The EAACI/GA²LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update

Abstract

This guideline is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2) LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The life-time prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).

Burden of chronic urticaria relative to psoriasis in five European countries

“…Patients with confirmed CSU may have different specific characteristics than CU, and therefore, these study results may underestimate the full impact of CSU on patients. In addition, this study did not include data on severity of CU; moreover, diagnosis of CU and its severity levels are more challenging than that of PsO 3. A quick self‐assessment method of disease activity/severity does not exist yet in CU.…”

“…Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of hives, angio‐oedema or both for >6 weeks 3. The prevalence of CSU is reported to be between 0.1% and 0.8% in European countries, and it represents over two‐third cases of chronic urticaria (CU) 3, 4.…”

“…The prevalence of CSU is reported to be between 0.1% and 0.8% in European countries, and it represents over two‐third cases of chronic urticaria (CU) 3, 4. CU primarily affects the working population as the peak age of CU onset is between 20 and 40 years 4.…”

Hydroxychloroquine in the treatment of anti-histamine refractory chronic spontaneous urticaria, randomized single-blinded placebo-controlled trial and an open label comparison study

“…CSU typically responds to H1-anti-histamines therapy and the dosing can be increased to four-fold in cases of non-response (1). In spite of the use of anti-histamines, some patients with CSU remain refractory to this therapy.…”

Urticaria inducible: serie de casos y revisión de la literatura

“…La urticaria es una enfermedad cutánea y de las mucosas caracterizada por la aparición de habones o angioedema que es preciso diferenciar de otras condiciones médicas en las que pueden presentarse habones, angioedema o los dos, por ejemplo, la anafilaxia, los síndromes autoinflamatorios o el angioedema hereditario (1). Según su duración se ha clasificado en aguda y crónica, definiéndose esta como aquella con una duración mayor a seis semanas.…”