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: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/196644 |
Resumo: | 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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Criado, Paulo RicardoMaruta, Celina WakisakaAlchorne, Alice de Oliveira de AvelarRamos, Andréa Machado CoelhoAssunção, Bernardo Faria GontijoSantos, Josemir Belo dosMartins, Luis Eduardo Agner MachadoMachado, Maria Cecília da Matta RivittiSilvares, Maria Regina CavarianiPires, Mario CezarSouza, Patricia Karla deOrfali, Raquel LeãoBonamigo, Renan RangelBedrikow, Roberta BuenseCriado, Roberta Fachini JardimOliveira, Zilda Najjar Prado de2019-07-09T02:38:10Z20190365-0596http://hdl.handle.net/10183/196644001095682Background: 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.application/pdfengAnais brasileiros de dermatologia. vol. 94, n. 2, supl. 1 (mar./abr. 2019), p. 56-66Antagonistas dos receptores histamínicosUrticariaCyclosporineDapsoneHistamine antagonistsMethotrexateOmalizumabUrticariaUrticaria/etiologyUrticaria/therapyConsensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults : Brazilian Society of Dermatologyinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001095682.pdf.txt001095682.pdf.txtExtracted Texttext/plain53880http://www.lume.ufrgs.br/bitstream/10183/196644/2/001095682.pdf.txt82e3c4e7eece29e52e6597f5db0c8cc0MD52ORIGINAL001095682.pdfTexto completo (inglês)application/pdf486399http://www.lume.ufrgs.br/bitstream/10183/196644/1/001095682.pdfa2e0a3f4581e4f634c104b420135972aMD5110183/1966442019-07-10 02:33:53.334344oai:www.lume.ufrgs.br:10183/196644Repositório InstitucionalPUBhttps://lume.ufrgs.br/oai/requestlume@ufrgs.bropendoar:2019-07-10T05:33:53Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.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 Antagonistas dos receptores histamínicos Urticaria 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 Assunção, Bernardo Faria Gontijo Santos, Josemir Belo dos Martins, Luis Eduardo Agner Machado Machado, Maria Cecília da Matta Rivitti 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 Assunção, Bernardo Faria Gontijo Santos, Josemir Belo dos Martins, Luis Eduardo Agner Machado Machado, Maria Cecília da Matta Rivitti 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 Assunção, Bernardo Faria Gontijo Santos, Josemir Belo dos Martins, Luis Eduardo Agner Machado Machado, Maria Cecília da Matta Rivitti 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 |
Antagonistas dos receptores histamínicos Urticaria |
topic |
Antagonistas dos receptores histamínicos Urticaria Cyclosporine Dapsone Histamine antagonists Methotrexate Omalizumab Urticaria Urticaria/etiology Urticaria/therapy |
dc.subject.eng.fl_str_mv |
Cyclosporine Dapsone Histamine antagonists Methotrexate Omalizumab Urticaria Urticaria/etiology Urticaria/therapy |
description |
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.accessioned.fl_str_mv |
2019-07-09T02:38:10Z |
dc.date.issued.fl_str_mv |
2019 |
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info:eu-repo/semantics/article info:eu-repo/semantics/other |
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publishedVersion |
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http://hdl.handle.net/10183/196644 |
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eng |
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eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Anais brasileiros de dermatologia. vol. 94, n. 2, supl. 1 (mar./abr. 2019), p. 56-66 |
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