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May 1983

Commentary: Antihistamines and the Treatment of Urticaria

Author Affiliations

From the Department of Dermatology, University of Illinois College of Medicine, Peoria.

Arch Dermatol. 1983;119(5):442-444. doi:10.1001/archderm.1983.01650290082023

It was 1945 and there was mounting excitement in the race to be the first American to find a compound to block histamine.1 Anaphylaxis, asthma, and urticaria could all be experimentally reproduced by histamine,2 so the goal of an antihistaminic was a great and elusive one. By 1932, 165 substances or methods had failed to block histamine in the experimental setting.3 The clinician, when confronted with urticaria, was relying on the development of tolerance (injections of histamine), the principle of immunization Hapamine (histamine azoprotein), and the use of an enzyme for histamine degradation Torantil (histaminase).4-6 He was wont also to try epinephrine, arsphenamine, atropine, or aspirin, and then to wander down through his therapeutic alphabet of calcium, ephedrine, nitrites, pilocarpine, quinine, and good old thyroid hormone, ending up with vitamins C and P.7 He was a man of little faith but many gospels.

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