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Matt Morgan, MD

Arch Dermatol. 2009;145(6):637-639.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF CASES

CASE 1

A 52-year-old woman with prediabetes reported 5 years of chronic urticaria (CU) with daily flare-ups that had abruptly worsened 1 month previously, with facial angioedema, purpura, wheals lasting longer than 24 hours, and lower limb arthralgias. H₁ and H₂ antihistamines proved ineffective. She had a positive result on the basophil histamine release test (IBT Laboratories, Lenexa, Kansas). She was thought to have urticarial vasculitis (UV) but declined confirmatory skin biopsy. Numerous alternative therapies were unsuccessful (Table). She became dependent on prednisone, 20 to 40 mg daily, to remain functional. She developed frank steroid-induced diabetes mellitus, with significant adipose and fluid weight gain, renal hyperfiltration, and dyslipoproteinemia.

Table appears in full text version. Table. Other Alternative Therapies Tried by Patients in This Studya

CASE 2

A 56-year-old man with hypertension and hypercholesterolemia had had onset of urticaria 3 years prior to presentation. H₁ and H₂ antihistamines and montelukast sodium reduced CU outbreaks to several . . . [Full Text of this Article]

CASE 3

THERAPEUTIC CHALLENGE

SOLUTION

COMMENT

AUTHOR INFORMATION

Allergy, Asthma, and Immunology of North Texas, McKinney; University of Texas Southwestern Division of Allergy and Immunology, Dallas

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