Urticaria and Angioedema
http://www.100md.com
《新英格兰医药杂志》
It would be unusual to find more than a single chapter devoted to urticaria and angioedema in most medical textbooks, including those devoted to allergies and to dermatology. So at first blush, I wondered how one could even consider developing a nearly 500-page book on the subject. Yet the two premier, internationally recognized leaders in the field who served as the editors of this book (and who also contributed a third of the chapters) have put together an unusual work that will be helpful reading for primary care physicians, allergists, and dermatologists. The book is a useful blend of bench and clinical science. Readers who are interested in the basic mechanisms of these conditions will find chapters dealing with the biology of mast cells and basophils, the IgE-dependent allergic response, and the complement and bradykinin mediator systems. Clinically, every relevant topic is discussed. Chapters outline various types of urticaria, including hereditary, pediatric, acute and chronic, and contact and papular disorders. I found the chapter on systemic conditions particularly interesting. Management is stressed, case presentations are included, and there are useful illustrations throughout the book.
Effective treatment of acute and chronic urticaria can be a difficult problem. I commend the editors and authors for presenting "off label" treatments — including H2-receptor blockers, leukotriene-receptor antagonists, and immunomodulatory agents — that are essential for the care of patients with difficult cases. The uses of combinations of several H1 antihistamines and of doses of these agents at levels that are higher than those approved by the Food and Drug Administration are also covered. One minor omission is the off-label use of omalizumab (the humanized monoclonal antibody to IgE) in patients with autoimmune chronic urticaria, which depends on autoantibodies to IgE or the high-affinity receptor for IgE (FcER1).
As in any textbook with multiple authors, there is some redundancy. Although this is a drawback, I find it a small one that is counteracted by the differences among authors regarding emphasis and perspective. This well-written, timely, comprehensive, and practical textbook will be a useful reference or clinical tool in the diagnosis and management of these common yet vexing disorders.
Ronald A. Simon, M.D.
Scripps Clinic
La Jolla, CA 92037(Malcolm W. Greaves and Al)
Effective treatment of acute and chronic urticaria can be a difficult problem. I commend the editors and authors for presenting "off label" treatments — including H2-receptor blockers, leukotriene-receptor antagonists, and immunomodulatory agents — that are essential for the care of patients with difficult cases. The uses of combinations of several H1 antihistamines and of doses of these agents at levels that are higher than those approved by the Food and Drug Administration are also covered. One minor omission is the off-label use of omalizumab (the humanized monoclonal antibody to IgE) in patients with autoimmune chronic urticaria, which depends on autoantibodies to IgE or the high-affinity receptor for IgE (FcER1).
As in any textbook with multiple authors, there is some redundancy. Although this is a drawback, I find it a small one that is counteracted by the differences among authors regarding emphasis and perspective. This well-written, timely, comprehensive, and practical textbook will be a useful reference or clinical tool in the diagnosis and management of these common yet vexing disorders.
Ronald A. Simon, M.D.
Scripps Clinic
La Jolla, CA 92037(Malcolm W. Greaves and Al)