A Practical Approach to Diagnosing and Managing Chronic Spontaneous Urticaria

• Main Authors: Adam Friedman (Author), Shawn G. Kwatra (Author), Gil Yosipovitch (Author)
• Format: Book
• Published: Adis, Springer Healthcare, 2024-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1007/s13555-024-01173-5; 2193-8210; 2190-9172
• Keywords: Chronic spontaneous urticaria; Chronic urticaria; Diagnosis; Angioedema; Wheals; Dermatology; RL1-803
• Source: Dermatology and Therapy, Vol 14, Iss 6, Pp 1371-1387 (2024)

Abstract Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition characterized by the spontaneous onset of itchy wheals, angioedema, or both, which occurs for longer than 6 weeks overall. Despite the relatively straightforward diagnostic algorithm for CSU, relying primarily on a detailed medical history and only limited laboratory tests, patients often wait years to be diagnosed, with many cycling through different healthcare practitioners before a diagnosis is made. Even then, current treatment options for CSU are limited, with approximately half of patients resistant to standard-of-care second-generation antihistamines at standard or higher doses. As such, there is an unmet need for improved, streamlined management for patients with CSU. Here, we review the evidence-based diagnostic algorithm for CSU, consider the required steps of the diagnostic workup, and provide practical, real-world advice on the management of CSU to improve the timely diagnosis and care of patients with this debilitating disease.