Regional Guidelines

Other local and regional guidelines are also available for the diagnosis and management of urticaria in France, Italy, Japan, Asia/Australia and India (Société Française de Dermatologie, 2003; Hide & Hiragun, 2012; Godse et al., 2011; Godse et al., 2016; Chow, 2012). The Société Française de Dermatologie (SFD), Italian Association of Hospital and Territorial Allergists and Immunologists (AAIITO), and Japanese Dermatological Association (JDA) are among a number of societies that have endorsed the 2017 international EAACI/GA2LEN/EDF/WAO urticaria guidelines (Zuberbier et al., 2018).

Figure 3. Regional and local guidelines for the diagnosis and management of urticaria.

Figure 3. Regional and local guidelines for the diagnosis and management of urticaria.

Common to the majority of these guidelines are:

  • Initial treatment with second generation H1-antihistamines at licensed doses
  • Escalation of dose of H1-antihistamine up to four-fold, or up to two-fold (Japan), if symptoms persist 
  • Addition of other agents, e.g., omalizumab, ciclosporin or leukotriene receptor antagonists if an adequate response is still not achieved

(Zuberbier et al., 2018; Bernstein et al., 2014; Powell et al., 2015; Grattan & Humphreys, 2007; NICE 2015; Société Française de Dermatologie, 2003; Hide & Hiragun, 2012; Godse et al., 2011; Godse et al., 2016; Chow, 2012).