Scratching the Itch: Managing Recurrent Pruritic Skin Conditions

Abstract

We describe the concurrent use of cyclosporine and omalizumab in a 30-year-old man with omalizumab-refractory chronic spontaneous urticaria (CSU). When initially diagnosed at age 21 years, he responded to 4-fold second-generation H1-antihistamine dosing in conjunction with cyclosporine. Following its Food and Drug Administration approval in 2014, omalizumab 300 mg every 4 weeks was added, with subsequent tapering of cyclosporine. He remained well controlled on fexofenadine and omalizumab, and both were discontinued 3 years later in the setting of sustained remission.