Diagnostic Delay in Patients With Chronic Urticaria: Results From the Chronic Urticaria Registry ( CURE )
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT Background Chronic urticaria (CU) diagnosis includes the patient's clinical history and physical examination. However, atypical presentations or misdiagnosis can lead to diagnostic delay (DD). Objective The impact and contributing factors of DD in CU are unknown and were assessed in the present study. Methods We retrospectively analysed data from CU adult patients from the international, multicenter Chronic Urticaria Registry (CURE). Results Of 4332 CU patients, 61% had standalone chronic spontaneous urticaria (sCSU), 18% had ≥ 1 form of chronic inducible urticaria (CIndU), and 21% had a combination of both (CSU + CIndU). Diagnosis of CU was delayed in 24% of patients by at least 1 year. CIndU patients showed a longer DD compared to those with sCSU or CSU + CIndU (median, [IQR]: 4, [0–22] vs. 1, [0–6] vs. 2, [0–9] months, p < 0.001). Among CIndU patients, symptomatic dermographism ( n = 264) and cholinergic urticaria ( n = 103) patients had the longest DD compared to all other CIndU subgroups (median: 4 months, p = 0.005 for both). In CIndU patients, a longer DD was associated with having an additional CIndU (OR: 12.8, p = 0.03), younger age, comorbidities, lower disease control, and lack of second‐generation H 1 ‐antihistamine treatment. In CSU patients, a DD of ≥ 6 months was associated with lower CSU activity (median weekly Urticaria Activity Score of 14 vs. 21, p = 0.02) compared to that of DD < 6 months. Conclusions Diagnosis of CU is delayed in one out of four patients. Greater awareness of the guideline‐recommended CU classification, clinical presentation, and diagnostic work‐up can facilitate CU diagnosis.
Source: Clinical & Experimental Allergy
DOI: 10.1111/cea.70215
Authors: Melba Muñoz, Pascale Salameh, Magdalena Zajac, Daria Fomina, Elena Kovalkova, Elena Bobrikova, Gerelma Andrenova, Alicja Kasperska‐Zając, Felix Aulenbacher, Leonie Shirin Herzog, Eva Maria Grekowitz, Thomas Buttgereit, Ana M. Giménez‐Arnau, Nidia Planella‐Fontanillas, David Pesque, Maria Puertolas, Kanokvalai Kulthanan, Papapit Tuchinda, Mojca Bizjak, Mitja Košnik, Maryam Khoshkhui, Farahzad Jabbari Azad, Raisa Meshkova, Sergey Savchenko, Michael Makris, Niki Papapostolou, Jonny G. Peter, Cascia Day, Cathryn McDougall, Mohamed Abuzakouk, Laurence Bouillet, Andrea Bauer, Claudio Alberto Salvador Parisi, Stamatios Gregoriou, Petra Staubach‐Renz, Joachim Dissemond, Emek Kocatürk, Martijn B. A. van Doorn, Riccardo Asero, Clive Grattan, Simon Francis Thomsen, Aurélie Du‐Thanh, Yana Hackler, Karsten Weller, Pavel Kolkhir
Institutions: Humboldt-Universität zu Berlin, Fraunhofer Institute for Translational Medicine and Pharmacology, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, University of Nicosia, Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban, Lebanese American University, Medical University of Silesia, Sechenov University, Astana Medical University, Universitat Pompeu Fabra, Hospital del Mar Research Institute, Siriraj Hospital, Mahidol University, University of Ljubljana, University Clinic of Pulmonary and Allergic Diseases Golnik, Mashhad University of Medical Sciences, Smolensk State Medical University, National and Kapodistrian University of Athens, University General Hospital Attikon, University of Cape Town, Groote Schuur Hospital, Cleveland Clinic, Cleveland Clinic Abu Dhabi, Centre Hospitalier Universitaire de Grenoble, University Hospital Carl Gustav Carus, Technische Universität Dresden, Hospital Italiano de Buenos Aires, Andreas Sygros Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Essen University Hospital, University of Duisburg-Essen, Bahçeşehir University, Erasmus MC, Centre for Human Drug Research, Guy's Hospital, University of Copenhagen, Bispebjerg Hospital, Centre Hospitalier Universitaire de Montpellier
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,760
Funders: Cleveland Clinic, Universitat Pompeu Fabra, Université Libanaise, Mahidol University, Mashhad University of Medical Sciences, National and Kapodistrian University of Athens, University of Cape Town, Univerza v Ljubljani, Śląski Uniwersytet Medyczny w Katowicach, I.M. Sechenov First Moscow State Medical University, Uniwersytet Śląski w Katowicach, Bahçeşehir Üniversitesi, Bispebjerg Hospital, University of Nicosia, Faculty of Medicine Siriraj Hospital, Mahidol University, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, NIH Clinical Center
OpenAlex ID: W7123594649