Delayed pressure urticaria successfully treated with omalizumab: A tertiary-level health-care center experience

Background: Delayed pressure urticaria (DpU) is a subtype of inducible urticaria characterized by painful erythematous swellings that appear after pressure is applied to the skin. Objectives: The aim of this study was to evaluate the efficacy of omalizumab treatment in patients with DpU and the effect of omalizumab treatment on disease control. Methods: This retrospective observational study included a total of 78 patients with chronic spontaneous urticaria (CSU) or DpU who received omalizumab treatment. At 6 months after the initiation of omalizumab treatment, the effects of the treatment on the the urticaria control test (UCT) and the Dermatology Quality of Life questionnaire (DLQI) score and the effects on pressure urticaria were evaluated. The effect of omalizumab on pressure urticaria was determined by performing a pressure provocation test. Results: At the end of the 6th month of omalizumab treatment, the increase in UCT scores was statistically significant in all the patients, in the patients with CSU, and in the patients with CSU plus DpU (p < 0.001, p = 0.025, and p < 0.001, respectively). At the end of the 6th month of omalizumab treatment, the improvement in DLQI scores was statistically significant in all the patients, in patients with CSU, and in patients with CSU plus DpU (p < 0.001, p = 0.002, and p < 0.001, respectively). After the pressure provocation test, no urticarial wheals were observed in the area where pressure had been applied in any patient within 6 hours. Conclusion: The findings of the current study provide evidence that omalizumab treatment may be effective in patients with DpU.