Recurrent chronic spontaneous urticaria in a tropical country: Clinical characteristics and associated factors

Abstract

Background: Limited data exist regarding recurrent chronic spontaneous urticaria (RCSU) following complete disease remission. Objective: This study investigated the clinical characteristics and factors associated with RCSU. Methods: We retrospectively reviewed data from chronic spontaneous urticaria (CSU) patients who actively visited the Urticaria Center of Reference and Excellence, Siriraj Hospital, between January 2021 and December 2023. Medical records were analyzed through May 2024. The RCSU was defined as a new CSU episode occurring after a 6-month symptom-free period without treatment. Results: Among 179 CSU patients, 19 (10.6%) developed RCSU. These patients had a mean age of 40 (SD 14.9) years, with a female predominance. The mean time to RCSU recurrence was 1.96 (SD 2.05) years. The UAS7 and medication scores were not significantly different between the recurrence and nonrecurrence groups (P = 0.675, P = 0.77). Multivariate analysis revealed that a shorter disease remission time from the first episode onset (< 3 years) was significantly associated with RCSU (odds ratio 5.13, 95%CI 1.83‒14.29; P = 0.002). Conclusion: The RCSU rate was 10.6%. The time to disease remission from the first episode onset significantly associated with RCSU. Several clinical characteristics may corelate with the recurrence: younger age at onset, the presence of angioedema, chronic inducible urticaria comorbidity, systemic corticosteroid use, and positive antinuclear antibody status.