What will be the management of Refractory chronic Urticaria. Please explain in details.

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Chronic spontaneous urticaria (CSU) is considered refractory when symptoms are not controlled by higher-dose, nonsedating H1 antihistamines in combination with other standard therapies (ie, additional H1 antihistamines, H2 antihistamines, and/or antileukotriene drugs).. In some cases, chronic hives may be related to an underlying illness, such as a thyroid disease or, rarely, cancer.. H2 blockers. ... Short-term oral corticosteroids, such as Prednisone. ... Antidepressants, such as doxepin cream .Immune suppressants. ... Monoclonal antibodies.. Allegra tab as par wt.1 tab OD. Ivermectin 6.mg.+ Albandazole400 .Mg 1 tab Once x 4 days.

Thank you doctor
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@ valuable answer of dr sharma , along with inj immunoglobin , allergen test also works well

Stool examination for round worm. Antihistamines

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Ebastine

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