Omalizumab for urticaria with dermatitis
Could we consider a Xolair trial for chronic urticarial dermatitis? Patient has been on prednisone and cyclosporine but side effects have been limiting. Biopsy did not reveal any evidence for a vasculitis.
We are grateful to expert panelist Dr. Peck Ong, who provided the following response. The history on this patient is limited eg. is he atopic? What was his IgE etc.? The answer depends on the underlying cause of his urticaria. Patients with atopic dermatitis are also prone to have urticaria. The reports below suggest that off-label use of Xolair was effective. Given that this patient has been on systemic immunosuppressants and that other systemic diseases have been ruled out, biologics are reasonable alternatives. We hope this information is useful to you.
J Dermatolog Treat. 2018 Dec 4:1-4. doi: 10.1080/09546634.2018.1550246. [Epub ahead of print] Rapid, persistent, and simultaneous remission of urticaria and severe atopic dermatitis after treatment with omalizumab. Del Duca E1, Esposito M1, Lechiancole S1, Giunta A1, Bianchi L1.
J Dermatolog Treat. 2018 Nov 2:1-6. doi: 10.1080/09546634.2018.1543844. [Epub ahead of print] Chronic urticaria in a child affected by atopic dermatitis: effective treatment with omalizumab. Leonardi L, Uva A, Duse M.
Jacqueline A. Pongracic, MD, FAAAAI