Via practica 4/2016

Chronic spontaneous urticaria

Typical symptoms of chronic urticaria are wheals and/or angioedema. The disease lasts more than 6 weeks. The wheals are manifested by a central swelling of variable size, almost always surrounded by a reflex erythema. The wheals are itchy, sometimes with a burning sensation, the wheals resolve within 24 hours. Angioedema is a sudden swelling of lower dermis and subcutis frequently occurring below mucous membranes and lasting up to 72 hours. Patients complain of itching and pain. Chronic spontaneous urticaria can be induced by autoimmune reactions or unknown causes. Disease activity should be assessed with the simple scoring system UAS7. Diagnosis of chronic spontaneous urticaria is based on a consistent patient history and a typical clinical picture. It is recommended to investigate the erythrocyte sedimentation rate, CRP and the differential blood count. Other diagnostic tests are suggested based on patient history. According to current guidelines, the treatment of chronic spontaneous urticaria is indicated in three lines. The goal of the treatment in patients with chronic spontaneous urticaria is an absence of symptoms.

Keywords: chronic spontaneous urticaria, wheals, angioedema, antihistamines, omalizumab