This summary was compiled from the tweets posted by @MatthewBowdish, an allergist/immunologist, who attended the 2012 Western Society of Allergy, Asthma and Immunology (WSAAI) meeting. The tweets were labeled #WSAAI. The text was edited and modified by me.Dr. Beck discussed chronic urticaria:
When urticaria lasts longer than 24 hours, think about neutrophils in the lesions, and consider a skin biopsy.
Skin biopsy may determine management
If there is no response to moderate doses of antihistamines in urticaria, get biopsy to rule out vasculitis or neutrophilic lesions.
If biopsy shows neutrophils, then use dapsone or colchicine. Sulfasalazine or cellcept work for lymphocyte-predominant lesions.
Neutrophil predominant urticaria is seen in delayed-pressure urticaria, urticarial vasculitis, Schnitzler’s syndrome, cryopyrin-asssociated periodic syndromes (CAPS). Rilonacept is helpful in Schnitzler’s (recurrent fevers, asthralgia, lymphadenopathy, high IgM, high ESR).
Antihistamines
All newer antihistamines have been tested at 5 times their normal dose to rule out QT prolongation. Doxepin 100 mg can cause ECG changes.
Ketotifen PO may be helpful for chronic urticaria.
Dr. Beck doesn't look for anti-IgE receptor antibodies because it doesn't change her management.
Anti-FceR1 autoantibodies in chronic autoimmune urticaria: IgG against FceRI (receptor for IgE) (click to enlarge the image).
This summary was compiled from some of the tweets posted by @MatthewBowdish . The tweets were labeled #WSAAI and they reached more than 3,000 people. I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Here is how to do it: Twitter for Physicians: How to use Twitter to keep track of the latest news and scientific meetings, and share information with colleagues and patients.
Disclaimer: The text was edited, modified, and added to by me.
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