The Prevalence of Symptomatic Dermographism: Results of the International UCARE PREVALENCE-D Study

Abstract

Background: The prevalence of symptomatic dermographism (SD) in the general population remains unclear. This study aimed to internationally estimate the prevalence of SD and two other dermographic subtypes—physiological red dermographism and simple urticarial dermographism—among adults worldwide. Methods: The PREVALENCE-D (Prevalence Estimation of Dermographism) study was the largest international, cross-sectional, internet-based investigation conducted by the Urticaria Centers of Reference and Excellence of the Global Allergy and Asthma Excellence Network from 2021 to 2024. A world expert-designed questionnaire was completed by participants from 28 centers across 19 countries to diagnose SD. Participants were recruited into three age groups (18–24, 25–60, and > 60 years), with ≥ 1000 individuals per group per country. We calculated sex- and age-adjusted prevalence estimates internationally and by country, with 95% confidence intervals. Results: Among 59,543 participants worldwide, those with SD had an adjusted point prevalence of 3.20% (95% confidence interval [CI] 2.68%–3.73%) and a lifetime prevalence of 5.94% (95% CI 5.32%–6.56%). The 25–60 years group presented the highest prevalence. Females had higher rates than males, with statistically significant differences across all age groups for both point and lifetime prevalence. Physiological red dermographism had an adjusted point prevalence of 10.02% (95% CI 9.48%–10.55%) and a lifetime prevalence of 33.47% (95% CI 32.01%–34.94%). Simple urticarial dermographism showed an adjusted point prevalence of 1.21% (95% CI 1.08%–1.35%) and a lifetime prevalence of 5.39% (95% CI 4.99%–5.79%). Conclusion: These findings provide comprehensive international estimates of dermographism, particularly SD, and emphasize the need for appropriate healthcare resource allocation and disease recognition.