Urticaria and angioedema affect at least 20% of the population and frequently become chronic and persistent, causing significant personal, domestic, social, and occupational disability. That “urticaria” encompasses a group of very different disorders is incompletely understood by many clinicians who nevertheless confidently make this diagnosis. For this reason and because, until recently, little progress has been made in understanding the pathomechanisms of the chronic forms, progress in diagnosis and treatment has been disappointingly slow. Nevertheless the past 10 to 15 years have been a time of considerable development with many new approaches, and interest has accelerated since publication of the first edition.
The first edition of Urticaria and Angioedema owes its outstanding success to its ability to satisfy a previously unmet need for a scholarly yet essentially practical handbook combining insights into recent exciting developments in the pathogenesis of urticaria and angioedema with practical advice on investigation and management based on our authors’ wide personal clinical experience. But now a pressing need has emerged for a second edition, prompted by important recent advances, including, at a cellular level, the realization of the importance of HLA class II—expressing dermal dendritic cells in immune responses in skin, the role of cross-talk between dermal mast cells and PAR-2 receptors expressed by unmyelinated C neurons in pruritus, and the development of screening tests for autoimmune urticaria based upon expression of activation markers such as CD203c upon exposure of donor basophils to serum from patients with autoimmune urticaria. Furthermore, treatment of recalcitrant chronic urticaria by anti-IgE receptor antibody (omalizumab) and anti-CD 20 monoclonals (e.g., rituximab) or physical urticarias by anti-TNFa and angioedema by novel anti-kallikrein or anti-bradykinin drugs are now being actively explored.
This second edition reflects all these new developments in the field and much more besides, with major revision and augmentation of all chapters plus new ones added where advances have warranted it. We begin with a discussion of the relevant biology of the skin and then describe the mediator cascades and effector cells of the inflammatory response relevant to the pathogenesis of the various forms that urticaria and angioedema can take. Then all of the clinical entities that one is likely to encounter are explored in depth including new chapters on epidemiology, anaphylaxis, mastocytosis, and the hypereosinophilic syndrome. Emphasis is given to new data regarding autoimmune mechanisms that appear to initiate chronic urticaria and angioedema in about 45% of patients, as well as to abnormalities of signal transduction that may be found in both the autoimmune and “idiopathic” subgroups.The book will be an important addition to the armamentarium of allergists and dermatologists and that it will also intrigue immunologists, cell biologists, and pharmacologists with an interest in clinical immunology and allergy. The unraveling of the ways in which dermal mast cells and basophil leucocytes become promiscuously activated, the interactions of the multiple inflammatory mediators thus released, and the ensuing cavalcade of cellular pruritic and vascular responses represent a paradigm for immunologically driven diseases. Moreover, urticaria and angioedema are models potentially accessible for study in human skin.
However, in many patients with chronic urticaria and especially in the physical urticarias, causation of dermal mast cell activation at the molecular level still remains elusive, and we have endeavored, in the relevant chapters, to point the way forward to future developments in these fields.
New to the Second Edition:
- updated content on cellular and clinical practice paradigms.
- new chapters on epidemiology, diagnostic techniques, acute urticaria, non-hereditary angioedema, systemic mastocytosis, and hypersinophilic syndrome.
- the latest screening tests for autoimmune urticaria.
- the latest data on autoimmune mechanisms that initiate chronic urticaria and angioedema in some patients, and abnormalities of signal transduction that may be found in both the autoimmune and "idiopathic" subgroups.
Contents
- 1. What Is Urticaria? Anatomical, Physiological, and Histological Considerations and Classification
- 2. Epidemiology
- 3. Mast Cells
- 4. Basophils
- 5. Mechanisms of Bradykinin Formation
- 6. The Complement System: Mechanisms of Activation, Regulation, and Role in Innate and Adaptive Immunity
- 7. The IgE-Mediated Cutaneous Late-Phase Reaction
- 8. Diagnostic Techniques for Urticaria and Angioedema
- 9. Acute Urticaria
- 10. Contact Urticaria
- 11. Physical and Cholinergic Urticarias
- 12. Urticaria and Angioedema in Infancy and Early Childhood
- 13. Papular Urticaria
- 14. Diagnosis of Difficult Urticaria and Angioedema
- 15. Hereditary Disorders with Urticaria or Angioedema
- 16. Hereditary Angioedema and Acquired C1 Inhibitor Deficiency
- 17. Chronic Urticaria: Autoimmune Chronic Urticaria and Idiopathic Chronic Urticaria
- 18. Chronic Urticaria: General Principles and Management
- 19. Urticaria: Principles of Antihistamine Treatment
- 20. Treatment of Chronic Urticaria: Approaches other than Antihistaminics
- 21. Urticarial Vasculitis/Venulitis
- 22. Nonhereditary Angioedema and Idiopathic Anaphylaxis
- 23. Systemic Disorders with Urticaria and/or Angioedema
- 24. Systemic Mastocytosis
- 25. Hypereosinophilic Syndromes
- Index
Book Details
- Hardcover: 400 pages
- Publisher: Informa Healthcare; 2 edition (February 25, 2009)
- Language: English
- ISBN-10: 1420077848
- ISBN-13: 978-1420077841
- Product Dimensions: 10 x 7.2 x 1.2 inches