22
Autoimmune Progesterone And Estrogen Dermatitis
Î Limited data are available for the use of hormonal therapies in
patients with autoimmune progesterone and estrogen dermatitis. (C)
Unproved/Controversial Therapies
Î The evidence is weak that pseudoallergen-free diets improve CU. (C)
• Given the lack of evidence and burden of adhering to these diets, their use in
patients with CU is NOT recommended. (D)
Î Other unproved therapies for CU that are not recommended include
allergen immunotherapy, herbal therapies, vitamins, supplements, and
acupuncture. (C)
Table 8. Pharmacology of H
1
-antihistamines
H
1
-antihistamine
Receptor-
binding
affinity,
Ki
(nmol/L)
t
max
(h) t½ (h)
Onset of
action
(h)
Duration
of action
(h)
Common adult
doses for urticaria
First generation
Diphenhydramine NA 1.7 9.2 2 12
25–50 mg
3–4 times daily
or at bedtime
Doxepin NA 2 13 NA NA
25–50 mg
3 times daily or
50–150 mg
at bedtime
Hydroxyzine NA 2.1 20 2 24
25–50 mg
3–4 times daily
or 50–150 mg
at bedtime
Second generation
Cetirizine 47.2 1.0 6.5-10 1 24
10–40 mg/d
Desloratadine 0.87 1-3 27 2 24
5–20 mg/d
Fexofenadine 175 2.6 14.4 2 24
180–540 mg/d
Levocetirizine 2 0.8 7 1 24
5–20 mg/d
Loratadine 138 1.2 7.8 2 24
10–40 mg/d
Treatment
