Allergists and dermatologists have far more expertise in caring for patients with urticaria than other specialists

R L Henderson, A B Fleischer, S R Feldman
Journal of the American Academy of Dermatology 2000, 43 (6): 1084-91

BACKGROUND: Urticaria is a common disease for which numerous treatments have been described, yet there is little information about what agents are commonly used to treat urticaria. There may be differences in the way in which urticaria is treated by different medical specialties.

OBJECTIVE: The purpose of this study was to characterize the visits and treatments of urticaria in office-based practices.

METHODS: National Ambulatory Medical Care Survey data from 1990 to 1997 were analyzed to determine patient populations, medications used, and physician specialties for visits of urticaria.

RESULTS: Women accounted for 69% of all patient visits, but an equal gender distribution was observed in patients 18 years of age and younger. There was a bimodal age distribution with peak visits in patients aged birth to 9 years and 30 to 40 years. H(1) antihistamines and systemic corticosteroids were used in 56% and 14% of visits, respectively. Other medications reported as useful in the treatment of urticaria were used in 12% of visits. Allergists and dermatologists had a mean of 47 and 37 visits per physician per year, respectively, compared with all other physicians who averaged fewer than 10 visits per physician per year. Allergists were the least likely to use a corticosteroid agent (6% of visits), whereas internists were the most likely (29% of visits). Dermatology and allergy recorded a relatively large percentage of visits for urticaria that were referred for their condition by other physicians (49% and 25% of visits, respectively).

CONCLUSION: We observed a bimodal utilization curve for age and urticaria not previously described. H(1) antihistamines remain the mainstay in treatment of urticaria, whereas the low use of systemic corticosteroids likely reflects physicians' understanding of their secondary function in the treatment of urticaria.

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