2023-06-13 12:16:15
The diagnostic and therapeutic path of patients with chronic spontaneous urticaria (Csu) can be tortuous and time-consuming to obtain the diagnosis of the disease and allow for the initiation of appropriate treatment. For this reason, ten specialists, among the leading national experts in the dermatological and allergy fields – gathered in an Advisory Board – have developed a document, a real “guide” with practical indications, to support doctors and patients. This is reported by an article published by Allies for Health (www.alleatiperlasalute.it), the medical-scientific information portal created by Novartis.
The document “on the diagnosis and therapy of the CSU – explains Silvia Ferrucci, medical director at the Sc Dermatology of the Milan Polyclinic and member of the Advisory Board – aims to improve the path that the patient follows to arrive at the right diagnosis and therapy . We know that the antihistamine is the therapy to be indicated in the first line, taking care to choose latest generation antihistamines that cause less drowsiness, given that the patient, due to the itching, has sleep disturbances and rests badly. If it doesn’t work, we increase the dosage up to 4 times, but to avoid useless waste of time, in a patient who has a truly compromised quality of life, you need to go to a specialist center to facilitate access to therapy with effective and well-balanced biological drugs. tolerated, for an improvement of the signs and symptoms of the pathology and of the quality of life”.
Csu is an inflammatory disease characterized by wheals, very itchy ‘mosquito bite’-like bumps on the skin “which are sometimes associated – underlines Ferrucci – angioedema, a swelling that can deform a part of the body, such as the eyelids or lips. It has a strongly negative impact on our patients due to the clinical manifestation, but above all due to the ever-present itch, which disturbs sleep and prevents them from carrying out daily activities”.
To facilitate the patient journey “we have thought of a document – continues Ferrucci – to give our colleagues, family doctors, local specialists, dermatologists, allergists and rheumatologists, a procedure, practical indications that help them understand what the path is ideal”. It is a tool that “has the objective of directing patients who do not respond to therapies to centers of reference in order to avoid wasting time and facilitate access to treatments which work in more than 70% of patients. For those who don’t respond, other treatments are available, or the ability to enter clinical trials and access other therapies.”
The diagnosis of chronic spontaneous urticaria “is essentially clinical – clarifies Riccardo Asero, head of the Allergology clinic of the San Carlo Clinic in Paderno Dugnano (Mi) and member of the Advisory Board – The patient must have urticaria lesions, the typical wheals with or without angioedema (i.e. swelling of the lips, eyelids, hands, feet and genitals) that occurs for 30 minutes to 24 hours, then disappears without a trace, continuously or otherwise, for 6 weeks or more” .
In practice, people “who do not respond to antihistamine therapy or those whose wheals last more than 24 hours and/or hesitate with purpuric-type lesions – Asero remarks – are referred to the specialist. Most of the CSUs respond quite easily to antihistamine therapy alone and can be managed by the general practitioner or local specialist, allergist or dermatologist”. Instead, when the patient does not respond to antihistamine therapy, “neither at a standard dose nor at dose increased up to 4 times, according to guidelines, then you must go to a dermatology or allergy center that has the authorization to prescribe the biological drug, the next step in the treatment”, he concludes.
#Chronic #spontaneous #urticaria #expert #guide #doctor #patient