V. Saraf, Pooja Gupta, Namrata Mahadkar, D. Dhoot, Hanmant Barkate
{"title":"Comparative real-world clinical assessment of mometasone furoate 0.1% and fluticasone propionate 0.005% in the treatment of atopic dermatitis","authors":"V. Saraf, Pooja Gupta, Namrata Mahadkar, D. Dhoot, Hanmant Barkate","doi":"10.25259/ijsa_4_2022","DOIUrl":"https://doi.org/10.25259/ijsa_4_2022","url":null,"abstract":"","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121560959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urticaria is a mast cell (MC)-driven skin disease. Degranulation of these cells is triggered by the activation of several receptors on its surface. The activation of MC in chronic spontaneous urticaria (CSU) appears to be associated with an autoimmune etiology. Certain comorbidities such as autoimmunity, infections, allergy, emotional stress, and metabolic syndrome are frequently associated with chronic urticaria (CU). The objective of this review is to highlight the frequent association between CU and several comorbidities, which can lead to a worse prognosis for the underlying disease. We searched for original and review articles on CU and comorbidities in PUBMED, abstracts published in AAAAI and EAACI; all of them in English. Our review reinforced how CSU, being itself an autoimmune disease, is strongly linked to several other autoimmune diseases. Besides autoimmunity, emotional stress was considered another frequent comorbidity associated with CU and also a trigger factor for urticaria exacerbation. Some studies recently considered CU as a low-grade chronic inflammatory condition and may be associated with metabolic syndrome. In conclusion, CU is considered a heterogeneous disease with distinct clinical features. It is worth remembering that CU should not be considered just a skin disease and its complete control could minimize a worse clinical outcome.
{"title":"Urticaria and comorbidities","authors":"M. Gotua, R. Agondi, I. Cherrez-Ojeda","doi":"10.25259/ijsa_5_2022","DOIUrl":"https://doi.org/10.25259/ijsa_5_2022","url":null,"abstract":"Urticaria is a mast cell (MC)-driven skin disease. Degranulation of these cells is triggered by the activation of several receptors on its surface. The activation of MC in chronic spontaneous urticaria (CSU) appears to be associated with an autoimmune etiology. Certain comorbidities such as autoimmunity, infections, allergy, emotional stress, and metabolic syndrome are frequently associated with chronic urticaria (CU). The objective of this review is to highlight the frequent association between CU and several comorbidities, which can lead to a worse prognosis for the underlying disease. We searched for original and review articles on CU and comorbidities in PUBMED, abstracts published in AAAAI and EAACI; all of them in English. Our review reinforced how CSU, being itself an autoimmune disease, is strongly linked to several other autoimmune diseases. Besides autoimmunity, emotional stress was considered another frequent comorbidity associated with CU and also a trigger factor for urticaria exacerbation. Some studies recently considered CU as a low-grade chronic inflammatory condition and may be associated with metabolic syndrome. In conclusion, CU is considered a heterogeneous disease with distinct clinical features. It is worth remembering that CU should not be considered just a skin disease and its complete control could minimize a worse clinical outcome.","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125064470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Rathod, Khushbu Harshadkumar Jadav, Akshay R Ambasana, Puja Moliya, Ashish Jagati
Hereditary angioedema (HAE) is a rare disease characterized by recurrent non-pitting subcutaneous edema, involving skin and mucosa of the upper respiratory tract and intestine. Approximately half of the cases manifest clinically in childhood. Due to the rarity of the condition, general practitioners may not be aware of this condition and hence every angioedema attack is managed with systemic steroids. Confirmation of the diagnosis and counseling of the family is also required for education of caregivers and emergency assistance for avoidance of triggering factors (trauma, mental stress, and infection) and prompt control of edematous attacks. We present a case of an 11-year-old child having HAE with recurrent episodes of swelling of face with family history positive and low level of C1 esterase inhibitor, C4 which was managed with systemic use of tranexamic acid.
{"title":"Successful use of tranexamic acid in the management of child having hereditary angioedema – a case report","authors":"S. Rathod, Khushbu Harshadkumar Jadav, Akshay R Ambasana, Puja Moliya, Ashish Jagati","doi":"10.25259/ijsa_7_2022","DOIUrl":"https://doi.org/10.25259/ijsa_7_2022","url":null,"abstract":"Hereditary angioedema (HAE) is a rare disease characterized by recurrent non-pitting subcutaneous edema, involving skin and mucosa of the upper respiratory tract and intestine. Approximately half of the cases manifest clinically in childhood. Due to the rarity of the condition, general practitioners may not be aware of this condition and hence every angioedema attack is managed with systemic steroids. Confirmation of the diagnosis and counseling of the family is also required for education of caregivers and emergency assistance for avoidance of triggering factors (trauma, mental stress, and infection) and prompt control of edematous attacks. We present a case of an 11-year-old child having HAE with recurrent episodes of swelling of face with family history positive and low level of C1 esterase inhibitor, C4 which was managed with systemic use of tranexamic acid.","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132435021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Rathod, Ashish Jagati, K. Kalra, Swanam Gangopadhyay
Urticarial vasculitis is a clinicopathologic entity characterized by recurring wheals along with histopathologic evidence of leukocytoclastic vasculitis. If associated with systemic involvement, it can lead to substantial morbidity. Associated hypocomplementemia and systemic symptoms need thorough evaluation to rule out possibility of connective tissue disorders and autoinflammatory syndromes. We, hereby, present a case of a 19-year-old male who presented to us with recurrent urticarial wheals along with disabling myalgia and joint pain.
{"title":"Urticarial vasculitis – A curious case with overlapping presentation","authors":"S. Rathod, Ashish Jagati, K. Kalra, Swanam Gangopadhyay","doi":"10.25259/ijsa_3_2022","DOIUrl":"https://doi.org/10.25259/ijsa_3_2022","url":null,"abstract":"Urticarial vasculitis is a clinicopathologic entity characterized by recurring wheals along with histopathologic evidence of leukocytoclastic vasculitis. If associated with systemic involvement, it can lead to substantial morbidity. Associated hypocomplementemia and systemic symptoms need thorough evaluation to rule out possibility of connective tissue disorders and autoinflammatory syndromes. We, hereby, present a case of a 19-year-old male who presented to us with recurrent urticarial wheals along with disabling myalgia and joint pain.","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129380330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nithiyaa Pavadai, R. Bhowmick, Vikram Raj Mohanam, P. Kommu
{"title":"Cutaneous loxoscelism with severe angioedema in a child – A rare case report","authors":"Nithiyaa Pavadai, R. Bhowmick, Vikram Raj Mohanam, P. Kommu","doi":"10.25259/ijsa_14_2021","DOIUrl":"https://doi.org/10.25259/ijsa_14_2021","url":null,"abstract":"","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"14 9 Pt 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131595025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Godse, Abhishek De, B. Shah, M. Girdhar, K. Shankar, Aarti Sarda, D. Dhoot, Hanmant Barkate
There are multiple guidelines for chronic spontaneous urticaria (CSU) by various dermatological associations, but in real-world practice in India, different approaches have been noted. In this paper, we courted to determine these different approaches in CSU management, adherence to various CSU guidelines, and the reasons for deviation from guidelines amidst dermatologists in India. A net-based questionnaire was created and validated by five panelists experienced in CSU management and then was circulated to all dermatologists in India in August 2020 for real-world management scenario. We received 880 completed response out of 2235 response. Most of the dermatologists (97%) were aware of some urticaria guidelines. Although many of them follow guidelines about three forth of them reported to deviate from it sometimes. The most common reason for deviation was rely on clinical experience as opted by 53% of respondents. Dermatologists who follow guidelines also investigate routinely in terms of complete blood count, the erythrocyte sedimentation rate, and thyroid-stimulating hormone as compared to those who do not. About 70.5% of the dermatologist prescribe second-generation antihistamine (SGAH) at approved dose as the first line of treatment whereas 63.6% up dose it as second line of treatment. Surprisingly, 68% prescribe first-generation antihistamine in the evening and SGAH in the morning as combination therapy in CSU. From the findings of the present study, it can be strongly implied that guidelines play a vital role in delivering superior attributes of patient care although 75% of dermatologists deviated from it. Main reasons for deviance are reliability on self-clinical proficiency and consideration of economic impediments. Both these factors need to be worked upon by continuous medical education of dermatologists and more pharmaco-economic research.
{"title":"Management of chronic spontaneous urticaria: Real-world Indian perspective","authors":"K. Godse, Abhishek De, B. Shah, M. Girdhar, K. Shankar, Aarti Sarda, D. Dhoot, Hanmant Barkate","doi":"10.25259/ijsa_4_2021","DOIUrl":"https://doi.org/10.25259/ijsa_4_2021","url":null,"abstract":"\u0000\u0000There are multiple guidelines for chronic spontaneous urticaria (CSU) by various dermatological associations, but in real-world practice in India, different approaches have been noted. In this paper, we courted to determine these different approaches in CSU management, adherence to various CSU guidelines, and the reasons for deviation from guidelines amidst dermatologists in India.\u0000\u0000\u0000\u0000A net-based questionnaire was created and validated by five panelists experienced in CSU management and then was circulated to all dermatologists in India in August 2020 for real-world management scenario.\u0000\u0000\u0000\u0000We received 880 completed response out of 2235 response. Most of the dermatologists (97%) were aware of some urticaria guidelines. Although many of them follow guidelines about three forth of them reported to deviate from it sometimes. The most common reason for deviation was rely on clinical experience as opted by 53% of respondents. Dermatologists who follow guidelines also investigate routinely in terms of complete blood count, the erythrocyte sedimentation rate, and thyroid-stimulating hormone as compared to those who do not. About 70.5% of the dermatologist prescribe second-generation antihistamine (SGAH) at approved dose as the first line of treatment whereas 63.6% up dose it as second line of treatment. Surprisingly, 68% prescribe first-generation antihistamine in the evening and SGAH in the morning as combination therapy in CSU.\u0000\u0000\u0000\u0000From the findings of the present study, it can be strongly implied that guidelines play a vital role in delivering superior attributes of patient care although 75% of dermatologists deviated from it. Main reasons for deviance are reliability on self-clinical proficiency and consideration of economic impediments. Both these factors need to be worked upon by continuous medical education of dermatologists and more pharmaco-economic research.\u0000","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126167899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Shah, A. Choudhary, N. Jangid, Deval Mistry, Shikhar H. Shah, Shruti Kamat, D. Dhoot, G. Deshmukh, Hanmant Barkate
Chronic spontaneous urticaria (CSU) is correlated with a high detrimental effect on the quality of life (QoL). Antihistamines are the first choice drugs in the management of CSU. QoL is important in the evaluation of the efficacy of antihistamines, as these are the most commonly used in CSU. In this comparative, three-arm study, patients with CSU were randomized to standard dose of either bilastine, fexofenadine, or levocetirizine for a period of 4 weeks. Patients were assessed for improvement in their QoL based on chronic urticaria QoL questionnaire (CU-Q2oL) questionnaire and urticaria activity score (UAS). Fifty-eight CSU patients were randomized to bilastine (n = 23), fexofenadine (n = 18) and levocetrizine (n = 17) groups. There was significant improvement in CU-Q2oL and UAS score in all the groups during study period. 83%, 72%, and 65% patients reported improvement in CU-Q2oL score in bilastine, fexofenadine, and levocetrizine group, respectively. Bilastine was associated with significant improvement in CU-Q2oL compared to fexofenadine and levocetrizine (P < 0.05). Mean reduction in UAS score was 86%, 77%, and 68% in bilastine, fexofenadine and levocetrizine group respectively. The difference was statistically insignificant between the groups. The CU-Q2oL total score correlated more strongly (r = 0.62; P = 0.001) with the UAS7 in bilastine group than fexofenadine (r = 0.57; P = 0.01) and levocetrizine groups (r = 0.53; P = 0.02). The results of the study proved that, in CSU patients, QoL was improved significantly with bilastine as compared to fexofenadine and levocetirizine.
{"title":"Comparative assessment of quality of life in chronic spontaneous urticaria receiving second generation anti histamines: A real world study","authors":"B. Shah, A. Choudhary, N. Jangid, Deval Mistry, Shikhar H. Shah, Shruti Kamat, D. Dhoot, G. Deshmukh, Hanmant Barkate","doi":"10.25259/ijsa_2_2021","DOIUrl":"https://doi.org/10.25259/ijsa_2_2021","url":null,"abstract":"Chronic spontaneous urticaria (CSU) is correlated with a high detrimental effect on the quality of life (QoL). Antihistamines are the first choice drugs in the management of CSU. QoL is important in the evaluation of the efficacy of antihistamines, as these are the most commonly used in CSU.\u0000\u0000\u0000\u0000In this comparative, three-arm study, patients with CSU were randomized to standard dose of either bilastine, fexofenadine, or levocetirizine for a period of 4 weeks. Patients were assessed for improvement in their QoL based on chronic urticaria QoL questionnaire (CU-Q2oL) questionnaire and urticaria activity score (UAS).\u0000\u0000\u0000\u0000Fifty-eight CSU patients were randomized to bilastine (n = 23), fexofenadine (n = 18) and levocetrizine (n = 17) groups. There was significant improvement in CU-Q2oL and UAS score in all the groups during study period. 83%, 72%, and 65% patients reported improvement in CU-Q2oL score in bilastine, fexofenadine, and levocetrizine group, respectively. Bilastine was associated with significant improvement in CU-Q2oL compared to fexofenadine and levocetrizine (P < 0.05). Mean reduction in UAS score was 86%, 77%, and 68% in bilastine, fexofenadine and levocetrizine group respectively. The difference was statistically insignificant between the groups. The CU-Q2oL total score correlated more strongly (r = 0.62; P = 0.001) with the UAS7 in bilastine group than fexofenadine (r = 0.57; P = 0.01) and levocetrizine groups (r = 0.53; P = 0.02).\u0000\u0000\u0000\u0000The results of the study proved that, in CSU patients, QoL was improved significantly with bilastine as compared to fexofenadine and levocetirizine.","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115821393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic inducible urticaria (CIndU) is a subtype of chronic urticaria characterized by recurrent itchy wheals and/or angioedema for more than 6 weeks. CIndU has a longer disease duration than chronic spontaneous urticaria (CSU) and wheals are shorter lasting than CSU. CIndU incudes physical and non-physical urticaria. Triggers and diagnosis of subtypes of CIndU differ from each other. Patient education for avoiding triggers is an important aspect of the treatment of CIndU. There is no significant difference in the treatment approach for CIndU and CSU. In this article, we have discussed different types of CIndU, their clinical features, diagnosis, and management.
{"title":"Chronic inducible urticaria: Clinical presentation, diagnosis, and management","authors":"P. Can, D. Fomina, E. Kocaturk","doi":"10.25259/ijsa_12_2021","DOIUrl":"https://doi.org/10.25259/ijsa_12_2021","url":null,"abstract":"Chronic inducible urticaria (CIndU) is a subtype of chronic urticaria characterized by recurrent itchy wheals and/or angioedema for more than 6 weeks. CIndU has a longer disease duration than chronic spontaneous urticaria (CSU) and wheals are shorter lasting than CSU. CIndU incudes physical and non-physical urticaria. Triggers and diagnosis of subtypes of CIndU differ from each other. Patient education for avoiding triggers is an important aspect of the treatment of CIndU. There is no significant difference in the treatment approach for CIndU and CSU. In this article, we have discussed different types of CIndU, their clinical features, diagnosis, and management.","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131050141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Podder, Anant D Patil, K. Godse, Abhishek De, N. Sharma
{"title":"Conference report: 8th Annual National Skin Allergy Meeting – India","authors":"I. Podder, Anant D Patil, K. Godse, Abhishek De, N. Sharma","doi":"10.25259/ijsa_2_2022","DOIUrl":"https://doi.org/10.25259/ijsa_2_2022","url":null,"abstract":"","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126145736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urticaria associated with COVID-19: A report of two patients and review of literature","authors":"Zawar Vijay P, B. Telhure","doi":"10.25259/ijsa_10_2021","DOIUrl":"https://doi.org/10.25259/ijsa_10_2021","url":null,"abstract":"","PeriodicalId":340475,"journal":{"name":"Indian Journal of Skin Allergy","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128903877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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