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Chronic urticaria phenotypes: clinical differences regarding triggers, activity, prognosis and therapeutic response

  • Clinical Report
  • Published:
European Journal of Dermatology

Abstract

Background

The subtypes of chronic urticaria (CU) share a common clinical expression, but phenotypically may show differences.

Objectives

To evaluate sociodemographic and clinical differences in CU phenotypes, including: (1) isolated chronic spontaneous urticaria (CSU); (2) isolated chronic inducible urticaria (CIndU); (3) CSU with concomitant CIndU (CSU-CIndU); (4) CSU with single or multiple episodes; (5) early and late-onset CSU (<45/65 years vs ≥45/65 years); and (6) CSU with presence vs absence of serum autoreactivity.

Materials and Methods

A retrospective observational study of 997 patients with urticaria was performed, with clinical, laboratory and therapeutic comparisons between CU subtypes.

Results

A clear female predominance was detected for CU, mostly in patients with serum autoreactivity. CIndU patients were younger, showed less angioedema, and had a better response to antihistamines. Stress and drugs were the main triggering factors for CSU. Patients with exclusive CIndU or recurrent CSU showed less psychiatric comorbidities. Patients with concomitant CIndU and serum autoreactivity showed greater urticaria activity.

Conclusion

Knowledge of the clinical differences between CSU subtypes may help to define an individual therapeutic strategy and improve the control of symptoms and quality of life.

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Acknowledgments and disclosures

Acknowledgments: This paper is based on a research project supported by a grant from Novartis. The authors thank Mariana Lacentra as data manager and Monica Giménez for assistance in drafting the manuscript. Funding sources: Novartis.

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Authors and Affiliations

  1. Department of Dermatology, Hospital del Mar - Institut Mar d’Investigacions Mèdiques (IMIM). Departament de Medicina de la UAB, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain

    Laia Curto-Barredo, Ramon M. Pujol & Ana M. Gimenez-Arnau

  2. Adknoma Health Research, Barcelona, Spain

    Guillem Roura-Vives

Authors
  1. Laia Curto-Barredo
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  2. Ramon M. Pujol
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  3. Guillem Roura-Vives
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  4. Ana M. Gimenez-Arnau
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Correspondence to Laia Curto-Barredo.

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Curto-Barredo, L., Pujol, R.M., Roura-Vives, G. et al. Chronic urticaria phenotypes: clinical differences regarding triggers, activity, prognosis and therapeutic response. Eur J Dermatol 29, 627–635 (2019). https://doi.org/10.1684/ejd.2019.3674

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