Researchers Look at Trends for Urticaria

Marcel Mazur, MD

With very little known about the triggers of urticaria, researchers are hoping to shed light on some of the potential causes.

A team, led by Marcel Mazur, Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, identified the prevalence and potential risk factors for acute and chronic urticaria in the population of children and adolescents living in Krakow, Poland.

With the lifetime prevalence of urticaria in the general population being approximately 20%, urticaria can lead to disablement, impair quality of life, and impact performance at work or school. The disease is characterized by a frequent, mast cell-driven condition, presenting with wheals, angioedema, or both. The recommended classification of chronic urticaria includes chronic spontaneous urticaria and inducible urticaria.

In the study, the investigators examined a population of children 7-8 years old and adolescents between 16-17 years old. The relation of urticaria prevalence and exposure to polluted air was also looked at. Overall, the study included 17,082 patients—9287 children and 7795 adolescents—between 2016-2018.

The mean age of the first episode was 7.7 years.

The lifetime occurrence of at least 1 episode of urticaria was found in 3.3% of respondents (3.6% in the children group and 2.8% in adolescents). The most frequently mentioned causative agent was medicines in children and food in adolescents. Chronic urticaria occurred in 2.1% of children and 1.1% of adolescents, while there were no relationship found between the volume of traffic and the distance of residence from the high-traffic street to the frequency of urticaria.

“A higher incidence of urticaria in the younger age group may suggest an upward trend in the incidence of this disease in the near future,” the authors wrote. “The incidence of chronic urticaria in children turned out to be higher than in the European population. As our research results show, the incidence of urticaria in children and adolescents does not depend on exposure to polluted air.”

While there have been numerous studies exploring urticaria, the etiopathogenesis of the disease has not been fully explained and the treatment that would be always effective has not been introduced yet. There is also much more data about the prevalence of urticaria in adults and much less known about the prevalence of the disease in children and its dependence on possible external provocative factors such as air pollution, which otherwise have proven to be important in the development of atopic diseases.

The study was part of a larger questionnaire-based survey in which researchers hope to assess the epidemiology of allergic diseases among children and adolescents. The investigators of the survey also hope to examine the impact of air pollution on the occurrence of allergic diseases.

Recently, researchers found patients with chronic spontaneous urticaria (CSU) tend to have higher rates of self-reported drug allergies compared to the general population.

The investigators identified 362 patients with CSU who had sought care at a university allergy and asthma clinic over a 10-year period, from 2007 to 2017. Patients were categorized based on their reported drug allergies or the lack thereof.

A majority of the patients in the study (56%) reported a drug allergy. The most commonly reported allergy was a penicillin allergy, an allergy whose most frequently reported symptom was urticaria, the authors said.

The data showed that the rate of drug allergies in patients with CSU is substantially higher than that of the general population, where rates of drug allergies are estimated at between 5-25%.

The study, “Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii,” was published online in Advances in Dermatology and Allergology.