https://link.springer.com/article/10.1007/s13555-024-01173-5
Dermatology and Therapy, Published: 17 May 2024
Adam Friedman, Shawn G. Kwatra & Gil Yosipovitch
Abstract
Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition characterized by the spontaneous onset of itchy wheals, angioedema, or both, which occurs for longer than 6 weeks overall. Despite the relatively straightforward diagnostic algorithm for CSU, relying primarily on a detailed medical history and only limited laboratory tests, patients often wait years to be diagnosed, with many cycling through different healthcare practitioners before a diagnosis is made. Even then, current treatment options for CSU are limited, with approximately half of patients resistant to standard-of-care second-generation antihistamines at standard or higher doses. As such, there is an unmet need for improved, streamlined management for patients with CSU. Here, we review the evidence-based diagnostic algorithm for CSU, consider the required steps of the diagnostic workup, and provide practical, real-world advice on the management of CSU to improve the timely diagnosis and care of patients with this debilitating disease.
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>”approximately half of patients resistant to standard-of-care second-generation antihistamines at standard or higher doses.” — IMO NIH and European researchers ran only poorly designed studies interpreted as indicating stabilizers, older H1s ineffective w/ CU. So these harmfully underprescribed for SMCDs too.