Abstract

Background: Psychiatric comorbidities of chronic urticaria (CU) have been reported and examined recently. The prevalence of mental disorders and emotional distress is high in patients with CU. This is a case report in which Histobulin was found to be effective for psychiatric manifestations in chronic spontaneous urticaria (CSU). Case Presentation: Three cases of CSU accompanying psychiatric manifestations (PMs) were treated with Histobulin. One patient with CSU with severe depression showed clinical changes in depressive symptoms in parallel to changes in allergic symptoms during treatment. Histobulin clearly improved not only CSU but also the accompanying PMs in one patient and slightly improved them in another patient. The PMs were not improved by an antihistamine (H1 blocker) in any case. Histobulin is effective not only for allergic manifestations (AMs) but also for PMs of CSU. Conclusions: PMs as well as AMs of CSU were improved by Histobulin therapy. PMs were suspected to be a part of the clinical manifestations in CSU, possibly through histamine-mediated mechanisms. These conditions were suggested to be ‘allergic psychiatric manifestations (APMs)’ or ‘histamine-mediated psychiatric manifestations (HPMs)’. Further study of PMs based on histamine-mediated mechanisms, including allergies, may be necessary. Accordingly, it should be clarified whether the PMs of CSU are a part of the clinical manifestations of CSU or are psychiatric comorbidities of CSU.

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