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Alergologia Polska - Polish Journal of Allergology
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1/2020
vol. 7
 
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Guidelines/recommendations

Urticaria. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society and the Polish Society of Allergology

Roman J. Nowicki
1
,
Elżbieta Grubska-Suchanek
1
,
Karina Jahnz-Różyk
2
,
Jerzy Kruszewski
3
,
Magdalena Trzeciak
1
,
Aleksandra Wilkowska
1
,
Lidia Rudnicka
4
,
Marek Kulus
5
,
Magdalena Czarnecka-Operacz
6
,
Cezary Kowalewski
7
,
Dorota Krasowska
8
,
Beata Kręcisz
9
,
Maciej Kupczyk
10
,
Magdalena Lange
1
,
Aleksandra Lesiak
11
,
Sławomir Majewski
12
,
Joanna Narbutt
11
,
Małgorzata Olszewska
4
,
Zbigniew Samochocki
4
,
Jacek Szepietowski
13
,
Radosław Śpiewak
14

1.
Katedra i Klinika Dermatologii, Wenerologii i Alergologii, Gdański Uniwersytet Medyczny, Gdańsk, Polska
2.
Klinika Chorób Wewnętrznych, Pneumonologii, Alergologii i Immunologii Klinicznej, Wojskowy Instytut Medyczny, Warszawa, Polska
3.
Klinika Chorób Infekcyjnych i Alergologii, Wojskowy Instytut Medyczny, Warszawa, Polska
4.
Katedra i Klinika Dermatologiczna, Warszawski Uniwersytet Medyczny, Warszawa, Polska
5.
Klinika Pneumonologii i Alergologii Wieku Dziecięcego, Warszawski Uniwersytet Medyczny, Warszawa, Polska
6.
Katedra i Klinika Dermatologii, Uniwersytet Medyczny w Poznaniu, Poznań, Polska
7.
Klinika Dermatologii i Immunodermatologii, Warszawski Uniwersytet Medyczny, Warszawa, Polska
8.
Katedra i Klinika Dermatologii, Wenerologii i Dermatologii Dziecięcej, Uniwersytet Medyczny w Lublinie, Lublin, Polska
9.
Klinika Dermatologii, Wydział Lekarski i Nauk o Zdrowiu, Uniwersytet Jana Kochanowskiego, Kielce, Polska
10.
Klinika Chorób Wewnętrznych, Astmy i Alergii, Uniwersytet Medyczny w Łodzi, Łódź, Polska
11.
Klinika Dermatologii, Dermatologii Dziecięcej i Onkologicznej, Uniwersytet Medyczny w Łodzi, Łódź, Polska
12.
Klinika Dermatologii i Wenerologii, Warszawski Uniwersytet Medyczny, Warszawa, Polska
13.
Katedra i Klinika Dermatologii, Wenerologii i Alergologii, Uniwersytet Medyczny, Wrocław, Polska
14.
Zakład Dermatologii Doświadczalnej i Kosmetologii, Uniwersytet Jagielloński Collegium Medicum, Kraków, Polska
Alergologia Polska – Polish Journal of Allergology 2020; 7, 1: 31–39
DOI: https://doi.org/10.5114/pja.2020.93829
Online publish date: 2020/03/28
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Urticaria has a complex aetiology and pathogenesis, and is characterized by the presence of wheals with accompanying pruritus or skin burning sensation. In 40% of cases, urticaria may be accompanied by angioedema. Depending on the duration, urticaria may be classified as acute or chronic. Acute urticaria is common (25% of the population). Its most common causes include food, drugs, infections, hymenoptera venom and plant pollen. Acute urticaria does not usually require diagnostic tests. Chronic urticaria is less common (1% of the population), and due to its diverse causal factors may cause considerable diagnostic and therapeutic difficulties. Chronic urticaria is divided into induced urticaria and spontaneous urticaria. Diagnosis of chronic urticaria includes detailed medical history, laboratory as well as imaging tests, and consultations with specialists. Therapeutic procedures in urticaria include avoidance of triggering factors, treatment of concomitant diseases, and pharmacological treatment of symptoms. Second-generation antihistamines, used in the doses in compliance with summary of product characteristics, are the treatment of choice in urticaria. When the therapeutic results fail to be satisfactory, an antihistamine drug may be changed to another one. In patients who do not react to standard doses, the dose may be increased four-fold. If there is no improvement after 2–4 weeks of treatment, it is recommended to administer a second-generation antihistamine with omalizumab at the dose of 300 mg every 4 weeks. Also, cyclosporine is recommended in treatment of chronic urticaria. Furthermore, a short-term general treatment with corticosteroids may be considered.
keywords:

urticaria, wheal, diagnostics, therapy



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