CSU Knowledge Centre
Disease Overview
This section of the Knowledge Centre introduces urticaria and covers the major topics in disease awareness. Choose one of the sections below, or scroll down the page, to learn about the epidemiology and different classifications of urticaria, the pathophysiology and symptoms to look out for, or see diagnosis and assessment tools. Current guidelines and potential treatments are also presented, allowing you to consider the options for your patient.
Added in September 2018 – the Comorbidities section reviews the autoimmune, atopy and psychiatric comorbidities that have been associated with CSU. In addition, real-world data has now been added to the treatment section, providing insights into efficacy and safety outside of a clinical trial setting.
Comorbidities
CSU is a debilitating condition, however, for many patients with CSU, this isn’t the only illness they need to contend with. Several conditions, including allergic, psychiatric and autoimmune diseases, are more common in patients with CSU than the general population. Discover more about the comorbidities experienced by patients with CSU.
Symptoms
CSU may occur spontaneously every day, or almost daily for 6 weeks or more, and include hives (wheals) with associated pruritus and angioedema characterised by a pronounced swelling of the lower dermis and subcutis (hypodermis or superficial fascia).
Treatment
Discover first-, second- and third-line treatment options for CSU following the EAACI/GA2LEN/EDF/WAO recommended treatment algorithm. Detailing second generation H1-antihistamines and add-ons including omalizumab, ciclosporin A and montelukast.
Guidelines
Best practice guidelines (including EAACI, JTFPP, and NICE), broadly speaking, recommend second generation antihistamines and then increased dose, followed by alternative agents such as anti-inflammatories, immunosuppressants or biologics.
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Diagnosis and Assessment
Diagnosis is based on a thorough medical history and physical examination as well as diagnostic tests including provocation tests such as heat, pressure, UV and visible light, elicit dermographism and routine differential blood count.
Paediatric Urticaria
Paediatric urticaria - its impact and how diagnosis and management compares to adult recommendations. Doctor Montse Alvaro discusses the challenge of managing paediatric patients where it's strongly recommended that first-generation H1-antihistamines are not prescribed.
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