Isolated chronic inducible urticaria and chronic inducible urticaria with chronic spontaneous urticaria have different endotypes, with the latter having a more severe and refractory prognosis, according to the findings of a retrospective study.
Chronic inducible urticaria (CIndU) is a clinical subtype of chronic urticaria that may occur as an isolated condition or with concomitant chronic spontaneous urticaria (CSU). CIndU patients experience impaired quality of life, primarily due to the effects of avoiding physical and non-physical triggers.
This retrospective analysis aimed to identify laboratory and clinical parameters and comorbidities among CIndU patients. The study findings are published in the Journal of the European Academy of Dermatology and Venereology.
Baseline Characteristics
The study included a total of 423 patients, including 289 patients with one CIndU subtype, 7 patients with more than one CIndU subtype, and 127 patients with accompanying CSU. The provocation tests were positive in 202/250 patients. The other diagnostic tool used in the study was photographic documentation.
Compared to patients with CSU and CIndU, patients with isolated CIndU were younger. Patients with CSU and CIndU had a relatively greater frequency of comorbid systemic disorders, angioedema, systemic symptoms during disease attacks, requirement for systemic steroids, and emergency referrals. Baseline urticaria control test scores were lower in patients with CIndU and CSU.
Comorbid Conditions in Chronic Inducible Urticaria
In the study cohort, 22.2% of the patients had autoimmune thyroid disease, 28.9% had atopic disease, 30.1% had systemic disease, 30.1% had psychiatric illness, 37.3% had stress, and 42% had chronic infection. The most common systemic conditions in both patient groups were arterial hypertension and gastritis.
Clinical Features in Chronic Inducible Urticaria
CIndU patients had a lower mean age and included a higher proportion of male patients than CIndU and CSU patients. Only patients in the symptomatic dermographism group did not experience angioedema, whereas systemic reactions were only present in the cold urticaria group. The cold urticaria group had a longer disease duration and a greater prevalence of autoimmune thyroiditis.
Source:
Örnek, S., Can, P. K., Degi̇Rmentepe, E. N., Curé, K., Singer, R., & Kocatürk, E. (2023b). A comparative analysis of chronic inducible urticaria in 423 patients: Clinical and laboratory features and comorbid conditions. Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.19637
