Clinical Practice Guideline Urticaria Angioedema 2557

Clinical Practice Guideline 2557
ก ก
(Urticaria/Angioedema)
F F
F F ก F
F ก F
F ก F F ก F F ก
ก F F F ก

Clinical Practice Guideline Urticaria/Angioedema238
Clinical Practice Guideline
F
ก :
F F
F F ก F
F F ˁ
F F ก ก F F
F ก F ก F
F F F F
:
F F ก ก ก F
ก ก :
F F F กF ก
F F
F F ก
F ก F
F F F ก F
F F F
ก F F ก ก
ก F F ก
F F
F F ก
F F F
F F ก F
ก ก ก :
F F F F F

Clinical Practice Guideline Urticaria/Angioedema 239
ก ก / ˈ F ก ก F F ก
ก F ˁ / ก / ก F ˈ
F F ก ก / ˈ /
ก F (spontaneous urticaria) F F F ˈ F
F F ˁ ก ก F ˁ Fก F ก ก
F ก ก F ˁ F ˆ ก F ก ก ก ก ˈ ก F
ก ก / F F F F F ก
ก ก ก ˈ ก ก ก F ก
ʾ ก 2552 F
ก F ก ก ˈ (wheal and
flare) / ก F (angioedema) ก F ก ˆ ก ก F ก
ก F ก ก F ก (physical) F ก F F
F ก F
ก ก
(urticaria) ก (wheal and flare) F F
F F ก ก F ก F ก ก F ก F
ก F (angioedema) F F ก F F ʾ ก ˈ F
ก ก ก ก F F ก 24 F F
ก ˈ F F ก ก F F
ก F ก ก F 24 ก F F
F ก F ˁ ˈ ก anaphylaxis ก
F F ก F F ก F ก F F F ก
ก ก ˈ ก (anaphylactic shock)
F ก F ˈ 2
1. (acute urticaria) ก F ก F ก 6 F
2. (chronic urticaria) ก F F 2 F F F ก
กก F 6 F

1 ก ก ( ก ก F (1) (2))
ก F ก F F
ก
(Spontaneous urticaria)
•
(Acute spontaneous urticaria)
/ ก F ก F
ก 6 F
•
(Chronic spontaneous urticaria)
/ ก F ก
กก F 6 F
ˆ ก F
ก กก
ก F ˆ F
ก
(Inducible urticaria or
physical urticaria)
• Cold urticaria ก
• Delayed pressure urticaria ก F ก
3-12 กก F
• Heat urticaria F
• Solar urticaria F / F
• Symptomatic dermographism F (mechanical shearing forces) F ก
1-5 กก F
• Vibratory angioedema F (pneumatic
hammer) F ก 1-2
• Aquagenic urticaria
• Cholinergic urticaria F ก
• Contact urticaria ก กF F ก
ก
ก ก F ก ก ˆ ก F 1
ก ก F ก ก Fก syndromes ก ก
/ 2

1 ก ก ( ก F (2) (3))
ACEI, angiotensin converting enzyme inhibitors; HAE, hereditary angioedema; AAE, acquired
angioedema
Histamine and other
mast cell mediators
Urticaria Angioedema
+ -
ก F ACEI ?
+-
+ - + - +- - +
+ - +
+-
Chronic
inducible
urticaria
HAE I-III
AAE
Chronic
spontaneous
urticaria
Urticarial
vasculitis
Auto-
inflammatory
disease
HistoryDiagnostictestsMediators
ACEI-
induced
angioedema
Interleukin-1 Bradykinin
F F , F , F ?
F
> 24 ?
hereditary
(HAE) acquired
angioedema (AAE) ?
ก
ก ?
Provocation test
Inducible
symptoms ?
-
Autoinflammatory
disorder ?
Histology:
vasculitis ?

2 Fก syndromes ก ก /
( ก ก F (2))
Fก
Maculopapular cutaneous mastocytosis (urticaria pigmentosa)
Urticarial vasculitis
Bradykinin-mediated angioedema ( F hereditary angioedema)
Exercise-induced anaphylaxis
Cryopyrin-associated periodic syndromes: recurrent fever attacks, arthralgia or arthritis,
eye inflammation, fatigue and headaches
-Muckle-Wells syndrome
-Neonatal onset multisystem inflammatory disease
-Familial cold autoinflammatory syndrome
Schnitzler s syndrome: monoclonal gammopathy, recurrent fever attacks,
bone and muscle pain, arthralgia or arthritis,
lymphadenopathy
Gleich s syndrome (episodic angioedema with eosinophilia): IgM gammopathy, eosinophilia
Well s syndrome (eosinophilic cellulitis): granulomatous dermatitis with eosinophilia
ก กก F F ก F F ก
ก F ก 3

3 ก F ก F ก ก F ก F F
F F ก ก ( ก ก F (2) (4))
ก F
ก
(Spontaneous urticaria)
F routine diagnostic tests ( ก F F F ก)
(CSU) Differential blood count**, ESR**
F NSAID
ก F autologous serum skin test*, test
Helicobacter**, gastroscopy**, ANA**, D-Dimer*,†
,
**, ก **, specific IgE**, F F
autoantibodies** ( F ˁ ก F ก F 15 ʾ ก antibodies
F F ˈ F ก )
ก ˆ F ก
1. Cold urticaria Cold provocation test (ice cube, cold water) *, differential blood count**,
ESR**, cryoglobulins**
2. Delayed pressure urticaria Pressure test* F F ก F F ก 0.2- 1.5
กก./ . . ˈ 10 20 F ก F 6.8
ก ก (15 F) F ก F ก ก F F
F F ˁ F ˈ 15
3. Heat urticaria Warm arm bath*
4. Solar urticaria F visible light F F *
5. Symptomatic
dermographism
dermographism*, differential blood count** ESR**
6. Vibratory angioedema F vortex F ˈ 1-5 *
7. Aquagenic urticaria F F F F 20
8. Cholinergic urticaria Exercise ก hot bath ˈ 15-20 *
9. Contact urticaria F ก immunologic nonimmunologic ก
F ก F patch test, skin prick testing F
F ก F F
* ก F ก ** ก F ก
† F ˁ CSU ก ก F coagulation pathway F plasma D-Dimer
F
CSU, chronic spontaneous urticaria; NSAID, non-steroidal anti-inflammatory drug;
ANA, antinuclear antibodies; ESR, erythrocyte sedimentation rate

F ก F F F ก F ก
F F ก ก F F ก ก F
chronic spontaneous urticaria (CSU) F ก ก spontaneous wheals ก
กก ก F F ก F
- F ˁ autoantibodies (IgG) F high-affinity IgE receptor (FcεRI) F IgE F
30-50 F ˁ ก F CSU ก F ˁ ก F F autoimmune urticaria
- F ˁ CSU ก ก F coagulation pathway F plasma D-Dimer F

ก F F ˁ
2 ก F ˁ F ˁ ก F F
• ก ˈ ก F F F prednisolone 20-30 ก. F
ก F ก 10
• ก ก F F ก F ก F aspirin, NSAIDs,
codeine, morphine, ACEI ˈ F
NSAIDs, non-steroidal anti-inflammatory drugs; ACEI, angiotensin converting enzyme inhibitors

4 ก Fก anaphylaxis*
anaphylaxis ก ก 1 3 F F
1. ก ก ( ˈ ) ก ก
F F ʾ ก F ˈ F
F ก ก F F F F
1.1. ก F ก
F (stridor) ก ก ก ก F F peak
expiratory flow (PEF) ก F ˈ F
1.2. ก F F F hypotonia (collapse) ˈ
ˆ ˈ F
2. ก กก F F ก 2 F F F ˁ ก F ˈ กF F ( ˈ
)
2.1. ก F ก F ˈ F
2.2. ก F ก
F (stridor) ก ก ก PEF ก
ˈ F
2.3. ก F F F ˈ ˆ ˈ F
2.4. ก F F F F ˈ F
3. ก ก F ˁ F F กF ( ˈ )
3.1. ก F systolic ก F ก systolic กก F
F 30 systolic *
3.2. F F F systolic F ก F 90 mmHg systolic กก F F
30 systolic
* ก Fก F systolic ก
< 70 mmHg ก 1 -1 ʾ
< 70 mmHg + (2 x ) ก 1 10 ʾ
< 90 mmHg ก 11-17 ʾ
* ก F ˁ ก F (Clinical Practice Guidelines for
Management Anaphylaxis) ʾ . .2551 F F ก F
F ก ก F F F
ก F F ก F F F ก F
F F

3 ก F F ˁ ( ก ก F (5) (6))
NSAIDs, non-steroidal anti-inflammatory drugs; SLE, systemic lupus erythematosus;
SPT, skin prick testing; ESR, erythrocyte sedimentation rate; ANA, antinuclear antibodies;
ASST, autologous serum skin testing
* ก ก F ก F ก F

ก F ˁ
1. ก
ก F ก F F ก ก ก F F
F ก ก ˆ F ˆ ก F F ก F ก F
4 ก ก
Response rate H1-antihistamines = 45-50%, low-dose corticosteroids = 70-80%,
ciclosporin = 70-80%, omalizumab = 70-80%
* NSAIDs, non-steroidal anti-inflammatory drugs
1
ก ก F ก ( F 4 F ) ก ก F F
ก F ก F F ก F กF fexofenadine, rupatadine, desloratadine
levocetirizine F ก F F (2)
2
ก F F ก F F F ก F F F F 2-4 F
3
F F F F

ก (Non-pharmacotherapy to minimize skin hyper-responsiveness)
1.1 ก F F F F F F
1.2 ก ก ก F F กF F ก ก ก ก F ก F ก
ก ก F ก ก ก F ก
ก F F ก ก
2. ก ก F
2.1 F (Antihistamines)
F 1 (H1-antihistamines) ก F ก F 2 F
ก. F 1 F 1 (First-generation or sedating antihistamines) F
F , F ก F ก F ก
F F F F กF F ก ก (benign prostate hypertrophy) F (glaucoma)
ก F ก F F EAACI/GA2LEN/DEF/WAO Guideline
2013 F ก ก F ก F ก F ก F non-sedating
antihistamines F ก F (2) ก ก ก ก F ก F sedating
antihistamines กF F ก non-sedating antihistamines ก ก F
ก ก F F ก F ก F
ก ก F (7) sedating antihistamines 5
. F 1 F 2 (Second-generation or non-sedating antihistamines) (
6) ˈ F F ก F F F
ก F ˈ ก F F ˁ F ก F
F

5 F 1 F 1 (First-generation or sedating antihistamines)
Drug
Pediatric dosage
(mg/Kg/day)
Age
approved
Adult dosage
Pregnancy
category
Dose adjustment
Grades of
evidence
Strength of
recommendation
Chlorpheniramine* 0.35-2 1 ʾ 4 ก. ก 4-6 . B -
4 C*
Cyproheptadine 0.25 2 ʾ 4 ก. ก 6-8 . B
ก ก
ก F
Diphenhydramine 5 2 ʾ 25-50 ก. ก 4-6 . B
ก ก
ก F
Hydroxyzine* 1-2 6 10 ก. ก 6 . C
ก ก
ก F
* grades of evidence strength of recommendation ก ˈ กF Fก ก ก F F ก F ก ก
ก
250 Clinical Practice Guideline Urticaria/Angioedema

6 F 1 F 2 (Second-generation or non-sedating antihistamines) ( ก ก F (2) (8))
Drug
Pediatric dosage Age
approved
Adult dosage Dose adjustment
Pregnancy
category
Grades of
evidence*
Strength of
recommendation*Age Dose
Cetirizine
2-6 ʾ
2.5 ก. 2
5 ก. >2 ʾ 10 ก.
ก ก F
(Ccr<30 / /1.73m2
)
B 1a A
>6 ʾ 10 ก.
Desloratadine
6-11 1 ก.
>6 5 ก.
ก ก F
(Ccr<30 / /1.73m2
)
C 1a A
1-5 ʾ 1.25 ก.
6-11 ʾ 2.5 ก.
>12 ʾ 5 ก.
Fexofenadine
6 - < 2 ʾ 15 ก. 2
>6
180 ก.
60 ก.
ก 12
ก ก F
(Ccr< 80 / /1.73m2
)
C 1a A
2-11 ʾ 30 ก. 2
>12 ʾ
60 ก. 2
180 ก.
Levocetirizine > 6 ʾ 5 ก. >6 ʾ 5 ก.
F ˈ F F ˁ
ก F F
F ˁ ก
(Ccr<50 / /1.73m2
)
B 1a A
Loratadine 2-12 ʾ 5 ก.
>2 ʾ 10 ก. ก ก F B 1a A
>12 ʾ, >30 กก. 10 ก.
Rupatadine
6-11 ʾ
( ≥ 25 กก.)
5 ก.
>12 ʾ ( )
>6 ʾ ( )
10 ก.
ก ก F
(Ccr<30 / /1.73m2
)
B 1a A
* ก ก F (8)

2.2 ก ก F
• F F (Corticosteroids)
F F F F prednisolone ก ˈ
ˈ (acute severe urticaria), serum sickness ˈ , urticarial vasculitis delayed pressure
urticaria F F ก ก F F F F F F physical urticaria
F F F prednisolone ˈ F F F ˈ F
F ˈ ก ก ก F (acute exacerbation) F ˈ
F F ก ก
• ก F F 1 2 F ก (H1- and H2-antihistamines)
F quality of evidence F 2 (H2-antihistamines) F ก F
1 (H1-antihistamines) F ก ก F ˁ F F ก
F F F ก F F ก F 1 ก ,
ก F F ก F ˁ ก ก F H1-antihistamine
F F 2 ก F F ก F ˁ F F F ก F H1-antihistamines ก F
F 2-4 F
• Leukotriene receptor antagonist ก montelukast F F ˁ
(chronic urticaria) F F F ก ก F F F montelukast F ก
ก F ˁ aspirin-sensitive F F ˁ chronic urticaria F
F ก F F quality of evidence F ก F montelukast ก F 2-4 F F
F F
• Ciclosporin F ก ก กก ก F F F F 2.5-5 ก./
กก./ ก ciclosporin ˈ F F F F F ก 3-6 F
F ก ก ก F ก F ก F 18 ʾ
• Omalizumab ก ก ก ก F F ก ก F ˁ
F ก ก ก ก ก ก F F ก F ˁ
12 ʾ F F ก ก F ก F F
ก ก ก F ก F F F F F F (appendix II; ก ก F
omalizumab)

7 ˈ ก ก ก ก ก ( ก ก F (2) (8))
ก ก RCT
F
ก ก RCT F
F ก non-sedating
H1-antihistamines
ก ก RCT F F
F F ก
F RCT (uncontrolled studies ,
case reports)
Grades of evidence*
Strength of
recommendation*
Doxepin X 3b B
Ketotifen X 3b B
Montelukast X 4 C
Nifedipine X 4 C
PUVA X 4 C
Warfarin X 4 C
Ciclosporin X 1a A
Hydroxychloroquine X 4 C
Montelukast X 3b B
Narrow band UVB X 4 C
Omalizumab X 1a A
Stanozolol X 3b B
Cromolyn X 4 C
Sedating H1-antihistamines + H2-
antihistamines (cimetidine)
X 4 C
Sedating H1-antihistamines + terbutaline X 4 C
Tranexamic acid X 4 C
Dapsone X 4 C
Corticosteroids X 3b B
Interferon X 4 C
Intravenous immunoglobulins X 4 C
Methotrexate X 4 C
Plasmapheresis X 4 D
Sulfasalazine X 4 C
* ก ก F (8) ; RCT, randomized controlled trial

3. ก ก
3.1 ก F calamine lotion ˈ ˂ menthol F F ˈ F
ก F F ˁ F ก ก ก ก กก ก F ˂ F
ก F
3.2 ก F ก ก ก ก ก ก F ก
F F ˁ
F ˁ F F F F ˈ F
F F ก F F ก ก ก ก F
F ˁ F ก F ก ก ก F ˁ ก ˆ F (holistic approach)
F F ˁ F F F ก F F F F ˁ F กก F
F ˁ F F F F F F ก
ก F F F ˁ F F
ก F Fก ก guidelines F F ก
F ˁ F F F ก F
ก ก F
1. F F ก ˈ F F F ก F ก 3 F F ˁ
ก ก ก F F 1 5 F 21 F
ก ˈ (9)
2.
F F F 50 F ˁ F 1 ʾ
F 20 F ˁ ˈ F กก F 20 ʾ ก F F ˁ F ก
F F F F 75 F ˁ F ก F 1 ʾ F
20 F ˁ ˈ ก F 20 ʾ 1 ʾ
1 3 F 34 (remission) 390
ก F 50 ก F ก 1 ʾ ( 16 ) F F 19
1 ʾ

ก
• ก F ก F F ก ก F ก
F F ก ก ก (first-line treatment F F )
F
1. ก F ก
- Complete blood count (CBC)
- Erythrocyte sedimentation rate (ESR)
- Stool examination
- Chest X-ray
- Sinus X-ray
- Antinuclear antibodies (ANA)
- D-dimer
- ก Helicobacter
- Gastroscopy
- Thyroid antibodies / thyroid function test: ก F F F F
F F
autoimmune urticaria
2. ก F ก (skin prick testing, SPT): ˈ ก ก F IgE-
mediated ก กก ˈ ก F F F ˁ allergen-specific IgE F F F ˈ ก F ก
ก F ก กก F กF F ก F
(negative predictive accuracy) F กก F F 95 ก IgE-mediated reactions ก F F F F
ก positive predictive accuracy F ก F F 50 ก ก double-blind, placebo-
controlled food challenge ก ก SPT F
SPT F ก ก ก F F
ก ก F IgE acute allergic urticaria กก F
3. ก ก F
Gold standard ก ก F ก double-blinded, placebo-controlled food challenge
ก ก F ก F ก IgE-mediated non-IgE-mediated reaction
ก ก F ˈ IgE-mediated reaction F skin prick testing serum
specific IgE ก F ก ก specific serum IgG F F
F Fก F

4. ก Autoantibodies ก F ˁ chronic autoimmune urticaria
F กF
4.1 In vivo test
• Autologous serum skin testing (ASST) ˈ screening test F ก
F ˁ chronic autoimmune urticaria ก F 70 F
80 ก F ก F 30-60 F ˁ CSU F F ก F F ก
ก ก
4.2 In vitro test F กF
• Basophil histamine release assay* ˈ ก functional autoantibodies F ˁ ก
F F fresh basophils ก ก
• Direct immunoassays* ˈ ก non-functional functional anti- FcεRI
autoantibodies ก F F กF Western blotting, immunoprecipitation, enzyme-linked
immunosorbent assay, flow cytometry F chimeric cell lines express human FcεRI α
* ก F F F F F F F

Appendix I. grades of evidence strength of recommendation F F clinical practice
guideline
Grades of evidence ( ก ก F (8))
1a Metaanalysis of RCT
1b Single RCTs
2a Systemic review of cohort studies
2b Single cohort studies and RCTs of limited quality
3a Systematic review of case control studies
3b Single case control study
4 Case series, case cohort series or cohort studies of limited quality, expert committee opinion
RCT, randomized controlled trial
Classification of strength of recommendation ( ก ก F (8))
Recommendation strength Evidence grade
A 1a, 1b
B 2a, 2b, 3a, 3b
C 4
D Expert opinion

Appendix II ก ก F Omalizumab
Omalizumab
omalizumab F ก ก F F ก ก F F
F ( 12 ʾ ) ก ก F omalizumab F F ก ก ก F H1-antihistamines
ก add on therapy
ก ก F omalizumab (anti-IgE treatment) F ˁ F ก ก F F
1. F ˁ F F ก F F F / F
2. 12 ʾ
3. F ก F F ˆ ก F F ก
- ก F ก ˈ complete blood count (CBC), ANA, urine analysis
4. F ก ก F F F ˈ ก (chronic spontaneous urticaria) F
F ก ก ก
5. F ˁ ก F F 3 F F F ก ก F F ก ก ก ก
( F ก ก F 2557 F F
F F ก F F ก F ) ก F
omalizumab
ก ก F nonsedating H1-antihistamines
F F 4 F
nonsedating H1-antihistamines กก F 1 modern second-generation
H1-antihistamines 1
( ก 4 F F ก ) F F 4 F
F ˁ F ก F ˈ ก
(chronic spontaneous urticaria)
F F ก ก
F F ก ก

F ก F
Urticaria Activity Score 7 (UAS7) >16
F ˁ F ก ก F F F F F
ก ก F ˁ ก F
1. absolute contraindications F ciclosporin2
* ก F ˁ ก ก F F
ciclosporin ก ก F 18 ʾ ก F
Fก F
2. absolute contraindications F systemic
corticosteroids3
F ก ก
7 (Urticaria Activity Score 7; UAS7)
F ก ก F omalizumab
UAS7 กก F F ก 16 ( ก
42 )
: ก F F Relative
contraindications F ciclosporin2
systemic
corticosteroids3
F F F ก F
Urticaria Activity Score 7 (UAS7) >16
F ˁ F ก ก F F F F ˁ ก
F F ก ก F omalizumab F F F
ก F UAS7 >16
1. Ciclosporin
- ciclosporin dependence F
ciclosporin F F ˈ 3
- F F ก ก F ciclosporin (
UAS7 F 30% ก F F ก
F F ก 3 ก./กก./ F F 4
F)
- ciclosporin treatment intolerance F
ก / F
blood pressure >140 mmHg systolic >90 mmHg
diastolic F ก 2 F
2. Corticosteroids
- F oral prednisolone กก F F ก 10
ก F F ก ก 30
- corticosteroid dependence F
F
F ก F H2-antihistamines leukotriene receptor antagonists
(LTRAs) F ก H1-antihistamines F F 4 F
F F ciclosporin F ก 3 ก./กก./
F F 4 F F F ก 3-6
F F ก ก
absolute
contraindications F
ciclosporin2
F F omalizumab
F F ก ก
F F ก F omalizumab

ก Fก ก ก F ˁ F omalizumab
ก ก ก F 150 ก ก 4 F ก ก F ก
ก 4 F F ก ก F ก 7 (UAS7) ก
F F ˁ complete response ( UAS7 F F 90% กกF ก ก ) significant
improvement ( UAS7 F F 30 90% กกF ก ก ) F F F F
F 150 ก ก 4 F ˈ 3-6
F F F ˁ F ˈ 4 F F F F significant improvement ( UAS7
F ก F 30% กกF ก ก ) F ˈ 300 ก F ˁ ก 2 F
ก F ˁ F significant improvement F ก ก F F ˁ F F ก ก (
UAS7 F ก F 30%) F
F F ˁ F omalizumab F omalizumab
F ก omalizumab F ก 3-6
ก F ก F ˁ F F ก ก F F F
ก omalizumab
omalizumab F ก 150-300 ก ก 4 F
F F F F F (deltoid) F (thigh) ก ก
ก F omalizumab F F ก ก ก ˆ F ˁ ก add on therapy
anaphylaxis anaphylactoid reactions F 0.1% ก ก
ก 0.2% ก ก Fก F ก F F 3 ก ก
ก ˂ anaphylaxis F ˁ ˈ 2 ก F ก ˂
ˈ 30
F F F
- F F F omalizumab F ก
F
- F F F (Pregnancy Category B)
- ก F anaphylaxis
- ก ( F ˁ F ก )
- ก live attenuated vaccines ก omalizumab F F 1-3

1
modern second-generation non-sedating H1-antihistamines ก ก F ก
4 F F ก ก F F ก F ก F F ก
F กF fexofenadine, rupatadine, desloratadine, levocetirizine
2
Absolute contraindications F ciclosporin F กF
- Live attenuated vaccines 1-3 กF
- Uncontrolled or severe hypertension
- Serious infection
- Immune compromise
Relative contraindication F ciclosporin F กF
- ก ciclosporin F F
- ก F ciclosporin F ก methotrexate, phototherapy immunosuppressive
3
Absolute contraindications F systemic corticosteroids F กF
- Systemic fungal infections
- Herpes simplex keratitis
- Hypersensitivity
Relative contraindications F systemic corticosteroids F กF
- Active tuberculosis or a positive tuberculin test (purified protein derivative [PPD])
- Active peptic ulcer disease (PUD)
- Recent anastomotic surgery
- Hypertension
- Depression or psychosis
- Diabetes mellitus (DM)
- Osteoporosis
- Cataracts and glaucoma

ก ก
Urticaria Activity Score 7 Diary
ก ก กF ก ก ก ก F กF Fก ก
ก ก
ก ก F 1 F ก 7 F F
1. F ก ก F ก F ก
2. F ก ก F ก F ก F ก
ก F F
F F ก ก F ก F F ก ก ก F
ก
1. 2. ก *
0 1 2 3 0 1 2 3
F24
<2024
20-5024
>5024
กˈ
F
Fก
กF
กก
กก
1
2
3
4
5
6
7
* ก ก ก
References
0 F ก
1 ก F ( ก ก F FกF F ก F F ก F ก )
2 ก ก ( ก กF F ก F ก F ก ก )
3 ก ก ( ก กF F ก ก F ก F ก ก )

1. Sanchez-Borges M, Asero R, Ansotegui IJ, Baiardini I, Bernstein JA, Canonica GW, et al. Diagnosis and
treatment of urticaria and angioedema: a worldwide perspective. WAO Journal. 2012;5(11):125-47.
2. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2)
LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013
revision and update. Allergy. 2014;69(7):868-87.
3. Maurer M, Magerl M, Metz M, Zuberbier T. Revisions to the international guidelines on the diagnosis and
therapy of chronic urticaria. J Dtsch Dermatol Ges. 2013. in press, PMID:24034140.
4. Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Gimenez-Arnau A, et al.
EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy.
2009;64(10):1417-26.
5. Wai YC, Sussman GL. Evaluating chronic urticaria patients for allergies, infections, or autoimmune disorders.
Clin Rev Allergy Immunol. 2002;23(2):185-93.
6. Powell RJ, Du Toit GL, Siddique N, Leech SC, Dixon TA, Clark AT, et al. BSACI guidelines for the
management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007;37(5):631-50.
7. Staevska M, Gugutkova M, Lazarova C, Kralimarkova T, Dimitrov V, Zuberbier T, et al. Night-time sedating
H1 -antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urticaria: a
randomized controlled trial. Br J Dermatol. 2014;171(1):148-54.
8. Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic
eczema (atopic dermatitis) part I. J Euro Acad Dermatol Venereol. 2012;26(8):1045-60.
9. Kulthanan K, Chiawsirikajorn Y, Jiamton S. Acute urticaria: etiologies, clinical course and quality of life.
Asian Pac J Allergy Immunol. 2008;26(1):1-9.
10. Wedi B, Kapp A. Evidence-based therapy of chronic urticaria. J Dtsch Dermatol Ges. 2007;5(2):146-57.
11. Khafagy NH, Salem SA, Ghaly EG. Comparative study of systemic psoralen and ultraviolet A and narrowband
ultraviolet B in treatment of chronic urticaria. Photodermatol Photoimmunol Photomed. 2013;29(1):12-7.
12. Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Gimenez-Arnau AM, et al.
EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009;64(10):1427-43.
13. Staevska M, Popov TA, Kralimarkova T, Lazarova C, Kraeva S, Papova D, et al. The effectiveness of
levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy
Clin Immunol. 2010;125:676-82.
14. Grattan CEH, Humphreys. Guidelines for evaluation and management of urticaria in adults and children. Br J
Dermatol. 2007;157: 1116-23.
15. Powell RJ, Du Toit GL, Siddique N, Leech SC, Dixon TA, Clark AT, et al. BSACI guidelines for
management of chronic urticaria and angio-edema. Clin Exp Allergy. 2007;37:631-50.
16. Zuberbier T. Acute urticaria. In: Greaves MW, Kaplan AP, editors. Urticaria and angioedema. 1 st ed. New
York: Marcel Dekker, Inc; 2004. p. 141-7.

17. Aoki T, Kojima M, Horiko T. Acute urticaria: history and natural course of 50 cases. J Dermatol. 1994;21:73-
7.
18. Champion RH, Roberts SO, Carpenter RG, Roger JH. Urticaria and angio-oedema. A review of 554 patients.
Br J Dermatol. 1969;81:588-97.
19. Volonakis M, Katsarou Katsari A, Stratigos J. Etiologic factors in childhood chronic urticaria. Ann Allergy.
1992;69:61-5.
20. Kaplan AP, Joseph K, Maykut RJ, Geba GP, Zeldin RK. Treatment of chronic autoimmune urticaria with
omalizumab. J Allergy Clin Immunol. 2008;122:569-73.
21. Pite H, Wedi B, Borrego LM, Kapp A, Raap U. Management of childhood urticaria: Current knowledge and
practical recommendations. Acta Derm Venereol. 2013;93:500-8.
22. Hide H, Hiragun T. Japanese guidelines for diagnosis and treatment of urticaria and comparison with other
countries. Allergol Int. 2012;61:517-27.
23. Chow SKW. Management of chronic urticaria in Asia: 2010 AADV consensus guidelines. Asia Pac Allergy.
2012;2:149-60.
24. Magerl M, Borzova E, Gimenez-Arnau A, Grattan CEH, Lawlor F, Mathelier-Fusade P, et al. The definition
and diagnostic testing of physical and cholinergic urticarias-EAACI/GA2LEN/EDF/UNEV consensus panel
recommendations. Allergy. 2009;64:1715-21.
25. Staevska M, Papov TA, Kralimarkova T, Lazarova C, Kraeva S, Papova D, et al. The effectiveness of
levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy
Clin Immunol. 2010;125:676-82.
26. Jirapongsananuruk O, Pongpreuksa S, Sangacharoenkit P, Visitsunthorn N, Vichyanond P. Identification of
the etiologies of chronic urticaria in children: A prospective study of 94 patients. Pediatr Allergy Immunol.
2010;21:508-14.
27. ก ก ก F. Physical urticaria. : ก ก ก F, ก . Urticaria.
ก : ก F F ; 2552. F 181-250.
28. Aydogan K, Karadogan SK, Tunali S, Saricaoglu H. Narrowband ultraviolet B (311 nm, TL01) phototherapy
in chronic ordinary urticaria. Int J Dermatol. 2012;51:98-103.
29. Engin B, Ozdermir M, Balevi A, Mevlitoglu I. Treatment of chronic urticaria with narrowband ultraviolet B
phototherapy: a randomized controlled trial. Acta Derm Venereol. 2008;88:247-51.
30. Kaplan AP. Treatment of Chronic Spontaneous Urticaria. Allergy Asthma Immunol Res. 2012;4:326-331.

Clinical Practice Guideline Urticaria Angioedema 2557

Recommended

Recommended

More Related Content

More from Utai Sukviwatsirikul

More from Utai Sukviwatsirikul (20)

Recently uploaded

Recently uploaded (20)

Clinical Practice Guideline Urticaria Angioedema 2557