There is a felt need for trying newer therapeutic modalities in patients with chronic spontaneous urticaria, especially in the subset of patients classified as non-responders to antihistamines. ...Autologous serum therapy is an upcoming modality of treatment, and we decided to study its efficacy by subcutaneous route.
To evaluate the effectiveness of subcutaneous autologous serum therapy (AST) in CSU.
This was a single blind, placebo-controlled parallel group, randomized, controlled study. Twenty-four patients with CSU (11M: 13 F) were given subcutaneous AST and seventeen patients (7 M: 10F) patients were given subcutaneous injection normal saline (placebo), along with levocetirizine in an on-demand basis in both groups.
Urticaria activity score (UAS) came down from 35.74 to 7 at the end of 9 weeks and the patients' requirement of antihistamines also reduced remarkably from 5.8 to 1.7 per week in the serum group. Sub-cutaneous saline group did not show statistically significant fall in UAS. Saline group showed UAS 32.8 at zero week to 22.1 at the end of 9 weeks. DLQI showed significant fall in serum group, from 14.26 to 4 at the end of 9 weeks.
Subcutaneous autoserum therapy is effective in treatment of CSU.
This article is developed by the Skin Allergy Research Society of India for an updated evidence-based consensus statement for the management of urticaria, with a special reference to the Indian ...context. This guideline includes updated definition, causes, classification, and management of urticaria. Urticaria has a profound impact on the quality of life and causes immense distress to patients, necessitating effective treatment. One approach to manage urticaria is by identification and elimination of the underlying cause(s) and/or eliciting trigger(s) while the second one is by treatment for providing symptomatic relief. This guideline recommends the use of second-generation nonsedating H1-antihistamines as the first-line treatment. The dose can be increased up to four times to meet the expected results. In case patients still do not respond, appropriate treatment options can be selected depending on the associated medical condition, severity of the symptoms, affordability of the drugs, and accessibility of modern biologics such as omalizumab.
Background Treating dermatological pathologies under occlusion therapy is a popular adjunct, especially in thickened, lichenified areas of psoriasis where sustained contact with topical ...corticosteroids plays a pivotal role. Film-forming spray (FFS) can be a novel, alternate approach along with topical treatment in this area for carefully selected cases. This study aimed to evaluate the safety profile and physical characteristics of a novel formulation of an FFS in patients with psoriasis and eczema. Methods This open-label, multicentre, comparative study included subjects diagnosed with chronic plaque psoriasis requiring topical corticosteroid therapy or those with eczema necessitating its application and occlusion therapy. The study product was applied to two groups of subjects. For patients in group 1, the FFS was applied to the skin area affected by the dermatological condition, which was covered with ointment only. In the second group, the FFS was applied to the corresponding unaffected skin area. The FFS was applied for 60-90 seconds and was observed for two hours after the application. The subjects were evaluated for primary outcomes, including safety assessment, overall physical characteristics, and appearance of FFS from local skin effects. The secondary outcomes included physical appearance characteristics and overall patient satisfaction following the application of FFS at the target sites. Further statistical assessments were conducted using the SAS software version 9.4 (2023; SAS Institute Inc
Cary, North Carolina, United States). Result A total of 100 subjects were included in the study across 10 outpatient centers, of which 79% had psoriatic plaques and 21% had eczematous lesions. Primary outcomes showed a lack of appearance of clinical symptoms such as dryness, flakiness, or irritation. A total of 10% of subjects in group 1 had erythema, and 6% had a tingling sensation, which was transient and mild. The secondary outcomes showed that only 12% of subjects in Group 1 and 6% of subjects in Group 2 showed a feeling of stickiness at the application site. In group 1, 8% reported a cooling sensation, which disappeared in one and two minutes, and none experienced a cooling sensation in Group 2. The average drying time for FFS in subjects with dermatological conditions was 5.19 minutes compared to 1.51 minutes on unaffected skin. The film washability results indicated that 96% of subjects in group 1 reported complete removal in less than two minutes. At the end of the study period, the mean satisfaction score was 8.99. No significant adverse events were reported in the patients. Conclusion This study highlights the potential application of a novel formulation of FFS as a safe and well-tolerated option for enhancing uniform skin coverage with the topical corticosteroid in patients affected with psoriasis and eczema.
Background: Antihistamines are one of the commonly prescribed groups of drugs for allergic disorders and pruritus. They are broadly grouped into two generations, the second-generation ones being more ...effective and with less side effects. The family physicians frequently use antihistamines as patients contact them initially for their problem. It will be interesting to know the mode of selection of antihistamines by them. Materials and Methods: The study was carried out on a sample of 100 family physicians. Primary data were collected from them after taking informed consent. A pre-validated questionnaire regarding knowledge, awareness, and prescribing schedule of antihistamines was filled up. The data were then analyzed with suitable statistical tests. Results: Almost 73% of physicians prescribed second-generation antihistamines, while 27% prescribed the first-generation ones. Only 15% of them were aware about the ARIA and GA2LEN guidelines and their recommendations for prescribing second-generation antihistamines over the older first-generation antihistamines, while 85% had not heard about them previously. A minimum 7% of practitioners revealed that they updosed the same drug four times in the treatment of urticaria, while 93% did not do it. Conclusion: Even though a sizeable percentage of family physicians prescribed second-generation antihistamines, most of them were not aware of their dosing guidelines.
Background: Sun exposure causes extensive intrinsic as well as extrinsic changes in the skin. Pathogenic effects of sun exposure such as tanning, melasma, skin cancer, and aggravation of various ...photodermatoses such as systemic lupus erythematosus (SLE) may be prevented by the use of sunscreens. We conducted the present study to assess the knowledge and attitudes regarding sun exposure and use of sunscreens. Methods: Two thousand and thirty-seven volunteers answered the questionnaire over a period of 2 years. All adults aged 18 years and above who voluntarily agreed to participate in the study after written informed consent were included. Results: Out of 2037 volunteers, 1242 volunteers had no knowledge of sunscreens. Sixty-eight percent of the volunteers from the upper class of society knew about sunscreens, and 86% of the volunteers from the lower middle class did not know about sunscreens. Eight-one percent of the volunteers did not suffer from sunburns. Eight-four percent of the volunteers were aware that sun exposure caused darkening, but awareness about other effects of sun exposure such as wrinkling, melasma, allergy, and photo-induced cancers was less. Most of the volunteers agreed that sunscreens protected against sun damage and tanning. Fifty-eight percent of the volunteers applied sunscreen before venturing out, and 78% of the volunteers applied sunscreen only on the face. Prevention of tanning was the most common reason for the usage of sunscreens. Cosmetic appeal and irritant potential were the prominent deciding factors in choosing sunscreens. Conclusion: Awareness about protective spectrum of sunscreens, their correct method of application, and misconceptions need to be focused on. Better product development keeping in mind the Indian conditions would help in increasing the usage of sunscreens.
The current European Academy of Allergology and Clinical Immunology/Global Allergy and Asthma European Network/European Dermatology Forum (EAACI/GA 2 LEN/EDF) guidelines call for updosing of ...nonsedating antihistamines (up to four times the standard dose) in those urticaria patients who do not respond satisfactorily to the standard doses. Routine investigations like complete blood count, blood sugar, thyroid-stimulating hormone (TSH), and urine examination were done to rule out infections before starting therapy.
Melasma, a chronic pigmentary skin condition mainly affecting the face, remains a challenge despite the availability of several options for treatment. Many melasma patients are not satisfied with ...treatment outcomes. Tranexamic acid (TXA), an anti-fibrinolytic drug has shown promising results in patients with melasma. Evidence from several clinical studies has surfaced on efficacy and tolerability of TXA in these patients. It can be used as monotherapy or adjuvant with other therapies. Currently, there is no published consensus or guideline document for its use in the treatment of melasma. TXA is available for oral use, topical use as well as an injection. In this article, a consensus of Indian experts is prepared based on the available literature and experience with use of oral TXA in melasma. This review article might help clinicians for use of oral TXA appropriately while treating melasma.
Background: Atopic dermatitis (AD) is a common and chronic, pruritic inflammatory skin condition that affects all age groups. There was a dearth of consensus document on AD for Indian practitioners. ...This article aims to provide an evidence-based consensus statement for the management of AD with a special reference to the Indian context. This guideline includes updated definition, etiological factors, classification, and management of atopic dermatitis. Methodology: The preparation of guidelines was done in multiple phases. Indian Dermatology Expert Board Members (DEBM), recommended by the Skin Allergy Society of India, prepared 26 evidence-based recommendations for AD. An extensive literature search was done in MEDLINE, Google scholar, Cochrane, and other resources. Articles published in the past 10 years were reviewed and recommendations were graded based on the quality of evidence as per GRADE. After forming the initial structure, DEBM met in Mumbai and gave their decisions on an agree and disagree scale with an Indian perspective. Finally, their suggestions were compiled for preparing the article. After DEBM finalized the draft, a treatment algorithm was formulated for the management of AD. Results: DEBM suggested a working definition for AD. The panel agreed that moisturizers should be used as mainstay of therapy and should be continued in all lines of therapy and in maintenance phase. Topical corticosteroids and topical calcineurin inhibitors should be considered as the first line of treatment. Among systemic therapies, cyclosporin should be considered first line, followed by azathioprine, methotrexate, and mycophenolate mofetil. Phototherapy can be an effecive alternative. Empirical food restriction was recommended against. Conclusion: These guidelines should form a reference for the management of patients with AD in an evidence-based manner.
The current European Academy of Allergology and Clinical Immunology/Global Allergy and Asthma European Network/European Dermatology Forum (EAACI/GA 2 LEN/EDF) guidelines call for updosing of ...nonsedating antihistamines (up to four times the standard dose) in urticaria patients who do not respond satisfactorily to the standard doses. Routine investigations like complete blood count, blood sugar, thyroid stimulating hormone (TSH) and urine examination were done to rule out infections before starting therapy.
Omalizumab-A Review Godse, Kiran; Mehta, Aayushi; Patil, Sharmila ...
Indian journal of dermatology,
07/2015, Volume:
60, Issue:
4
Journal Article
Peer reviewed
Open access
Omalizumab is a recombinant, humanized, monoclonal antibody against human immunoglobulin E (IgE). The US FDA has approved this molecule for chronic urticaria.
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