Key messages: Urticaria guidelines

The EAACI/GA²LEN/EDF/WAO Guideline for the Definition, Classification, Diagnosis, and Management of Urticaria

The American Academy of Dermatology was one of 42 organizations from 25 countries involved in the development of the guideline.
- The AAD also endorsed the final guideline, published in the journal Allergy.
In addition to the definition and classification of urticaria, the guideline outlines an evidence-based approach to urticaria management.
- The guideline presents diagnostic algorithm for chronic urticaria and recommends a limited workup rather than more extensive diagnostic screening tests.
- Second-generation H1-antihistamines are recommended as a first-line treatment for chronic urticaria.
  - If the patient does not respond to this treatment, the guideline recommends increasing the dosage up to four times.
  - Omalizumab is recommended for patients who remain unresponsive to antihistamines after the dose is increased.
  - Ciclosporin is recommended for those who remain unresponsive to both antihistamines and omalizumab.
- The guideline recommends against the long-term use of systemic corticosteroids in chronic urticaria, although a short course may be considered for patients with acute exacerbation of their symptoms.
Chronic urticaria has a negative effect on quality of life, creating a significant burden on patients, their families and friends, and the health care system.
- This guideline provides dermatologists with a resource to help them provide the best possible care for people with chronic urticaria, in addition to and in collaboration with other specialists.