Summary Background Measurement of disease activity guides treatment of chronic spontaneous urticaria (CSU). A weekly Urticaria Activity Score – here, the average of twice‐daily patient assessment of itch and hives scores summed over 1 week (UAS7TD) – measures severity from 0 to 42. Insufficient evidence exists on whether disease activity states, defined by categorical UAS7TD scores, correlate with other patient‐reported outcomes and treatment response. Objectives To evaluate and compare categorical UAS7TD scores with selected measures of disease‐related quality of life and impact. Methods Data from three randomized clinical trials of omalizumab in CSU were pooled. Continuous UAS7TD scores were categorized into five disease activity states: urticaria‐free, well‐controlled, mild, moderate and severe urticaria. Total scores from the Dermatology Life Quality Index; the Chronic Urticaria Quality of Life questionnaire; and questions on sleep and daily activity interference, presence of angioedema and diphenhydramine use were compared within categorized UAS7TD disease‐state scores, using anova for analysis at different time points and mixed‐effects regressions for analysis of all data pooled. Results Pooled analyses showed that categorical UAS7TD disease states accurately predicted differences among treated patients with CSU with different levels of disease activity. A consistent pattern existed between categories, with higher‐activity disease states associated with significantly higher impact and an increase in angioedema frequency. Results at different treatment time points were consistent. Conclusions Categorical UAS7TD disease states can discriminate between measures when considering the impact of urticaria activity. Using five categorical disease states could simplify clinical assessment and monitoring of treatment efficacy.

Background: Real-world evidence describing the benefits of recommended therapies and their impact on the quality of life (QoL) of chronic urticaria (CU) patients is limited. Objective: To investigate disease burden, current treatment schedule, and the use of clinical resources by patients with H 1-antihistamine-refractory CU in Europe. Methods: AWARE (A Worldwide Antihistamine-Refractory chronic urticaria patient Evaluation) is a global, prospective, non-interventional study in the real-world setting, sponsored by the manufacturer of omalizumab. Disease characteristics, pharmacological treatments, and health-related QoL of patients (N = 2727) ≥18 years of age diagnosed with H 1-antihistamine-refractory chronic spontaneous urticaria (without inducible urticaria) for >2 months are reported here. Results: Of the 2727 patients included, 1232 (45.2%) and 1278 (46.9%) were successfully followed up for any assessment and for the key outcome, the urticaria control test (UCT) score, respectively, and patients with complete remission (14.1%) were excluded from analyses.The proportion of patients with uncontrolled CSU (UCT score <12) dropped from 78% (n/N = 1641/2104) at baseline to 28.7% (n/N = 269/936) after two years of participation in the AWARE study. In addition, the proportion of patients with no impact of CSU on their QoL (assessed by the Dermatological Life Quality Index) increased to 57% (n/N = 664/1164) from 18.7% (n/N = 491/2621) at baseline. Emergency room visits (2.4% [n/N = 7/296] vs 33.5% [n/N = 779/2322]) and hospital stays (1.7% [n/N = 5/296] vs 24.2% [n/N = 561/2322]) reduced at Month 24 vs baseline. Overall, 23.2% (n/N = 26/112) patients on nonsedating H 1-antihistamines (nsAH) and 41.9% (n/N = 44/105) patients on up-dosed nsAH had uncontrolled CSU (UCT <12) at Month 24. In omalizumab-treated patients, 27.1% (n/N = 78/288) had uncontrolled CSU at Month 24. Conclusion: These data confirm improvements for most patients with CSU over a 2-year follow-up period. Further studies are needed to understand the differences between guideline recommendations and reported management. K E Y W O R D S angioedema, chronic spontaneous urticaria, quality of life, urticaria | 1167 MAURER Et Al.

No abstract

7. Durmischev AL, Davidoff MS. Depigmentation effect of hydroquinone monomethyl ether. Dermatol Monatsschr. 1976;162:306-311. 8. Becker H, Vogel H. The role of hydroquinone monomethyl ether in the stabilization of acrylic acid. Chem Eng Tecnol. 2006;29:1227-1231. 9. Chivers CP. Two cases of occupational leucoderma following contact with hydroquinone monomethyl ether. Br J Ind Med. 1972;29:105-107. 10. Frenk E, Ott F. Evaluation of the toxicity of the monoethyl ether of hydroquinone for mammalian melanocytes and melanoma cells. The prevalence of formaldehyde sensitization differs between regions. The concentration of formaldehyde used in the patch test has been controversial, but the latest European recommendations 1 suggest that formaldehyde 2% aq. is the optimal concentration because clinically relevant contact allergy to formaldehyde may be missed by testing with formaldehyde 1% aq. For this reason, the Spanish baseline series was updated by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC), and the concentration of formaldehyde increased to 2% aq. in 2016. 2 The aims of this descriptive one-year prospective study were to determine the prevalence of sensitization to formaldehyde and assess the features of patients with sensitization to formaldehyde in Spain. METHODS In 14 Spanish hospitals, 2971 patients were patch tested in 2017 with the Spanish baseline series. Formaldehyde 2% aq. was supplied by 458 SANZ-SÁNCHEZ ET AL. Chemotechnique Diagnostics (Vellinge, Sweden) in 7 hospitals and AllergEAZE (Calgary, Canada) in the other 7. Readings were done on day (D) 2 and D4 and graded according to International Contact Dermatitis Research Group evaluation criteria (+, ++, and +++ as positive). We compared the demographic characteristics of the patients according to the MOAHLFA index. RESULTS Of the 2971 patients tested with formaldehyde 2% aq., 113 patients (3.80%) reacted positively, and only four irritant reactions were recorded. The demographic data obtained in our study show that a higher percentage of women (men: 26.6%), younger people (age > 40 years: 21.2%), atopic patients (27.5%), and people with leg dermatitis (46.8%) are allergic to formaldehyde compared to the overall study population. Twelve occupational cases were observed, mostly in women (health care workers and hairdressers), and the hands were the most frequently involved areas. DISCUSSIONIn this study, the frequency of sensitization to formaldehyde was found to be higher (3.80%) than in previous studies in Spain (ranging from 2.58 to 1.38). 3-5 This higher yield may be due to the fact that formaldehyde 2% aq. detects more contact allergies to formaldehyde than 1% aq., while only a few cases are considered irritant reactions. These data are in accordance with previously published European studies. 1,6The demographic data are similar to those in other studies, 3 except for a higher percentage of patients with leg dermatitis than in other studies. 3,6 As an explanation for this, previous dermatitis could be a risk factor for the ...