A study of autologous serum skin test and autologous serum therapy in chronic urticaria
Keywords:Autologous serum skin test, Autologous serum therapy, Autoimmune urticaria, Urticaria activity score, Total severity score, Daily quality life index
Background: Chronic urticaria (CU) is a vexing problem and patients suffer from the morbidity that arise from irritable itch and wheals and are also subjected to a huge antihistamine pill burden. A subset of patients with CU may have an autoimmune basis for their condition, as shown by a positive skin test to ASST. The objective of the study was to compare efficacy of AST in ASST positive and negative patients and its impact on dermatology life quality index (DLQI) in patients, before and after AST.
Methods: A prospective, interventional study was conducted in the Department of dermatology (Skin) OPD of our institute from October 2016 to October 2017. Fifty patients were selected randomly and antihistaminics were withdrawn before ASST. Test was performed in all patients and AST was given for 9 weeks in both (ASST positive & negative) groups, along with tablet levocetrizine on demand basis and followed for 4 weeks after completion of 9 weeks of therapy. Total severity score (TSS), urticaria activity score (UAS), dermatologic life quality index (DLQI) were used as primary effective parameters and were recorded at baseline and weekly after each injections of AST.
Results: UAS and TSS showed significant improvement (>50%) after 5th week in both group patients. DLQI showed higher improvement in ASST positive patients.
Conclusions: We found significant improvement in ASST positive and ASST negative patients but ASST positive patients required more time to experience the benefit of AST.
Vikramkumar AG, Kuruvila S, Ganguly S. Autologous serum skin test as an indicator of chronic autoimmune urticaria in a tertiary care hospital in South India. Indian Dermatol Online J. 2014;5:2
Azim ZA, Mongy SE, Salem H. Autologous Serum Skin Test in Chronic Idiopathic Urticaria: Comparative Study in Patients with Positive versus Negative Test J Egypt Women Dermatol Soc. 2010;7(2):87-91.
Vohra S, Sharma NL, Mahajan VK. Autologous serum skin test: Methodology, interpretation and clinical applications: Indian J Dermatol Venereol Leprol. 2009;75:5.
Patil S, Sharma N, Godse K. Autologous Serum Therapy in Chronic Urticaria. Indian J Dermatol. 2013;58(3):225–6.
Debbarman P, Sil A, Datta PK, Bandyopadhyay D, Das NK. Autologous serum therapy in chronic urticaria: A promising complement to antihistamines. Indian J Dermatol B. 2014;59:375-82.
Debbarman P, Sil A, Datta PK, Bandyopadhyay D, Das NK. Autologous Serum Therapy in Chronic Urticaria: A Promising Complement to Antihistamine: Indian J Dermatol. 2014;59:4.
Godse KV. Urticaria meter. Indian J Dermatol 2012;57:410-1.
Bhanja DC, Ghoshal L, Das S, Das S, Roy AK. Azathioprine in autologous serum skin test positive chronic urticaria: A case-control study in a tertiary care hospital of eastern India. Indian Dermatol Online J. 2015;6:185-8.
Heberden W. Of the nettle rash. Med Trans. 1772;2:173.
Maurer M, Ortonne JP, Zuberbier T. Chronic urticaria: A patient survey on quality of life, treatment usage and doctor patient relation. Allergy. 2009;64:581,8.
Grob JJ, Gaudy Marqueste C. Urticaria and quality of life. Clin Rev Allergy Immunol. 2006;30:47-51.
Godse KV. Autologous serum skin test in chronic idiopathic urticaria. Indian J Dermatol Venereol Leprol. 2004;70:283-4.
Bajaj AK, Saraswat A, Upadhyay A, Damisetty R, Dhar S. Autologous serum therapy in chronic urticaria: Old wine in a new bottle. Indian J Dermatol Venereol Leprol. 2008;74:109
Vohra S, Sharma NL, Mahajan VK, Shanker V. Clinicoepidemiologic features of chronic urticaria in patients having positive versus negative autologous serum skin test: A study of 100 Indian patients. Indian J Dermatol Venereol Leprol. 2011;77:156-9.
Swerdt AD, Keybus CV, Kasran A, Cadot P, Neyens K, Coorevits L, et al. Detection of basophil-activating IgG autoantibodies in chronic idiopathic urticaria by induction of CD63. J Allergy ClinImmunol. 2005;116:662-7.
Yadav S, Kanwar AJ, Parsad D, Minz RW. Chronic idiopathic urticaria and thyroid autoimmunity: Perplexing association. Indian J Dermatol. 2013;58:325.
17. Toubi E, Kessel A, Avshovich N, Bamberger E, Sabo E, Nusem D, et al. Clinical and laboratory parameters in predicting chronic urticaria duration: A prospective study of 139 patients. Allergy. 2004;59:869-73.