Skip to main content
Log in

Rational Use of Antihistamines in Allergic Dermatological Conditions

  • Practical Therapeutics
  • Published:
Drugs Aims and scope Submit manuscript

Summary

For many years, the use of antihistamines in dermatological conditions has been closely linked to the treatment of urticarias and to the symptomatic relief of pruritus. H1- receptor antagonists are the first-line drugs for urticarias. Those urticarias of type I immunological origin respond better than physical urticarias. H2-receptor antagonists may be added for refractory patients but are rarely effective alone. Conventional H1-blockers are frequently associated with somnolence and anticholinergic effects. Therefore, new antihistamines without depressive effects on the central nervous system have recently been introduced.

In other pruritic conditions such as atopic dermatitis the limited effects of these drugs suggest that histamine is not the only mediator involved in pruritus. In these cases, their beneficial effects seem to be due mainly to their sedative properties; recently available non-sedative H1-blockers are less effective.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Reference

  • Advenier C, Regoli D. Pharmacologie clinique des antihistaminiques. Semaine des Hôpitaux (Paris) 63: 1699, 1987

    CAS  Google Scholar 

  • Basran GS, Paul W, Morley J, Turner-Warvick M. Adrenoreceptor against inhibition of the histamine induced cutaneous response in man. British Journal of Dermatology 107 (Suppl. 23): 140, 1982

    Article  PubMed  CAS  Google Scholar 

  • Bowman WC, Rand MJ. Local hormones and antacids: biogenic amines, purines, kinins and prostaglandins. In Blackwell (Ed.) Textbook of Pharmacology ch.12, pp. 12.2-12.16, 1980

  • Callier J, Engelen RF, Ianniello J, Olzem R, Zeisner M, et al. Astemizole (R43512) in the treatment of hay fever. Current Therapeutic Research 29: 24, 1981

    Google Scholar 

  • Calvieri S, Fattorossi A. Cimetidine for kaposi’s sarcoma. Clinical and Experimental Dermatology 10: 499–500, 1985

    Article  PubMed  CAS  Google Scholar 

  • Clissold SP, Sorkin EM, Goa KL. Loratadine. A preliminary review of its pharmacodynamic properties and therapeutic efficacy. Drugs 37: 42–57, 1989

    Article  PubMed  CAS  Google Scholar 

  • Cook J, Shuster S. The effect of H1 and H2 receptor antagonists on the dermographic response. Acta Dermato-Venereologica (Stockholm) 63: 260, 1983

    CAS  Google Scholar 

  • Douglas WW. Histamine and 5-hydroxytryptamine (serotonin) and their antagonists. In Goodman et al. (Eds) The Pharmacological basis of therapeutics, p 605, Macmillan Publishing Co., New York, 1985

    Google Scholar 

  • Dupont C, de Maubeuge J, Kotlar W, Lays Y, Masson M. Oxatomide in the treatment of pruritus senilis: a double blind placebo controlled trial. Dermatologica 169: 348, 1984

    Article  PubMed  CAS  Google Scholar 

  • Dvorak HF, Mihm MC, Dvorak A. Morphology of delayed-type hypersensitivity in man. Journal of Investigative Dermatology 67: 391, 1976

    Article  PubMed  CAS  Google Scholar 

  • Eady RAJ, Cowen T, Marshall TF, Plummer V, Greaves MW. Mast cell population density, blood vessel density and histamine content in normal human skin. British Journal of Dermatology 100: 623, 1979

    Article  PubMed  CAS  Google Scholar 

  • El Ackad TM, Brody MJ. Evidence for non-mast cell histamine in the vascular wall. Blood Vessels 12: 181, 1975

    PubMed  Google Scholar 

  • Emanuel MB, Towse BDW. Oxatomide. A new drug combining antiallergic and antispasmogenic properties. Medicamentos Actualidat 16: 219, 1980

    CAS  Google Scholar 

  • Fadel R, Herpin-Richard N, Rihoux JP, Henocq E. Inhibitory effect of cetirizine 2 HC1 on eosinophil migration in vivo. Clinical Allergy 17: 373, 1987

    Article  PubMed  CAS  Google Scholar 

  • Foreman J, Jordan C. Histamine release and vascular changes induced by neuropeptides. Agents and Actions 13: 105, 1983

    Article  PubMed  CAS  Google Scholar 

  • Frosch PJ, Schwanitz HJ, Macher E. A double blind trial of H1 and H2 receptor antagonists in the treatment of atopic dermatitis. Archives of Dermatological Research 276: 36, 1984

    Article  PubMed  CAS  Google Scholar 

  • Girard JP, Sommacal-Schopf D, Bigliardi P, Henauer SA. Double blind comparison of astemizole, terfenadine and placebo in hay fever with special regard to onset of action. Journal of International Medical Research 13: 102, 1985

    PubMed  CAS  Google Scholar 

  • Goldman MA, Simpson BA, Dvorak HE. Histamine and basophils in delayed type hypersensitivity reactions. Journal of Immunology 110: 1511, 1973

    CAS  Google Scholar 

  • Granerus G, Wass U. Urinary excretion of histamine methylhistamine (1me-Hi) and methylimidozoleacetic acid (MelmAA), in mastocytosis: comparison of new HPLC methods with other present methods. Agents and Actions 14: 314, 1984

    Article  Google Scholar 

  • Greaves MW, Marks R, Robertson I. Receptor for histamine in human skin blood vessels: a review. British Journal of Dermatology 97: 225, 1977

    Article  PubMed  CAS  Google Scholar 

  • Greaves MW. Novel in vivo models of human skin pathophysiology. British Journal of Dermatology 111 (Suppl. 27): 183, 1984

    Article  PubMed  CAS  Google Scholar 

  • Huther KJ, Renftle G, Barraud N, Burke J, Koch-Weser J. Inhibitory activity of terfenadine on histamine-induced skin wheals in man. European Journal of Clinical Pharmacology 12: 195, 1977

    Article  PubMed  CAS  Google Scholar 

  • Izuka H, Adachi K, Halprin KM, Levine V. Histamine (H2) receptor-adenylcyclase system in pig skin (epidermis). Bio-chimica et Biophysica 437: 150, 1976

    Google Scholar 

  • Jorizzo JL, Sams W, Jegasothy BW, Orlansky AJ. Cimetidine as an immunomodulator: chronic mucocutaneous candidiasis as a model. Annals of Internal Medicine 92: 192–195, 1980

    PubMed  CAS  Google Scholar 

  • Krause L, Shuster S. Mode of action of antihistamines in itch. British Journal of Dermatology 109 (Suppl. 24): 30, 1983

    Article  Google Scholar 

  • Krause LB, Shuster S. The effect of terfenadine on dermographic whealing. British Journal of Dermatology 110: 3, 1984

    Article  Google Scholar 

  • Krause LB, Shuster S. Minimal effect of complete H1receptor blockade on urticaria pigmentosa. Acta Dermato-Venereologica 65(4): 338, 1985

    PubMed  CAS  Google Scholar 

  • Kreutner W, Chapman RW, Gulbenkian A, Siegel MI. Antiallergic activity of loratadine, a non-sedating antihistamine. Allergy 42: 5.7, 1987

    Article  Google Scholar 

  • Lahti A. Terfenadine does not inhibit non-immunologic contact urticaria. Contact Dermatitis 16: 220, 1987

    Article  PubMed  CAS  Google Scholar 

  • Lewis T. The blood vessels of the human skin and their responses, Shaw et Sons Ltd, London, 1927

    Google Scholar 

  • Lichtenstein LM, Gillespie E. The effects of the HI and H2 antihistamines on ‘allergic’ histamine release and its inhibition by histamine. Journal of Pharmacology and Experimental Therapeutics 192(2): 441, 1975

    PubMed  CAS  Google Scholar 

  • Lunde I. Antihistamines (H1 -receptor antagonists). In Dukes (Ed.) Meyler’s side effects of drugs, 1 lth ed., p. 316, Elsevier Science Publishers B.V., 1988

  • Mamus SW, Mladenovic J, Hordunski MK, Dahl MV, Kay NE. Cimetidine-induced remission of myocosis fungoides. Lancet 2: 409, 1984

    Article  PubMed  CAS  Google Scholar 

  • Martin U, Romer D. The pharmacological properties of a new orally active antianaphylactic compound: ketotifen, a benzocycloheptathiophene. Arzneimittel-Forschung 28: 770, 1978

    PubMed  CAS  Google Scholar 

  • Misch KH, Kobza Black A, Barr R, Hensby CN, Mallet AI, et al. Histamine and non-histamine activity in cold-urticaria. Journal of Investigative Dermatology 78: 329, 1982

    Google Scholar 

  • Morley J, Page CP, Mazzoni L, Sanjar S. Antiallergic drugs in asthma. Triangle 24: 59, 1985

    Google Scholar 

  • Mota I, Da Silva D. The antianaphylactic and histamine releasing properties of the antihistamines: their effect on the mastcells. British Journal of Pharmacology 15: 396, 1960

    CAS  Google Scholar 

  • Mughal TI, Robinson WA, Thomas MR, Spiegel R. Role of recombinant interferon alpha-2 and cimetidine in patients with advanced malignant melanoma. Journal of Cancer Research and Clinical Oncology 114: 108–109, 1988

    Article  PubMed  CAS  Google Scholar 

  • Nabe M, Agrawal DK, Sarmiento EU, Mitagawa H, Townley RG. Inhibitory effect of terfenadine on mediator release from human blood basophils and eosinophils. Abstract. Journal of Allergy and Clinical Immunology 83: 281, 1989

    Google Scholar 

  • Nimegeers CJE, Awouters FHL, Janssen PAJ. The in vivo pharmacological profile of histamine H1 -antagonists in the rat. Drug Development Research 2: 559, 1982

    Article  Google Scholar 

  • Paton DM, Webster DR. Clinical pharmacokinetics of H1 -receptor antagonists. Clinical Pharmacokinetics 10: 477, 1985

    Article  PubMed  CAS  Google Scholar 

  • Paul E, Bodeker RH. Behandlung der chronischen Urtikaria mit Terfenadin und Ranitidin Ergebnisse einer randomisierten Doppelblind-Studie. Allergologie 10(3): 113, 1987

    Google Scholar 

  • Paul E, Pfeffer M, Bodeker RH. Urtikaria Therapie mit H1 und H2 -Antihistaminika: Ergebnisse Klinischer und experimentaller Studien. Zeitschrift fur Hautkranheiten H and G 62(5): 401, 1987

    CAS  Google Scholar 

  • Radermecker M. Inhibition of allergen-mediated histamine release from human cells by ketotifen and oxtomide. Respiration 41: 45, 1981

    Article  PubMed  CAS  Google Scholar 

  • Reinberg A, Ghata J, Sidi E. Les variations circadiennes (environ 24 heures) des reáctions cutanées à l’histamine et le rythme corticosurrenalien. Annales d’Endocrinologie (Paris) 25(6): 670, 1964

    CAS  Google Scholar 

  • Reinhardt D, Borchard U. H1-receptor antagonists: comparative pharmacology and clinical use. Klinische Wochenschrift 60: 983, 1982

    Article  PubMed  CAS  Google Scholar 

  • Richards DM, Brogden RN, Heel RC, Speight TM, Avery GS. Oxatomide: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 27: 210–231, 1984a

    Article  PubMed  CAS  Google Scholar 

  • Richards DM, Brogden RN, Heel RC, Speight TM, Avery GS. Astemizole: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 28: 38–61, 1984b

    Article  PubMed  CAS  Google Scholar 

  • Rose C, Quach TT, Llorens C, Schwartz JC. Relationship between occupation of cerebral H1 -receptors and sedative properties of antihistamine. Arzneimittel-Forschung (Drug Research) 32: 1171, 1982

    CAS  Google Scholar 

  • Ruzicka T, Gluck S. Cutaneous histamine levels and histamine releasibility from the skin in atopic dermatitis and hyper IgE syndrome. Archives of Dermatological Research 275: 41, 1983

    Article  PubMed  CAS  Google Scholar 

  • Schocket AL, Phanuphak P, Arboyae CM, Kolher PK. Skin histamine in chronic urticaria. Journal of Allergy and Clinical Immunology 3: 172, 1979

    Google Scholar 

  • Schwartz JC, Arrang JM, Garbarg M. Three classes of histamine receptors in brain. Trends in Pharmacological Sciences 7(1): 24, 1986

    Article  CAS  Google Scholar 

  • Simons FER, Simons KJ. H1 receptor antagonist treatment of chronic rhinitis. Journal of Allergy and Clinical Immunology 81: 975, 1988

    Article  PubMed  CAS  Google Scholar 

  • Sorkin EM, Heel RC. Terfenadine. A review of its pharmacodynamic properties and therapeutic efficacy. Drugs 29: 34–56, 1985

    Article  PubMed  CAS  Google Scholar 

  • Soter NA, Wasserman SI, Austen KF. Cold urticaria: release into the circulation of histamine and eosinophilic chemotactic factor of anaphylaxis during cold challenge. New England Journal of Medicine 294: 687, 1976

    Article  PubMed  CAS  Google Scholar 

  • Tan OT, Gaylarde PM, Sarkany I. Blocking of alcohol-induced flush with a combination of H1 - and H2 -histamine antagonists. Lancet 2: 365, 1979

    Article  PubMed  CAS  Google Scholar 

  • Theoharides TC. Histamine2 (H2 )-receptor antagonists in the treatment of urticaria. Drugs 37: 345–355, 1989

    Article  PubMed  CAS  Google Scholar 

  • Trzeciakowski JP, Levi R. Antihistamines. In Meddleton Jr E. et al. (Eds) Allergy principles and practice. Vol. 2, p. 757, Mosby, St Louis, 1983

    Google Scholar 

  • Vigersky RA, Mehlman I, Glass AR, Smith CE. Treatment of hirsute women with cimetidine. New England Journal of Medicine 303: 1042–1044, 1980

    Article  PubMed  CAS  Google Scholar 

  • Wilkin JKN, Rountree CB. Blockade of carcinoid flush with cimetidine and clonidine. Archives of Dermatology 118: 109, 1982

    Article  PubMed  CAS  Google Scholar 

  • Zacchariae H. Histamine in delayed skin reactions. Fluorometric determinations on patch tests. Journal of Investigative Dermatology 42: 431, 1964

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Advenier, C., Queille-Roussel, C. Rational Use of Antihistamines in Allergic Dermatological Conditions. Drugs 38, 634–644 (1989). https://doi.org/10.2165/00003495-198938040-00009

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-198938040-00009

Keywords

Navigation