Urticaria is a disorder characterized by rapid onset of localized swelling of the skin or mucosa, called wheals or urtica. According to frequency and duration,
urticaria can be divided into acute and chronic type.
Chronic urticaria is any type of
urticaria occurring every day or twice per week, lasting longer than 6 weeks.
Chronic urticaria is a common disorder and estimated prevalence is 1% of the population. Also, it is not rare in childhood. The pathogenesis of
chronic urticaria has not yet been completely understood.
Chronic urticaria is a heterogeneous group of disorders, and according to the etiology and cause, several groups of
chronic urticaria are distinguished, i.e. autoimmune, pseudoallergic,
infection-related, physical
urticaria,
vasculitis urticaria and idiopathic
urticaria. Treatment and management of chronic
urticaria can be non-pharmacological and pharmacological, and sometimes it is not possible to control the disease with
antihistamines only, which are considered to be the mainstay of treatment. In severe cases of
chronic urticaria, especially if autoimmunity has been proven, several authors describe different modules of
immunomodulation:
cyclosporine,
cyclophosphamide,
mycophenolate-mofetil,
omalizumab,
plasmapheresis, systemic
corticosteroids, and immunoglobulin therapy. This article primarily addresses the treatment of chronic idiopathic and
autoimmune urticaria.