Hello. My name is Marcus Maurer,
and I'm very happy that you have the time to join us in
our review of chronic spontaneous and chronic inducible urticaria.
We will talk about chronic inducible urticaria and
the diagnostic workup of chronic inducible urticaria,
and end up with therapeutic approaches for
patients with chronic spontaneous and chronic inducible urticaria.
Let's move from chronic spontaneous urticaria to chronic inducible urticaria.
Chronic inducible urticaria is characterized by the presence of triggers,
so what we should do in
the diagnostic workup is we should confirm the trigger that is suspected,
we should measure the threshold in individual patients,
and assess and monitor their control and their disease activity.
How do we do that? The best question to ask
patients with chronic urticaria is to ask them,
can you make your wheals come?
Is there anything you can do right now to make a wheal come?
If patients tell us that they can make wheals come by scratching their skin,
then we scratch their skin.
We want to confirm that this is a relevant trigger,
and it's enough to do that with a pen or a wooden spatula.
When we make a wheal by doing this,
we have diagnosed chronic inducible urticaria,
we have diagnosed symptomatic dermographism.
The guidelines ask us to test how hard this trigger needs to be on the skin,
how hard patients need to scratch in order for their wheals to come.
This is assessed by the help of dermographometers.
There are different types of dermographometers,
and I'm showing you two different ones here.
What they have in common is that they are tools to scratch the skin of patients.