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Dasatinib-induced panniculitis in a patient with chronic myeloid leukaemia

87 symptoms, like angioedema and wheals, may significantly and rapidly improve [3, 4], as was the case in our study. Staubach et al. [4] also reported an improvement in quality of life with this therapy. Except for fatigue, the efficacy of omalizumab on extracutaneous CSU symptoms is still unknown. These symptoms are, however, not uncommon. Indeed, Doong et al. [2] reported a cohort of 155 patients, of whom 103 had systemic complaints, such as joint pain, headache, fatigue, wheezing or GI complaints. In our cohort, patients reported reduced fatigue under omalizumab therapy, as described previously in the literature (reported time to improvement: four months) [4]. Omalizumab also seems to be effective for other symptoms, especially GI symptoms. Our study also shows an association between CSU and POTS, which has not been extensively described previously in the literature [5]. Indeed, we reported improvements in most POTS cases, which has not been previously described. Overall, this study demonstrates that treatment of CSU+ patients with omalizumab leads to rapid improvement (table 1), and these results are in line with previous studies [4, 6]. Moreover, we reported few side effects associated with omalizumab which is also in line with other studies [4, 6-8]. In several previous reports, off-label dosing periods during monthly administration of omalizumab were suspected and increased dosing intervals have been reported to be more effective [9]. In this study, we also adapted interval dosing based on symptom recurrence; following dose interval decrease, no increase in side effects was found and improvement was observed. Despite some limitations of our study (in particular, its retrospective nature and the non-objective criteria for improvement), we consider omalizumab as a safe and effective therapy for extracutaneous symptoms of CSU.