RESUMO
The Italian Board on Urticaria has prepared a document focusing on the definition and classification of urticaria, taking into account the recent progress in identifying the causes, eliciting factors, and pathomechanisms of this disease. As urticaria has a profound impact on the quality of life, effective treatment is important. Therefore, specific treatment options for the management of urticaria are evaluated on the basis of the recent literature. Non-sedating H(1) antihistamines are recommended as the first-line treatment as they have proven effective in several randomized double-blind controlled studies. Dosages higher than those recommended may be necessary in some cases. However, additional or alternative therapies may be required for different urticaria subtypes and in view of individual variations in the course of the disease and response to treatment. Immunosuppressive drugs such as corticosteroids are not recommended for long-term treatment due to unavoidable, severe adverse effects.
Assuntos
Urticária , Adulto , Alérgenos/efeitos adversos , Antialérgicos/uso terapêutico , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/imunologia , Doenças Autoimunes/patologia , Basófilos/patologia , Criança , Diagnóstico Diferencial , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/imunologia , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Itália , Mastócitos/patologia , Transtornos de Fotossensibilidade/diagnóstico , Transtornos de Fotossensibilidade/etiologia , Transtornos de Fotossensibilidade/radioterapia , Estimulação Física , Terapia Ultravioleta , Urticária/classificação , Urticária/diagnóstico , Urticária/dietoterapia , Urticária/tratamento farmacológico , Urticária/epidemiologia , Urticária/etiologiaAssuntos
Hidroxiureia/efeitos adversos , Neoplasias Primárias Múltiplas/induzido quimicamente , Neoplasias Cutâneas/induzido quimicamente , Idoso , Carcinoma Basocelular/induzido quimicamente , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/induzido quimicamente , Carcinoma de Células Escamosas/patologia , Humanos , Hidroxiureia/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Neoplasias Primárias Múltiplas/patologia , Neoplasias Cutâneas/patologiaRESUMO
This study was designed to evaluate the therapeutic efficacy and toxicity of recombinant interferon alpha-2a (rIFN alfa-2a) given as initial systemic therapy in untreated mycosis fungoides and/or Sezary's syndrome patients, at a slowly escalating schedule up to the maximal tolerated dose. At the same time this schedule was administered in patients who had relapsed or were refractory to previous treatment; 28 newly diagnosed and 15 previously treated patients entered the study. IFN was given daily with dose escalation from 3 to 18 MU. The last follow-up in June 1990 indicates that 90% of previously untreated patients who obtained a complete remission remain in continuous complete remission after 18 to 40 months and that 75% of previously untreated patients who obtained partial remission remain in partial remission after 20-44 months. The event-free survival projected, calculated using the Kaplan and Meier product limit technique, was 21% of all patients at 54.7 months (40% in the previously untreated groups and 14% in the previously treated group: P = 0.12). In conclusion, interferon is very effective as a single agent in cutaneous T-cell lymphomas.
