The challenges of chronic urticaria part 1: Epidemiology, immunopathogenesis, comorbidities, quality of life, and management

Sánchez‐Borges, Mario; Ansotegui, Ignacio J.; Baiardini, Ilaria; Bernstein, Jonathan A.; Canonica, Giorgio Walter; Ebisawa, Motohiro; Gómez, Maximiliano; González‐Díaz, Sandra Nora; Martin, Bryan; Morais‐Almeida, Mário; Martell, José Antonio Ortega

doi:10.1016/j.waojou.2021.100533

Cited by 61 publications

(61 citation statements)

References 92 publications

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“…In most patients, CSU lasts for several years and then shows spontaneous remission. Because of the severe pruritus and the unpredictability of the occurrence of the signs and symptoms, most patients who are not adequately treated are severely affected in their quality of life ( 179 ). CSU is a mast cell-driven disease, and its signs and symptoms occur in response to the activation of skin mast cells and their subsequent release of histamine and other mediators.…”

Section: Autoimmune Skin Diseasesmentioning

confidence: 99%

Unmet Medical Needs in Chronic, Non-communicable Inflammatory Skin Diseases

et al. 2022

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An estimated 20–25% of the population is affected by chronic, non-communicable inflammatory skin diseases. Chronic skin inflammation has many causes. Among the most frequent chronic inflammatory skin diseases are atopic dermatitis, psoriasis, urticaria, lichen planus, and hidradenitis suppurativa, driven by a complex interplay of genetics and environmental factors. Autoimmunity is another important cause of chronic skin inflammation. The autoimmune response may be mainly T cell driven, such as in alopecia areata or vitiligo, or B cell driven in chronic spontaneous urticaria, pemphigus and pemphigoid diseases. Rare causes of chronic skin inflammation are autoinflammatory diseases, or rheumatic diseases, such as cutaneous lupus erythematosus or dermatomyositis. Whilst we have seen a significant improvement in diagnosis and treatment, several challenges remain. Especially for rarer causes of chronic skin inflammation, early diagnosis is often missed because of low awareness and lack of diagnostics. Systemic immunosuppression is the treatment of choice for almost all of these diseases. Adverse events due to immunosuppression, insufficient therapeutic responses and relapses remain a challenge. For atopic dermatitis and psoriasis, a broad spectrum of innovative treatments has been developed. However, treatment responses cannot be predicted so far. Hence, development of (bio)markers allowing selection of specific medications for individual patients is needed. Given the encouraging developments during the past years, we envision that many of these challenges in the diagnosis and treatment of chronic inflammatory skin diseases will be thoroughly addressed in the future.

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Section: Autoimmune Skin Diseasesmentioning

confidence: 99%

Unmet Medical Needs in Chronic, Non-communicable Inflammatory Skin Diseases

et al. 2022

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“…Urticaria is identified by the presence of pruritic wheals or hives, accompanied by angioedema (AE) in ~40% of cases. Up to 20% of patients present with isolated AE ( 1 – 3 ).…”

Section: Looking For Diagnostic Certainty On Urticariamentioning

confidence: 99%

Chronic Urticaria: The Need for Improved Definition

Gómez¹,

Bernstein²,

Ansotegui³

et al. 2022

Front. Allergy

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“…Chronic spontaneous urticaria lasts on average between 3 and 5 years and monitoring of patients has shown that in approximately 50% of patients spontaneous remission occurs in the first 3 months of the disease. However, in 10% of patients, the disease is expected to last longer than 5 years 5 . Due to possible long duration, frequent relapses, unknown cause or trigger and resistance to applied therapy, urticaria holds a significant psychosocial burden.…”

confidence: 99%

The psychosocial burden of urticaria

Jerković¹,

Bešlić²,

Ćesić³

et al. 2021

Rad Hrvatske akademije znanosti i umjetnosti

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Urticaria is one of the most common dermatologic allergic diseases, but also holds a significant psychosocial burden due to possible long duration, frequent relapses, unknown cause or trigger and resistance to applied therapy. Many patients associate the onset and worsening of the disease with stressful experiences indicating it can be a psychosomatic disease within the psychoneuroimmunological approach. Apart from that, urticaria greatly affects the quality of life (QoL) of patients, disrupts their daily lives in all aspects, and is a dermatological disease with one of the highest prevalence of psychiatric comorbidities. Therefore, in this review article we discuss why a multidisciplinary approach, which includes both biological, psychological and social aspects of the disease, must be acknowledged for effective treatment. Finally, we provide suggestions for clinical management of patients suffering from urticaria.

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The challenges of chronic urticaria part 1: Epidemiology, immunopathogenesis, comorbidities, quality of life, and management

Cited by 61 publications

References 92 publications

Unmet Medical Needs in Chronic, Non-communicable Inflammatory Skin Diseases

Unmet Medical Needs in Chronic, Non-communicable Inflammatory Skin Diseases

Chronic Urticaria: The Need for Improved Definition

The psychosocial burden of urticaria

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