Clinical difference between single subtype and mixed subtype chronic urticaria: A retrospective study

Abstract

Background: The subtypes of chronic urticaria share a common clinical expression, but may show differences phenotypically. Meanwhile, two or more different subtypes of chronic urticaria can coexist in any given patient which may involve different phenotypes. Aims: The study aims to compare the two phenotypes in terms of demographics, clinical profile and treatment response. Methods: In this retrospective study, 2678 chronic urticaria patients were divided into the single subtype chronic urticaria group and mixed subtype chronic urticaria group as was appropriate.The differences in the clinical features, possible causes, urticaria activity score of seven days, dermatology life quality index score, laboratory investigations and response to treatments were evaluated among the two groups. Results: An obvious female predominance was detected in chronic urticaria, especially in mixed subtype chronic urticaria patients. Of the 2678 chronic urticaria patients, there were 837(31.25%) mixed subtype chronic urticaria. Chronic spontaneous urticaria combined with symptomatic dermographism was the most common group in the mixed subtype chronic urticaria. Patients with mixed subtype chronic urticaria were more likely to have associated chest tightness/shortness of breath and showed greater urticaria activity. In patients with single subtype chronic urticaria, the positive rate of family history with allergic rhinitis, asthma or urticaria was lower. Based on evaluation of the treatment, control with second-generation antihistamines at licensed doses was achieved in only 38.83% of mixed subtype chronic urticaria patients, compared with 56.32% of patients with single subtype. Limitations: First, this study was a single-center design retrospective study. Second, omalizumab treatment was not included. Third, the differences between different subtypes of mixed subtype chronic urticaria were not discussed in detail. Conclusion: This study showed that mixed subtype chronic urticaria had some distinct features. Comprehensive knowledge about it may help us define effective therapeutic strategies and improve symptom control and the quality of life for chronic urticaria patients.

Research hotspots in urticaria: A bibliometric study of the top 100 most cited articles

“… 1 CSU accounts for 2/3 of the incidence, and different types of CU can be combined. 2 This point of view has also been verified through literature retrieval. This study on urticaria is mainly focused on CU, with CSU being the primary focus of the research.…”

“…According to the presence or absence of specific predisposing factors, chronic urticaria (CU) is divided into chronic spontaneous urticaria (CSU) and chronic induced urticaria (CIndU) 1 . CSU accounts for 2/3 of the incidence, and different types of CU can be combined 2 . This point of view has also been verified through literature retrieval.…”

Diagnosis and Management of Urticaria in Indian Settings

“…According to a single-centre, retrospective study, at standard doses, control of symptoms is seen in 38.83 and 56.32% of patients with mixed subtype and single subtype CU, respectively. [ 59 ]…”