The efficacy of a 2-week course of oral steroid in the treatment of chronic spontaneous urticaria refractory to antihistamines

Even though antihistamines are the mainstay in the treatment of chronic spontaneous urticaria (CSU), some CSU patients have not responded to antihistamines. Many clinicians have accepted the efficacy of steroids in the treatment of CSU. There is, however, little evidence supporting steroid use in antihistamine-resistant CSU. The purpose of this study was to demonstrate the efficacy of, and suggest a regimen for, oral steroid in the treatment of CSU patients who were refractory to a high dosage of antihistamines. We conducted a retrospective chart review of all patients diagnosed with urticaria between Feburary 1, 2012, and December 31, 2014. A total of 98 patients with CSU were included. Of these, 16 patients (16.3%) were antihistamine-resistant and prescribed a 2-week course of steroid. Thirteen patients (81.2%) were successfully controlled with antihistamines only after stopping the first course. Second course of steroid induced remission additionally in two patients (12.5%). No adverse events and complications associated with oral steroid were observed over the study period. This study demonstrated the excellence of a 2-week course of oral corticosteroid in antihistamine-resistant CSU and propose standardized corticosteroid treatment regimen.