaria , 2013, Allergy.

[38]  A. Sheraz,et al.  Cholinergic urticaria responding to botulinum toxin injection for axillary hyperhidrosis , 2013, The British journal of dermatology.

[39]  T. Casale,et al.  Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. , 2013, The New England journal of medicine.

[40]  O. Dereure,et al.  Solar urticaria: a time-extended retrospective series of 61 patients and review of literature. , 2013, European journal of dermatology : EJD.

[41]  V. Samarasinghe,et al.  Class action of oral coumarins in the treatment of a patient with chronic spontaneous urticaria and delayed‐pressure urticaria , 2012, Clinical and experimental dermatology.

[42]  P. Schmid‐Grendelmeier,et al.  Treatment of Severe Cold Contact Urticaria with Omalizumab: Case Reports , 2012, Case Reports in Dermatology.

[43]  A. Gosmanov,et al.  Sitagliptin-Associated Angioedema , 2012, Diabetes Care.

[44]  C. Nishigori,et al.  Successful and long‐lasting treatment of solar urticaria with ultraviolet A rush hardening therapy , 2012, The British journal of dermatology.

[45]  P. Martus,et al.  Critical temperature threshold measurement for cold urticaria: a randomized controlled trial of H1‐antihistamine dose escalation , 2012, The British journal of dermatology.

[46]  C. Bindslev‐Jensen,et al.  Cold Urticaria Patients Exhibit Normal Skin Levels of Functional Mast Cells and Histamine after Tolerance Induction , 2012, Dermatology.

[47]  K. Kabashima,et al.  Cholinergic urticaria: pathogenesis‐based categorization and its treatment options , 2012, Journal of the European Academy of Dermatology and Venereology : JEADV.

[48]  A. Bircher,et al.  Failure of omalizumab (Xolair®) in the treatment of a case of solar urticaria caused by ultraviolet A and visible light , 2011, Photodermatology, photoimmunology & photomedicine.

[49]  T. Luger,et al.  Delayed pressure urticaria – Dapsone heading for first‐line therapy? , 2011, Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG.

[50]  S. Spector,et al.  A randomized, placebo-controlled, dose-ranging study of single-dose omalizumab in patients with H1-antihistamine-refractory chronic idiopathic urticaria. , 2011, The Journal of allergy and clinical immunology.

[51]  K. Schäkel,et al.  Efficacy and safety of omalizumab in patients with chronic urticaria who exhibit IgE against thyroperoxidase. , 2011, The Journal of allergy and clinical immunology.

[52]  E. Karabulut,et al.  Chronic Urticaria: Etiology and Natural Course in Children , 2011, International Archives of Allergy and Immunology.

[53]  P. Stock,et al.  Chronic spontaneous urticaria in children: Itching for insight , 2011, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[54]  Z. Nie,et al.  Systemic photoprotection in solar urticaria with α‐melanocyte‐stimulating hormone analogue [Nle4‐d‐Phe7]‐α‐MSH , 2011, The British journal of dermatology.

[55]  T. Zuberbier,et al.  Antihistamine‐resistant urticaria factitia successfully treated with anti‐immunoglobulin E therapy , 2010, Allergy.

[56]  G. Kojda,et al.  Therapeutic efficacy of icatibant in angioedema induced by angiotensin-converting enzyme inhibitors: a case series. , 2010, Annals of emergency medicine.

[57]  G. Koren,et al.  Safety of using montelukast during pregnancy. , 2010, Canadian family physician Medecin de famille canadien.

[58]  T. Zuberbier,et al.  Anti-Immunoglobulin E Treatment of Patients with Recalcitrant Physical Urticaria , 2010, International Archives of Allergy and Immunology.

[59]  L. Bielory,et al.  Efficacy and tolerability of second- and third-generation antihistamines in the treatment of acquired cold urticaria: a meta-analysis. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[60]  R. Sabroe Failure of omalizumab in cholinergic urticaria , 2010, Clinical and experimental dermatology.

[61]  M. Sánchez-Borges,et al.  Angiotensin-Converting Enzyme Inhibitors and Angioedema , 2010, Allergy Asthma and Immunology Research.

[62]  A. Kaplan Treatment of Cold Urticaria , 2010, Current allergy and asthma reports.

[63]  J. Bousquet,et al.  Risk of first‐generation H1‐antihistamines: a GA2LEN position paper , 2010, Allergy.

[64]  Todor A Popov,et al.  The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. , 2010, The Journal of allergy and clinical immunology.

[65]  K. Waibel,et al.  Partial improvement of solar urticaria after omalizumab. , 2010, The Journal of allergy and clinical immunology.

[66]  C. Grattan,et al.  Methotrexate: a useful steroid‐sparing agent in recalcitrant chronic urticaria , 2010, The British journal of dermatology.

[67]  C. Bindslev‐Jensen,et al.  Efficacy of omalizumab in delayed pressure urticaria: a case report , 2010, Allergy.

[68]  G. Vena,et al.  An overview of delayed pressure urticaria with special emphasis on pathogenesis and treatment , 2009, Dermatologic therapy.

[69]  Samir K. Gupta,et al.  Metabolism of loratadine and further characterization of its in vitro metabolites. , 2009, Drug metabolism letters.

[70]  M. Weinberger,et al.  Experience with Cyclosporine in Children with Chronic Idiopathic Urticaria , 2009, Pediatric dermatology.

[71]  T. Luger,et al.  [Antipruritic efficacy of a high-dosage antihistamine therapy. Results of a retrospectively analysed case series]. , 2009, Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete.

[72]  A. Kaplan,et al.  Pathogenesis of chronic urticaria , 2009, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[73]  M. Maurer,et al.  Antipruritische Wirksamkeit einer hoch dosierten Antihistaminikatherapie , 2009, Der Hautarzt.

[74]  T. Zuberbier,et al.  High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. , 2009, The Journal of allergy and clinical immunology.

[75]  R. Zeldin,et al.  Treatment of chronic autoimmune urticaria with omalizumab. , 2008, The Journal of allergy and clinical immunology.

[76]  Christof Schaefer,et al.  The safety of cetirizine during pregnancy. A prospective observational cohort study. , 2008, Reproductive toxicology.

[77]  M. Shaker,et al.  An update on childhood urticaria and angioedema , 2008, Current opinion in pediatrics.

[78]  S. Sachdeva THE DERMATOSES OF PREGNANCY , 2008, Indian journal of dermatology.

[79]  H. Wulf,et al.  Synergistic effect of broad-spectrum sunscreens and antihistamines in the control of idiopathic solar urticaria. , 2008, Archives of dermatology.

[80]  P. Michel,et al.  Angio-œdème acquis induit par les IEC : traitement aux urgences par concentré de C1 inhibiteur , 2008 .

[81]  Yan-Ren Lin,et al.  First attack of acute urticaria in pediatric emergency department. , 2008, Pediatrics and neonatology.

[82]  L. DiGrande,et al.  Urticaria and urticaria related skin condition/disease in children. , 2008, European annals of allergy and clinical immunology.

[83]  C. Camargo,et al.  Multicenter study of patients with angiotensin-converting enzyme inhibitor-induced angioedema who present to the emergency department. , 2008, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[84]  J. H. Feinberg,et al.  Successful treatment of disabling cholinergic urticaria. , 2008, Military medicine.

[85]  T. Zuberbier,et al.  Successful treatment of solar urticaria with anti‐immunoglobulin E therapy , 2008, Allergy.

[86]  T. Zuberbier,et al.  Successful treatment of cholinergic urticaria with anti‐immunoglobulin E therapy , 2008, Allergy.

[87]  S. Spector,et al.  Effect of omalizumab on patients with chronic urticaria. , 2007, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[88]  S. Jiamton,et al.  Chronic idiopathic urticaria: prevalence and clinical course , 2007, The Journal of dermatology.

[89]  S. Nasser,et al.  BSACI guidelines for the management of chronic urticaria and angio‐oedema , 2007, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[90]  M. Maurer,et al.  Successful treatment of delayed pressure urticaria with anti-TNF-alpha. , 2007, The Journal of allergy and clinical immunology.

[91]  James Brian Byrd,et al.  Angiotensin-converting enzyme inhibitor-associated angioedema. , 2006, Immunology and allergy clinics of North America.

[92]  Ronald W. England,et al.  Severe refractory cholinergic urticaria treated with danazol. , 2006, Journal of drugs in dermatology : JDD.

[93]  J. Boyce Successful treatment of cold-induced urticaria/anaphylaxis with anti-IgE. , 2006, The Journal of allergy and clinical immunology.

[94]  T. Zuberbier,et al.  EAACI/GA2LEN/EDF guideline: management of urticaria , 2006, Allergy.

[95]  A. Schocket Chronic urticaria: pathophysiology and etiology, or the what and why. , 2006, Allergy and asthma proceedings.

[96]  H. Sørensen,et al.  Maternal use of Loratadine during pregnancy and risk of hypospadias in offspring , 2006, International journal of medical sciences.

[97]  E. W. Nielsen,et al.  Angioedema from angiotensin‐converting enzyme (ACE) inhibitor treated with complement 1 (C1) inhibitor concentrate , 2006, Acta anaesthesiologica Scandinavica.

[98]  T. Casale,et al.  Incidence and characteristics of angioedema associated with enalapril. , 2005, Archives of internal medicine.

[99]  S. Ellenberg Food and Drug Administration (FDA) , 2005 .

[100]  A. Kaplan Chronic urticaria: pathogenesis and treatment. , 2004, The Journal of allergy and clinical immunology.

[101]  E. Nettis,et al.  Desloratadine in combination with montelukast in the treatment of chronic urticaria: a randomized, double‐blind, placebo‐controlled study , 2004, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[102]  M. Sanak,et al.  Hypersensitivity to aspirin: common eicosanoid alterations in urticaria and asthma. , 2004, The Journal of allergy and clinical immunology.

[103]  C. Saçkesen,et al.  The Etiology of Different Forms of Urticaria in Childhood , 2004, Pediatric dermatology.

[104]  G. Dawn,et al.  Effect of high‐dose intravenous immunoglobulin in delayed pressure urticaria , 2003, The British journal of dermatology.

[105]  M. Beck,et al.  Cold urticaria responding to systemic ciclosporin , 2003, The British journal of dermatology.

[106]  A. Ornoy,et al.  Pregnancy outcome after gestational exposure to loratadine or antihistamines: a prospective controlled cohort study. , 2003, The Journal of allergy and clinical immunology.

[107]  Calman Prussin,et al.  IgE, mast cells, basophils, and eosinophils. , 2003, The Journal of allergy and clinical immunology.

[108]  M. Shih,et al.  Clinical features and anaphylaxis in children with cold urticaria. , 2003, Pediatrics.

[109]  Charles A. Johnson,et al.  Pharmacodynamics of omalizumab: implications for optimised dosing strategies and clinical efficacy in the treatment of allergic asthma , 2003, Current medical research and opinion.

[110]  D. McGee Steroid use during pregnancy. , 2002, The Journal of perinatal & neonatal nursing.

[111]  S. Ahmed,et al.  The impact of corticosteroids on growth and bone health , 2002, Archives of disease in childhood.

[112]  A. Camm,et al.  Potential cardiac toxicity of H1-antihistamines. , 2002, Clinical allergy and immunology.

[113]  B. Källén,et al.  Use of antihistamine drugs in early pregnancy and delivery outcome , 2002, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[114]  M. Mahmoudi,et al.  Cold-induced urticaria , 2001, The Journal of the American Osteopathic Association.

[115]  S. Beissert,et al.  UVA rush hardening for the treatment of solar urticaria. , 2000, Journal of the American Academy of Dermatology.

[116]  A. Bonnevalle,et al.  Urticaire solaire : désensibilisation UVA avant PUVAthérapie , 2000 .

[117]  F. Simons,et al.  Clinical Pharmacology of New Histamine H1 Receptor Antagonists , 1999, Clinical pharmacokinetics.

[118]  M. Greaves,et al.  The extent and nature of disability in different urticarial conditions , 1999, The British journal of dermatology.

[119]  Grattan,et al.  The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria , 1999, The British journal of dermatology.

[120]  A. Kapp,et al.  Physical urticaria: classification and diagnostic guidelines , 1997, Allergy.

[121]  A. Ros,et al.  Cyclosporin A therapy for severe solar urticaria , 1997, Photodermatology, photoimmunology & photomedicine.

[122]  A. Black,et al.  Angiotensin–converting enzyme (ACE) inhibitors and angio–oedema , 1997, The British journal of dermatology.

[123]  W A Ray,et al.  Black Americans have an increased rate of angiotensin converting enzyme inhibitor‐associated angioedema , 1996, Clinical pharmacology and therapeutics.

[124]  B. D. Lucas,et al.  Terfenadine pharmacokinetics in breast milk in lactating women , 1995, Clinical pharmacology and therapeutics.

[125]  N. Soter Urticaria: current therapy. , 1990, The Journal of allergy and clinical immunology.

[126]  A. Black,et al.  Symptomatic dermographism: wealing, mast cells and histamine are decreased in the skin following long‐term application of a potent topical corticosteroid , 1989, The British journal of dermatology.

[127]  E. Radwanski,et al.  Excretion of Loratadine in Human Breast Milk , 1988, Journal of clinical pharmacology.

[128]  E. Radwanski,et al.  The Pharmacokinetics of Loratadine in Normal Geriatric Volunteers , 1988, The Journal of international medical research.

[129]  M. Greaves,et al.  Beneficial effects of danazol on symptoms and laboratory changes in cholinergic urticaria , 1987, The British journal of dermatology.

[130]  C. Kennedy,et al.  A serological mediator in chronic idiopathic urticaria—a clinical, immunological and histological evaluation , 1986, The British journal of dermatology.

[131]  H. Doeglas Reactions to aspirin and food additives in patients with chronic urticaria, including the physical urticarias * , 1975, The British journal of dermatology.

[132]  M. Moore-Robinson,et al.  Effect of salicylates in urticaria. , 1967, British medical journal.

[133]  F. Bettley A device for the measurement of factitious urticaria. , 1962, The Journal of investigative dermatology.

[134]  M. Maurer,et al.  Omalizumab is an effective and rapidly acting therapy in difficult-to-treat chronic urticaria: a retrospective clinical analysis. , 2014, Journal of dermatological science.

[135]  R. Asero,et al.  Extraordinary response to omalizumab in a child with severe chronic urticaria. , 2014, European annals of allergy and clinical immunology.

[136]  J. Silvestre,et al.  Omalizumab in the treatment of chronic urticaria. , 2014, Actas dermo-sifiliograficas.

[137]  K. Alysandratos,et al.  Mast cells and inflammation. , 2012, Biochimica et biophysica acta.

[138]  M. Maurer,et al.  Physical Urticaria , 2012, Current Allergy and Asthma Reports.

[139]  M. López-Trascasa,et al.  Consensus statement on the diagnosis, management, and treatment of angioedema mediated by bradykinin. Part I. Classification, epidemiology, pathophysiology, genetics, clinical symptoms, and diagnosis. , 2011, Journal of investigational allergology & clinical immunology.

[140]  M. Hide,et al.  Six cases of antihistamine-resistant dermographic urticaria treated with oral ciclosporin. , 2011, Allergology international : official journal of the Japanese Society of Allergology.

[141]  T. Nagano,et al.  Rapid desensitization with autologous sweat in cholinergic urticaria. , 2011, Allergology international : official journal of the Japanese Society of Allergology.

[142]  A. Giménez-Arnau,et al.  Rupatadine and its effects on symptom control, stimulation time, and temperature thresholds in patients with acquired cold urticaria. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[143]  Li Cheng-xin,et al.  EAACI/GA2LEN/EDF/WAO Guideline:Management of Urticaria , 2010 .

[144]  É. Task The Management of Anaphylaxis in Childhood:Position Paper of the European Academy of Allergology and Clinical Immunology , 2009 .

[145]  B. Wedi,et al.  Urticaria and infections , 2009 .

[146]  B. Gelée,et al.  [Angiotensin-converting enzyme inhibitor-related angioedema: emergency treatment with complement C1 inhibitor concentrate]. , 2008, La Revue de medecine interne.

[147]  J. Mullol,et al.  Antihistamines in the treatment of chronic urticaria. , 2007, Journal of investigational allergology & clinical immunology.

[148]  J. Mullol,et al.  Use of antihistamines in pediatrics. , 2007, Journal of investigational allergology & clinical immunology.

[149]  A. Isaksson,et al.  Urticarial dermographism: clinical features and response to psychosocial stress. , 2007, Acta dermato-venereologica.

[150]  P. Greenberger,et al.  Investigation of angioedema associated with the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. , 2007, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[151]  J. Gardeazabal,et al.  Urticaria solar. Estudio de 20 casos , 2005 .

[152]  J. Gardeazabal,et al.  [Solar urticaria. Study of 20 cases]. , 2005, Actas dermo-sifiliograficas.

[153]  B. Wedi,et al.  Helicobacter pylori Infection in Skin Diseases , 2002 .

[154]  L. Hültner,et al.  Mast cells and inflammation. , 2002, Archivum immunologiae et therapiae experimentalis.

[155]  B. Wedi,et al.  Helicobacter pylori infection in skin diseases: a critical appraisal. , 2002, American journal of clinical dermatology.

[156]  E. Delaporte,et al.  [Solar urticaria: pre-PUVA UVA desensitization]. , 2000, Annales de dermatologie et de venereologie.

[157]  G S Watson,et al.  Effects of fexofenadine, diphenhydramine, and alcohol on driving performance. A randomized, placebo-controlled trial in the Iowa driving simulator. , 2000, Annals of internal medicine.

[158]  G. Alcaraz,et al.  The receptor with high affinity for immunoglobulin E. , 1986, Annual review of immunology.

[159]  D. Conrad,et al.  Binding characteristics of human IgE receptors and initial triggering events in human mast cells for histamine release. , 1983, Monographs in allergy.

[160]  G. Zina,et al.  [Solar urticaria]. , 1982, Therapeutische Umschau. Revue therapeutique.

[161]  T. Ryan,et al.  Delayed pressure urticaria. , 1968, The British journal of dermatology.