Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Anais brasileiros de dermatologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962019000700056 |
Resumo: | Abstract: Background: Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute ( ≤ 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. Objectives: To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods: A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. Results: Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). Conclusions: Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine. |
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Anais brasileiros de dermatologia (Online) |
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Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of DermatologyCyclosporineDapsoneHistamine antagonistsMethotrexateOmalizumabUrticariaUrticaria/etiologyUrticaria/therapyAbstract: Background: Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute ( ≤ 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. Objectives: To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods: A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. Results: Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). Conclusions: Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine.Sociedade Brasileira de Dermatologia2019-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962019000700056Anais Brasileiros de Dermatologia v.94 n.2 suppl.1 2019reponame:Anais brasileiros de dermatologia (Online)instname:Sociedade Brasileira de Dermatologia (SBD)instacron:SBD10.1590/abd1806-4841.2019940209info:eu-repo/semantics/openAccessCriado,Paulo RicardoMaruta,Celina WakisakaAlchorne,Alice de Oliveira de AvelarRamos,Andréa Machado CoelhoGontijo,BernardoSantos,Josemir Belo dosMartins,Luis Eduardo Agner MachadoRivitti-Machado,Maria CecíliaSilvares,Maria Regina CavarianiPires,Mario CezarSouza,Patricia Karla deOrfali,Raquel LeãoBonamigo,Renan RangelBedrikow,Roberta BuenseCriado,Roberta Fachini JardimOliveira,Zilda Najjar Prado deeng2019-05-30T00:00:00Zoai:scielo:S0365-05962019000700056Revistahttp://www.anaisdedermatologia.org.br/https://old.scielo.br/oai/scielo-oai.phpabd@sbd.org.br||revista@sbd.org.br1806-48410365-0596opendoar:2019-05-30T00:00Anais brasileiros de dermatologia (Online) - Sociedade Brasileira de Dermatologia (SBD)false |
dc.title.none.fl_str_mv |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology |
title |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology |
spellingShingle |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology Criado,Paulo Ricardo Cyclosporine Dapsone Histamine antagonists Methotrexate Omalizumab Urticaria Urticaria/etiology Urticaria/therapy |
title_short |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology |
title_full |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology |
title_fullStr |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology |
title_full_unstemmed |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology |
title_sort |
Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology |
author |
Criado,Paulo Ricardo |
author_facet |
Criado,Paulo Ricardo Maruta,Celina Wakisaka Alchorne,Alice de Oliveira de Avelar Ramos,Andréa Machado Coelho Gontijo,Bernardo Santos,Josemir Belo dos Martins,Luis Eduardo Agner Machado Rivitti-Machado,Maria Cecília Silvares,Maria Regina Cavariani Pires,Mario Cezar Souza,Patricia Karla de Orfali,Raquel Leão Bonamigo,Renan Rangel Bedrikow,Roberta Buense Criado,Roberta Fachini Jardim Oliveira,Zilda Najjar Prado de |
author_role |
author |
author2 |
Maruta,Celina Wakisaka Alchorne,Alice de Oliveira de Avelar Ramos,Andréa Machado Coelho Gontijo,Bernardo Santos,Josemir Belo dos Martins,Luis Eduardo Agner Machado Rivitti-Machado,Maria Cecília Silvares,Maria Regina Cavariani Pires,Mario Cezar Souza,Patricia Karla de Orfali,Raquel Leão Bonamigo,Renan Rangel Bedrikow,Roberta Buense Criado,Roberta Fachini Jardim Oliveira,Zilda Najjar Prado de |
author2_role |
author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Criado,Paulo Ricardo Maruta,Celina Wakisaka Alchorne,Alice de Oliveira de Avelar Ramos,Andréa Machado Coelho Gontijo,Bernardo Santos,Josemir Belo dos Martins,Luis Eduardo Agner Machado Rivitti-Machado,Maria Cecília Silvares,Maria Regina Cavariani Pires,Mario Cezar Souza,Patricia Karla de Orfali,Raquel Leão Bonamigo,Renan Rangel Bedrikow,Roberta Buense Criado,Roberta Fachini Jardim Oliveira,Zilda Najjar Prado de |
dc.subject.por.fl_str_mv |
Cyclosporine Dapsone Histamine antagonists Methotrexate Omalizumab Urticaria Urticaria/etiology Urticaria/therapy |
topic |
Cyclosporine Dapsone Histamine antagonists Methotrexate Omalizumab Urticaria Urticaria/etiology Urticaria/therapy |
description |
Abstract: Background: Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute ( ≤ 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. Objectives: To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods: A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. Results: Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). Conclusions: Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962019000700056 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962019000700056 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/abd1806-4841.2019940209 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Dermatologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Dermatologia |
dc.source.none.fl_str_mv |
Anais Brasileiros de Dermatologia v.94 n.2 suppl.1 2019 reponame:Anais brasileiros de dermatologia (Online) instname:Sociedade Brasileira de Dermatologia (SBD) instacron:SBD |
instname_str |
Sociedade Brasileira de Dermatologia (SBD) |
instacron_str |
SBD |
institution |
SBD |
reponame_str |
Anais brasileiros de dermatologia (Online) |
collection |
Anais brasileiros de dermatologia (Online) |
repository.name.fl_str_mv |
Anais brasileiros de dermatologia (Online) - Sociedade Brasileira de Dermatologia (SBD) |
repository.mail.fl_str_mv |
abd@sbd.org.br||revista@sbd.org.br |
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1752126423772954624 |