Non-skin symptoms in chronic spontaneous urticaria: new insights

Published online April 24, 2024

Chronic spontaneous urticaria (CSU) is characterized by the presence of skin signs and symptoms such as wheals, angioedema, or both lasting for more than six weeks. Non-skin-related symptoms (NSRS) such as fever and joint pain have been reported in CSU, but their relevance is still poorly investigated.

A recent study by Pyatilova et al., published in The Journal of Allergy and Clinical Immunology: In Practice, explored the prevalence and clinical implications of NSRS, such as recurrent fever, joint, bone, and/or muscle pain (JBMP), and malaise in patients with CSU. This study analyzed 2,521 CSU patients ≥16 years old from the Chronic Urticaria Registry (CURE).

The study showed that 31.2% of CSU patients experienced NSRS, with JBMP being the most common (19.1%), followed by malaise (18.6%) and recurrent fever (5.3%). These symptoms were often associated with high disease activity, long-lasting wheals, presence of angioedema, longer disease duration, poor quality of life, and insufficient disease control. Presence of NSRS indicates a need for better CSU control, consideration of comorbid conditions and/or exclusion of differential diagnoses such as urticarial vasculitis and autoinflammatory diseases.

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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