ABSTRACT
BACKGROUND: Chronic urticaria (CU) is a common skin condition. It is frequently a disabling disease due to the persistency of clinical symptoms, the unpredictable course and negative influence on the quality of life. OBJECTIVE: The aim of this study is to determine whether montelukast, a LTD4 receptor antagonist, plus desloratadine, is more efficacious than desloratadine alone in the treatment of chronic urticaria. MATERIALS: A randomized, double-blind, placebo-controlled study was conducted on 81 patients with a diagnosis of CU. A 1-week single-blind placebo run-in period (baseline) was followed by a 6-weeks double blind active treatment period. The patients were randomized to receive the following treatment once daily: (a) oral desloratadine (5 mg) plus placebo; (b) desloratadine (5 mg) plus montelukast (10 mg); (c) oral placebo alone. The study ended after another 1-week single-blind placebo washout period. RESULTS: The evaluable population thus consisted of 76 patients. Both desloratadine alone and desloratadine plus montelukast administered once daily yielded improvements with respect to the baseline assessment as regards pruritus, number of separate episodes, size and number of weals, visual analogue score and patients' quality of life and with respect to the placebo group both in the active treatment period and in the run-out period. However, desloratadine plus montelukast was shown to improve the symptoms and patients' quality of life significantly more than desloratadine alone, although it did not have a significant effect on the number of urticarial episodes. CONCLUSION: The combination of desloratadine plus montelukast is effective in the treatment of CU. It may therefore be a valid alternative in patients with relatively mild CU, in view of its efficacy and the lack of adverse events.
Subject(s)
Acetates/administration & dosage , Histamine H1 Antagonists, Non-Sedating/administration & dosage , Leukotriene Antagonists/administration & dosage , Loratadine/analogs & derivatives , Loratadine/administration & dosage , Quinolines/administration & dosage , Urticaria/drug therapy , Administration, Oral , Adolescent , Adult , Aged , Chronic Disease , Cyclopropanes , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Pruritus/drug therapy , Pruritus/pathology , Quality of Life , Severity of Illness Index , Sulfides , Treatment Outcome , Urticaria/pathologyABSTRACT
BACKGROUND: In the workplace, the skin is at high risk of exposure to chemicals and other contaminants, and occupational dermatitis is an important field of study. METHODS: We evaluated 230 patients referred to our clinic because they were affected by dermatitis suspected to be of occupational and allergic origin. They were tested with the allergens of the GIRDCA standard series, and with supplementary series when indicated. RESULTS: Among the 230 subjects, 49 were positive only to supplementary series (26.3% of all allergic contact dermatitis), while 130 (69.9% of all allergic contact dermatitis) were considered to have an occupational allergic contact dermatitis diagnosed by the standard series alone. The most frequent occupations of the patients were health care workers and hairdressers/beauticians. The most common agents responsible for occupational allergic contact dermatitis were metals and para-phenylenediamine. CONCLUSIONS: As the standard series detected a relatively low proportion of occupational allergic contact dermatitis, it is not adequate to recognize an occupational allergic contact dermatitis, certain supplementary series should also to be tested. However, even if such occupational series are used, we remain likely to continue to underestimate the frequency of occupational allergic contact dermatitis, because workers come into contact with a large number of substances that are often unknown.
