The symptoms of chronic spontaneous urticaria (CSU) include itchy hives (wheals) and angioedema.
The symptoms of CSU may appear without warning with a variable intensity (Maurer et al., 2011; Zuberbier et al., 2018) and may profoundly impact patients' day-to-day lives (Maurer et al., 2011; O'Donnell et al., 1997; Kang et al., 2009; Barbosa et al., 2011; Engin et al., 2008). In CSU, itchy hives, angioedema or both, may occur spontaneously every day, or almost daily for 6 weeks or more (Zuberbier et al., 2018).
A hive consists of three typical features (Zuberbier et al., 2018):
Angioedema (deep tissue swelling) is typically characterised by (Zuberbier et al., 2018):
The eyelids and lips are most commonly affected, while the tongue, extremities, genitalia, oral cavity mucosa and upper respiratory tract may also be affected (Kulthanan et al., 2007).
In CSU, changes in symptom severity are closely linked to changes in health-related quality of life (HRQoL). If an improvement (or worsening) in signs and symptoms is found, it is highly likely that an improvement (or worsening) HRQoL is also experienced (Stull et al., 2016).