Chronic Urticaria in Returning Travellers: The Role of Anthelmintic Treatment

Dermatology. 2016;232(4):468-71. doi: 10.1159/000445715. Epub 2016 Jun 1.

Abstract

Background: Chronic urticaria often poses a therapeutic challenge. The human immune response to helminths has a high degree of similarity to an allergic response in terms of skin manifestations, eosinophilia, and IgE elevation. Unfortunately, it is often complicated to diagnose such infections.

Objective: We sought to assess the effect of empirical anthelmintic treatment among returning travellers diagnosed with chronic urticaria, without clear proof of helminthic infection.

Methods: This is a retrospective case series of 19 returning travellers with chronic urticaria. All patients were treated with anthelmintic treatment given based on clinical suspicion only. A randomly selected control group of 20 patients with chronic urticaria, with no history of travel, was also enrolled.

Results: A positive clinical response was reported in 68.4% (13 patients) of the travellers' group within 3 months after treatment with anthelmintic therapy compared with 10% (2 patients) of chronic urticaria patients in the control group. No adverse effects from treatment were recorded.

Conclusion: In patients with chronic urticaria, travel history to developing countries must be obtained. Empiric anthelmintic therapy might be beneficial, even in the absence of findings suggestive of helminthic infection.

MeSH terms

  • Adult
  • Albendazole / therapeutic use*
  • Animals
  • Anthelmintics / therapeutic use
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Helminthiasis / complications*
  • Helminthiasis / drug therapy
  • Helminths / immunology*
  • Humans
  • Immunity, Innate*
  • Male
  • Retrospective Studies
  • Travel*
  • Urticaria / drug therapy*
  • Urticaria / etiology
  • Urticaria / immunology

Substances

  • Anthelmintics
  • Albendazole