Urticaria relapse after mRNA COVID-19 vaccines in patients affected by chronic spontaneous urticaria and treated with antihistamines plus omalizumab: A single-center experience

Dermatol Ther. 2022 Nov;35(11):e15838. doi: 10.1111/dth.15838. Epub 2022 Sep 27.

Abstract

Urticaria is a disease characterized by wheals and/or angioedema. Chronic spontaneous urticaria (CSU) occurs for longer than 6 weeks and appears independently of any identifiable exogenous stimulus. During the vaccination campaign for Coronavirus disease 2019 (COVID-19) pandemic, several cutaneous adverse events have been described, among which urticaria lasting less than 6 weeks (acute urticaria, AU). AU due to vaccines can be IgE or non-IgE mediated; the former typically develop within 4 h of drug exposure, the latter occurs later and the mechanism is unclear. In this retrospective study we analyzed the frequency and clinical characteristics of urticaria occurring after COVID-19 vaccine (post-vaccination urticaria relapse) in adult CSU patients treated with antihistamine and omalizumab, and in clinical remission.

Keywords: COVID-19; acute urticaria; chronic spontaneous urticaria; mRNA vaccines; wheals.

MeSH terms

  • Adult
  • Anti-Allergic Agents* / adverse effects
  • COVID-19 Vaccines / adverse effects
  • COVID-19*
  • Chronic Disease
  • Chronic Urticaria* / drug therapy
  • Histamine Antagonists / adverse effects
  • Humans
  • Omalizumab / adverse effects
  • RNA, Messenger
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Urticaria* / chemically induced
  • Urticaria* / etiology

Substances

  • Omalizumab
  • COVID-19 Vaccines
  • RNA, Messenger
  • Anti-Allergic Agents
  • Histamine Antagonists