Through the Looking Glass: Chronic Urticaria Treated with Anti-IgE Therapy

Chronic urticaria (CU) is a skin condition characterized by the presence of intensively pruritic lesions occurring intermittently or continuously for more than 6 weeks. Because the cause(s) of CU are often not known, it is usually referred as chronic spontaneous urticaria (CSU) or chronic idiopathic urticaria (CIU). It affects 0.1%–0.3% of children. Moreover, solar urticaria (SU) is a rare chronic photodermatosis that is burdened by frequent reductions in patients’ quality of life. Some individuals with various forms of CU are insufficiently controlled by standard treatment, including high dose of H1-antihistamines. In this issue, Olszowiec-Chlebna et al. report the case of an adolescent female with CSU and idiopathic anaphylaxis who was effectively treated with omalizumab. Interestingly during the treatment (6 months) and 3 months later, the patient has not presented CSU or anaphylaxis symptoms. Up to now, there is not a single randomized trial on children with urticaria or idiopathic anaphylaxis. Therefore, this case represents a potential strategy to identify an effective treatment for children and adolescents with uncontrolled severe allergic cutaneous disorders.