Chronic spontaneous urticaria clinical case 6, Centre de Preuves en Dermatologie

chronic spontaneous urticaria Dec 19

Responsibility

The information provided by this website comes from sources deemed reliable. However, the Société Française de Dermatologie recommends that the user ensure the validity of this information. Some may prove to be erroneous or be subject to typos or display errors.

The use of this data is under the sole responsibility of the user. The Société Française de Dermatologie cannot be blamed for a misinterpretation of the data provided by the site, or in the event of erroneous information. This decision tree and all the contents of this site have been developed in the context of updated data from science according to the HAS methodology, expert opinions and reviewers of the various documents and in the context of the French healthcare system.

I have read and accept the general conditions of use of this website

Treatment of chronic spontaneous urticaria and pregnancy

Presentation

Mrs A., 27 years old, consults for chronic spontaneous urticaria that has been ongoing for more than 3 years. The clinical examination is normal, apart from a few superficial urticarial patches. She has never had angioedema. She had a normal initial blood workup (CBC, CRP).

Previous treatments

She initially took various anti-H1 antihistamines at conventional doses (MA dose). For the past 2 years, she has been taking bilastine, the doses of which have been gradually increased to 3 doses per day. She explains that the outbreaks of urticaria have become less frequent, remain present, but currently cause her little discomfort.

Other elements

She is not on any other medication.
She has just stopped using birth control because she is planning to have a child.

What do you suggest?

See proposition

Proposition

Assessment

It is recommended to assess CSU activity using the UCT and UAS7 scores, as well as the impact of CSU on her quality of life (/home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/view/content/ucs/cas/vignette-06.php on line 50
">DLQI or CU-QoL scores); further management will depend on these assessments.

Treatment

There is no demonstrated predictive evidence regarding CSU during pregnancy. ^*Most experts interviewed reported that, in their experience, there is a tendency for CSU to improve during pregnancy, and sometimes to worsen after childbirth.
Choose anti-H1 antihistamines for which abundant and reassuring data in pregnant women exists: propose therefore to substitute bilastine by cetirizine or levocetirizine (www.lecrat.fr). These anti-H1 antihistamines may be continued during pregnancy, at the minimum effective dose. ^*Some experts suggest lowering the dosage to 2 or even 1 tablet per day near term (to avoid any risk of drowsiness in the newborn), others leave the anti-H1 antihistamine at the same dose during the whole pregnancy.
Breastfeeding is possible if desired. As anti-H1 antihistamines pass into the milk, find the minimum effective dose to avoid any risk of drowsiness in the infant.

References

Warning: Array to string conversion in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Undefined variable $Array in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Trying to access array offset on null in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37
Warning: Array to string conversion in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Undefined variable $Array in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Trying to access array offset on null in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Array to string conversion in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Undefined variable $Array in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Trying to access array offset on null in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

➜

Warning: Array to string conversion in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Undefined variable $Array in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Trying to access array offset on null in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Centre de Preuves en Dermatologie

Work

10 cité Malesherbes

75009Paris

Île-de-France

FRANCE

Work
Warning: Array to string conversion in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Undefined variable $Array in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Trying to access array offset on null in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37
1 43 27 01 56

Fax
Warning: Array to string conversion in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Undefined variable $Array in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37

Warning: Trying to access array offset on null in /home/clients/d0fa621b06e69d3a150fb7f06cec713f/vhost/sfdermato.org/reco/dev/APP/worker/locale.php on line 37
1 43 27 01 86

centredepreuvesdermato@sfdermato.org

chronic spontaneous urticaria Dec 19