Fromer Leonard
Department of Family Medicine, UCLA School of Medicine, Santa Monica, California, USA.
South Med J. 2008 Feb;101(2):186-92. doi: 10.1097/SMJ.0b013e3181611bc8.
Chronic urticaria is a cutaneous condition in which recurrent pruritic wheals (hives) manifest on the body and typically last for longer than 6 weeks. Chronic urticaria, including physically induced urticarias, such as cold, solar exposure or delayed pressure urticaria, is estimated to occur in approximately 25% of urticaria patients. Of these patients, 75% present with idiopathic disease, which is essentially an exclusionary diagnosis when no contributing factors can be determined that cause the cutaneous reaction. Chronic urticaria symptoms can have a profound effect on a patient's quality of life (QoL); therefore, treatment should address both physical symptom relief and improvements in QoL. This review will discuss the benefits and limitations of several treatment options available to relieve urticarial symptoms, including H1- and H2-receptor antagonists, doxepin, antileukotriene therapy and corticosteroids. Other experimental therapies, such as immunomodulatory agents, plasmapheresis treatment, i.v. immunoglobulins, and omalizumab will also be discussed.
慢性荨麻疹是一种皮肤疾病，患者身体上会反复出现瘙痒性风团（荨麻疹），且通常持续超过6周。慢性荨麻疹，包括物理性诱导的荨麻疹，如寒冷性、日光暴露性或迟发性压力性荨麻疹，据估计在约25%的荨麻疹患者中出现。在这些患者中，75%表现为特发性疾病，当无法确定导致皮肤反应的相关因素时，这本质上是一种排除性诊断。慢性荨麻疹症状会对患者的生活质量（QoL）产生深远影响；因此，治疗应兼顾缓解身体症状和改善生活质量。本综述将讨论几种可用于缓解荨麻疹症状的治疗选择的益处和局限性，包括H1和H2受体拮抗剂、多塞平、抗白三烯疗法和皮质类固醇。还将讨论其他实验性疗法，如免疫调节剂、血浆置换治疗、静脉注射免疫球蛋白和奥马珠单抗。
