Therapeutic effects of cetirizine in delayed pressure urticaria: Clinicopathologic findings - 12/10/17

Doi : 10.1016/0190-9622(91)70163-V

Kalliopi Kontou-Fili, MD ^{^{a
From the Section of Allergology, Laikon General Hospital.},}^⁎, Georgia Maniatakou, MD ^{^{a
From the Section of Allergology, Laikon General Hospital.}}, Panayiota Demaka, MD ^{^{a
From the Section of Allergology, Laikon General Hospital.}}, Michael Gonianakis, MD ^{^{a
From the Section of Allergology, Laikon General Hospital.}}, George Palaiologos, MD ^{^{a
From the Section of Allergology, Laikon General Hospital.}}, Kyriaki Aroni, MD ^{^{b
the Pathology Department, University of Athens Medical School.}}
Athens, Greece

^*Reprint requests: Kalliopi Kontou-Fili, MD, Chief, Section of Allergology, Laikon General Hospital, Goudi, Athens 115-27, Greece.

Abstract

Cetirizine, a peripheral H₁ antagonist, was administered to patients with delayed pressure urticaria in a double-blind, placebo-controlled, crossover study. Efficacy in reducing pressure-induced wheals and flares was evaluated. Histologic changes were also assessed with the skin window technique in weight-induced wheals. Results showed a statistically significant reduction in weight-induced wheal area (p < 0.01) after cetirizine therapy; this improvement was accompanied by a concomitant reduction in eosinophil recruitment as demonstrated by the skin window technique (p = 0.0029). Subsequently, 14 patients with delayed pressure urticaria underwent biopsy before and after 3 weeks of cetirizine therapy to evaluate the drug's histologic effects. A blinded observer performed the histologic studies. Weight-induced lesions showed a mixed inflammatory infiltrate, primarily polymorphonuclear (neutrophils and eosinophils), whereas the unchallenged skin sites were normal. Cell counts from pressure-induced lesions showed a significant reduction in eosinophils after cetirizine treatment.

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