A Practical Approach to Diagnosing and Managing Chronic Spontaneous Urticaria

Authors

Adam Friedman, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA. ajfriedman@mfa.gwu.edu.
Shawn G. Kwatra, Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA.
Gil Yosipovitch, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Coral Gables, FL, USA.

Document Type

Journal Article

Publication Date

5-17-2024

Journal

Dermatology and therapy

DOI

10.1007/s13555-024-01173-5

Keywords

Angioedema; Chronic spontaneous urticaria; Chronic urticaria; Diagnosis; Wheals

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.

APA Citation

Friedman, Adam; Kwatra, Shawn G.; and Yosipovitch, Gil, "A Practical Approach to Diagnosing and Managing Chronic Spontaneous Urticaria" (2024). GW Authored Works. Paper 4915.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4915

Department

Dermatology