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Chronic spontaneous urticaria: treatment guidelines and non-biologic therapy
신효승 ( Hyoseung Shin ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
·Avoidance of triggers and aggravating factors ·European Academy of Allergy and Clinical Immunology recommends the following stepwise approach. . First line treatment includes non-sedating, second-generation H1 antihistamines . Second-line therapy involves up-dosing the second-generation H1 antihistamine (up to fourfold dosage) . Third-line treatment includes adding leukotriene receptor antagonist, cyclosporine, or omalizumab. . Corticosteroids may be used as rescue therapy as rescue therapy for a maximum of 10 days. . First generation H1 antihistamines are not included based on the benefit-to-risk ratio of these agents. ·However, American Academy of Allergy, Asthma, and Immunology guidelines consider the options of up-dosing second-generation H1 antihistamines, adding other second-generation H1 antihistamines, and adding H2 antagonists, leukotriene receptor antagonists or first-generation H1 antihistamines at bedtime to all be equally weighted second-line options. ·The expected response rate by antihistamines is about 45% based on the literature. The response rate of omalizumab was 65% of reminder. And then, the response rate of cyclosporine was 65% of reminder. Calculated total response rate was 92%. (Ref> Ann Allergy Asthma Immunol. 2014;112:419-25) ·Miscellaneous treatments: dapsone, hydroxychloroquine, sulfasalazine, colchicine, methotrexate, intravenous gamma-globulin, and phototherapy have all been used to treat chronic spontaneous urticaria.
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성남희 ( Nam Hee Sung ),김도훈 ( Do Hun Kim ),신효승 ( Hyoseung Shin ),이애영 ( Ai Young Lee ),이승호 ( Seung Ho Lee ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.11
Cutaneous bone formation may be primary or secondary. If it is primary, there are no preceding cutaneous lesions. If it is secondary, bone forms through metaplasia within a preexisting lesion caused by inflammation, traumaticinjury, and a neoplastic tumor. Paronychia is inflammation of the proximal nail fold and presents as painful periungual erythema, sometimes with associated purulence. Chronic paronychia is most commonly related to mechanical or chemical factors. Here, we report a case of chronic paronychia accompanied by cutaneous ossification in a 33-year-old woman who presented with a 2-year history of recurrent paronychia on the left first finger. (Korean J Dermatol 2014;52(11):806∼808)
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성남희 ( Nam Hee Sung ),김태한 ( Tae Han Kim ),김도훈 ( Do Hun Kim ),신효승 ( Hyoseung Shin ),이애영 ( Ai Young Lee ),이승호 ( Seung Ho Lee ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.8
Autoimmune progesterone dermatitis is a rare disorder involving hypersensitivity to progesterone. It is most frequently characterized by recurrent erythema multiforme, eczematous or urticarial eruptions during the luteal phase of the menstrual cycle. It resolves or partially improves after menstruation. Sensitivity is demonstrated by a challenge test with medroxyprogesterone acetate. The therapeutic goal for autoimmune progesterone dermatitis is the suppression of ovulation. Currently, the first-line choice of therapy is a combination oral contraceptive. Here, we report a case of autoimmune progesterone dermatitis that manifested as cyclic bullous erythema multiforme. A reactive intradermal progesterone test confirmed the diagnosis. (Korean J Dermatol 2015;53(8):631∼634)
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