Six Cases of Antihistamine-Resistant Dermographic Urticaria Treated with Oral Ciclosporin

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Background: Dermographic urticaria (DU) is characterized by strong itch and wheals induced by mechanical scratching. H₁-receptor antagonists may reduce symptoms of DU to some extent, but other treatments being used for chronic spontaneous urticaria, such as H₂-receptor antagonists and corticosteroids, are not usually effective for DU.
Case Summary: We here report six cases of antihistamine-resistant DU treated with oral ciclosporin. Four cases suffering from severe itches that spontaneously occurred before the appearance of wheals in response to scratching were substantially improved by use of ciclosporin for 21, 16, 32, and 8 months, and one of them reached complete remission. Two cases did not obtain a benefit from the treatment, because of insufficient effects and/or side effects.
Discussion: Oral ciclosporin may be of value as a potential treatment of anti-histamine-resistant DU.