Description
Made available in DSpace on 2019-10-04T12:38:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-03-01. Added 1 bitstream(s) on 2019-10-09T18:34:12Z : No. of bitstreams: 1 S0365-05962019000700056.pdf: 486399 bytes, checksum: a2e0a3f4581e4f634c104b420135972a (MD5)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
BACKGROUND: Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute (<= 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. OBJECTIVES: To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods: A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. RESULTS: Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). CONCLUSIONS: Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine.
Univ Sao Paulo, Dermatol, Fac Med, Sao Paulo, SP, Brazil
Fac Med ABC, Postgrad Program, Sao Paulo, SP, Brazil
Univ Sao Paulo, Dept Dermatol, Fac Med, Sao Paulo, SP, Brazil
Univ Fed Pernambuco, Recife, PE, Brazil
Univ Nove Julho, Dermatol, Sao Paulo, SP, Brazil
Univ Fed Minas Gerais, Dermatol Serv, Hosp Clin, Belo Horizonte, MG, Brazil
Univ Fed Minas Gerais, Dermatol, Fac Med, Belo Horizonte, MG, Brazil
Univ Fed Pernambuco, Dept Dermatol, Ctr Ciencias Med, Fac Med, Recife, PE, Brazil
Fac Evangel Curitiba, Dermatol Serv, Curitiba, Parana, Brazil
Univ Sao Paulo, Div Dermatol, Hosp Clin, Fac Meclicina, Sao Paulo, SP, Brazil
Univ Estadual Paulista, Dept Dermatol & Radiotherapy, Botucatu, SP, Brazil
Hosp Padre Bento Guarulhos, Training & Improvement Management, Sao Paulo, SP, Brazil
Hosp Serv Publ Estadual Sao Paulo, Dermatol Serv, Sao Paulo, SP, Brazil
Univ Fed Sao Paulo, Urticaria Outpatient Clin, Dept Dermatol, Sao Paulo, SP, Brazil
Univ Fed Rio Grande do Sul, Dermatol Serv, Hosp Clin Porto Alegre, Fac Med, Porto Alegre, RS, Brazil
Ambulatorio Dermatol Sanitaria, Porto Alegre, RS, Brazil
Santa Casa Porto Alegre, Dermatol Serv, Porto Alegre, RS, Brazil
Santa Casa Misericordia Sao Paulo, Dermatol Clin, Sao Paulo, SP, Brazil
Santa Casa Misericardia Sao Paulo, Dermatol, Fac Ciencias Med, Sao Paulo, SP, Brazil
Fac Med ABC, Sao Paulo, SP, Brazil
Univ Estadual Paulista, Dept Dermatol & Radiotherapy, Botucatu, SP, Brazil
CAPES: 001
