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Elias Toubi, Zahava Vadasz

J Dermatol . 2021 Sep 14. doi: 10.1111/1346-8138.16119. Online ahead of print.

Chronic spontaneous urticaria is an autoimmune condition for, at least, 50% of the cases, and sometimes it is associated with other autoimmune diseases such as thyroid autoimmunity and systemic lupus erythematosus. They have an increased prevalence of autoreactive T-cell responses to FceRI and serum anti-thyroid antibodies. There are still a lot of unclear aspects to be determined, namely how long CSU will last. Most patients with chronic spontaneous urticaria are concerned about the probability of recurrence and wish for the existence of clinical or laboratory markers. The aim of this study was to understand the prevalence and characteristics of the recurrence of chronic spontaneous urticaria to prevent stressful comorbidities.

The study included 180 regular patients from the local registry. Chronic spontaneous urticaria lasted more than 5 years in 47 (26%) patients and was resolved during the first year in 23 (13%) patients. 21% of the patients reported recurrence of chronic spontaneous urticaria after a full remission between 1 and 10 years (mean 2.9 years).

In the search for predictive clinical or laboratory markers, the main differences found are registered in the table below.

Recurrent urticaria

General urticaria

P value

Bronchial asthma

10/25 (40%) 45/180 (25%)

p=0.049

Total immunoglobulin E

10/25 (40%) 34/150 (23%)

p=0.04

Anti-thyroid peroxidase antibodies

11/25 (44%) 32/160 (20%)

p=0.003

In conclusion, the prevalence of chronic spontaneous urticaria after a full remission is significantly higher in patients with bronchial asthma, increased levels of total IgE and autoimmunity. More studies are needed to support these findings.

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