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Factors associated with quality of life in patients with urticarial vasculitis

Published: July 18, 2022

Urticarial vasculitis (UV) is a rare and often long overlooked chronic disease. Patients with UV have daily appearing wheals on any parts of the body which can be itchy, burning and painful. The skin lesions in most cases stay for over 24 hours and resolve with bruising. Diagnosis is based on inflammation of vessels of the skin (leukocytoclastic vasculitis) seen on skin biopsy. Besides the very burdensome skin symptoms, patients can also show systemic symptoms which include impairment of the eyes, lungs, gastrointestinal tract and/or kidneys. Patients with UV often present with fatigue, joint and musculoskeletal complaints. Management of patients with UV is difficult for physicians as no clinical guidelines or approved treatment options exist. In addition, little is known about patients’ perspective on the disease.

In this study, Bonnekoh et al. assessed UV patients’ perspective on the clinical course, treatment response, greatest challenges and quality of life impairment. A questionnaire was designed by the authors and disseminated in a Facebook ® group of patients with UV. The questionnaire included questions on patients’ dermographic characteristics, disease characteristics, associated diseases, treatment, quality of life and greatest challenges of the patients. The results of the study were first published in The Journal of Allergy and Clinical Immunology: In Practice in July 2022.

Eighty-seven patients with UV formerly confirmed by skin biopsy were included in the study and were middle-aged and mostly female. The time from symptom onset to diagnosis was on average 8 months. Most patients (97.7%) had at least 1 systemic symptom besides their skin complaints. The most common systemic symptoms were fatigue, joint swelling/pain and muscle/bone aches. More than half of the patients with UV reported a severely or very severely decrease of their quality of life. The impairment of quality of life was also the most frequently indicated greatest challenge for patients with UV. Low quality of life was associated with longer disease duration, higher rates of systemic symptoms, allergies, lung diseases and chronic infections, and a higher number of drugs used.

This is the first study which is based on patient-reported information and which shows that patients with UV have a considerable impairment of quality of life. Disease awareness and better management focusing on patients’ needs and preferences is necessary to improve the quality of life of patients with UV.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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