Diagnostic Delay in Patients With Chronic Urticaria: Results From the Chronic Urticaria Registry (CURE)
Issued Date
2026-01-01
Resource Type
ISSN
09547894
eISSN
13652222
Scopus ID
2-s2.0-105027653511
Pubmed ID
41532284
Journal Title
Clinical and Experimental Allergy
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical and Experimental Allergy (2026)
Suggested Citation
Muñoz M., Salameh P., Zajac M., Fomina D., Kovalkova E., Bobrikova E., Andrenova G., Kasperksa-Zajac A., Aulenbacher F., Herzog L.S., Grekowitz E.M., Buttgereit T., Giménez-Arnau A.M., Planella-Fontanillas N., Pesque D., Puertolas M., Kulthanan K., Tuchinda P., Bizjak M., Košnik M., Khoshkhui M., Azad F.J., Meshkova R., Savchenko S., Makris M., Papapostolou N., Peter J.G., Day C., McDougall C., Abuzakouk M., Bouillet L., Bauer A., Parisi C.A.S., Gregoriou S., Staubach-Renz P., Dissemond J., Kocatürk E., van Doorn M.B.A., Asero R., Grattan C., Thomsen S.F., Du-Thanh A., Hackler Y., Weller K., Kolkhir P. Diagnostic Delay in Patients With Chronic Urticaria: Results From the Chronic Urticaria Registry (CURE). Clinical and Experimental Allergy (2026). doi:10.1111/cea.70215 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114575
Title
Diagnostic Delay in Patients With Chronic Urticaria: Results From the Chronic Urticaria Registry (CURE)
Author(s)
Muñoz M.
Salameh P.
Zajac M.
Fomina D.
Kovalkova E.
Bobrikova E.
Andrenova G.
Kasperksa-Zajac A.
Aulenbacher F.
Herzog L.S.
Grekowitz E.M.
Buttgereit T.
Giménez-Arnau A.M.
Planella-Fontanillas N.
Pesque D.
Puertolas M.
Kulthanan K.
Tuchinda P.
Bizjak M.
Košnik M.
Khoshkhui M.
Azad F.J.
Meshkova R.
Savchenko S.
Makris M.
Papapostolou N.
Peter J.G.
Day C.
McDougall C.
Abuzakouk M.
Bouillet L.
Bauer A.
Parisi C.A.S.
Gregoriou S.
Staubach-Renz P.
Dissemond J.
Kocatürk E.
van Doorn M.B.A.
Asero R.
Grattan C.
Thomsen S.F.
Du-Thanh A.
Hackler Y.
Weller K.
Kolkhir P.
Salameh P.
Zajac M.
Fomina D.
Kovalkova E.
Bobrikova E.
Andrenova G.
Kasperksa-Zajac A.
Aulenbacher F.
Herzog L.S.
Grekowitz E.M.
Buttgereit T.
Giménez-Arnau A.M.
Planella-Fontanillas N.
Pesque D.
Puertolas M.
Kulthanan K.
Tuchinda P.
Bizjak M.
Košnik M.
Khoshkhui M.
Azad F.J.
Meshkova R.
Savchenko S.
Makris M.
Papapostolou N.
Peter J.G.
Day C.
McDougall C.
Abuzakouk M.
Bouillet L.
Bauer A.
Parisi C.A.S.
Gregoriou S.
Staubach-Renz P.
Dissemond J.
Kocatürk E.
van Doorn M.B.A.
Asero R.
Grattan C.
Thomsen S.F.
Du-Thanh A.
Hackler Y.
Weller K.
Kolkhir P.
Author's Affiliation
Københavns Universitet
Charité – Universitätsmedizin Berlin
Erasmus MC
National and Kapodistrian University of Athens
Universität Duisburg-Essen
Sechenov First Moscow State Medical University
Universitat Pompeu Fabra Barcelona
Universitätsmedizin Mainz
Mashhad University of Medical Sciences
Slaski Uniwersytet Medyczny w Katowicach
Guy's Hospital
Universitätsklinikum Carl Gustav Carus Dresden
Centre Hospitalier Universitaire de Montpellier
Centre Hospitalier Universitaire de Grenoble
Siriraj Hospital
Bispebjerg Hospital
Université Libanaise
Groote Schuur Hospital
Bahçeşehir Üniversitesi
Hospital Italiano de Buenos Aires
Univerza v Ljubljani Medicinska Fakulteta
Moscow Healthcare Department
Cleveland Clinic Abu Dhabi
University of Nicosia Medical School
Astana Medical University
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Gilbert and Rose-Marie Chagoury School of Medicine
Center for Human Drug Research
Smolensk State Medical Academy
Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban
University of Cape Town Lung Institute
Bolnišnica Golnik
Clinica San Carlo
UNEV gGmbH
Charité – Universitätsmedizin Berlin
Erasmus MC
National and Kapodistrian University of Athens
Universität Duisburg-Essen
Sechenov First Moscow State Medical University
Universitat Pompeu Fabra Barcelona
Universitätsmedizin Mainz
Mashhad University of Medical Sciences
Slaski Uniwersytet Medyczny w Katowicach
Guy's Hospital
Universitätsklinikum Carl Gustav Carus Dresden
Centre Hospitalier Universitaire de Montpellier
Centre Hospitalier Universitaire de Grenoble
Siriraj Hospital
Bispebjerg Hospital
Université Libanaise
Groote Schuur Hospital
Bahçeşehir Üniversitesi
Hospital Italiano de Buenos Aires
Univerza v Ljubljani Medicinska Fakulteta
Moscow Healthcare Department
Cleveland Clinic Abu Dhabi
University of Nicosia Medical School
Astana Medical University
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Gilbert and Rose-Marie Chagoury School of Medicine
Center for Human Drug Research
Smolensk State Medical Academy
Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban
University of Cape Town Lung Institute
Bolnišnica Golnik
Clinica San Carlo
UNEV gGmbH
Corresponding Author(s)
Other Contributor(s)
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<inf>1</inf>-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.