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Cause And Symptoms

Complications

Diagnosis And Treatment

Overview

Prevention

References

chronic-spontaneous-urticaria-csu

Chronic spontaneous urticaria (csu)

<h2 style="text-align:center;">CSU IS AN IMMUNE-MEDIATED INFLAMMATORY SKIN DISEASE</h2>
CSU is characterized by the following:
Spontaneous appearance of wheals and/or angioedema that recur for 6 weeks or more, occurring on most days of the week1–4

Wheals2,5
<ul>
 <li>Central swelling surrounded by reflex erythema that can appear anywhere on the body</li>
 <li>Accompanied by an itch or burning sensation</li>
 <li>Lesions may resolve within 24 hours while new lesions appear elsewhere</li>
</ul>
Angioedema2–6
<ul>
 <li>Sudden, pronounced erythematous or skin-colored swelling of the deep dermis and subcutis, or mucous membranes that can last up to 72 hours</li>
 <li>Often localized. Commonly affects the face, lips, cheeks, tongue, hands, feet, and genitalia</li>
 <li>Sometimes pain, rather than itch</li>
 <li>Present in around half of patients</li>
</ul>

Chronicity7–9 
 The average duration of CSU is reported as 1–5 years, but may be longer in more severe cases

Intense itch1,2,4 
 Patients rate itch as the most bothersome symptom of CSU7

Significant burden on quality of life:

Sleep disturbance5*,10**
&nbsp;&nbsp;
Most people with CSU (92%) experience sleep problems

black

Appearance5*,10**
&nbsp; &nbsp;
People with CSU ‘sometimes’ or ‘always’ feel: 
 Self-conscious and embarrassed (75%) 
 Less attractive than they used to (68%)

Social interactions5*,10**,11
&nbsp; &nbsp;&nbsp;
People with CSU often report that their disease leads to: 
 Interference with sexual relationships (73%) 
 Avoidance of other people (51%) 
 Withdrawal from social activities (63%) 
 Decreased work productivity and increased absenteeism

Mental health12†,13*‡
&nbsp; &nbsp;
The most common mental health disorders among patients with CSU are: 
 Anxiety disorders (31%) 
 Mood disorders (29%) 
 Traumatic and stress-related disorders (17%)

CSU, chronic spontaneous urticaria. *Study pertains to patients with chronic urticaria **In ASSURE-CSU study with 673 CSU patients †In a survey of 2,579 dermatology patients ‡A systematic review and meta-analysis

References

<h2>CSU LEADS TO LONG-TERM PATIENT BURDEN1-3</h2>
Who is affected by CSU?

Global prevalence of CSU is 0.5–1%4,5

Most patients diagnosed are 20–40 years old4

CSU is more common in adults than in children6

Twice as many women are affected as men4,7

CSU, chronic spontaneous urticaria.

CSU IS A MAST CELL-DRIVEN DISEASE, THAT MAY BE INFLUENCED BY A DYSREGULATED TYPE 2 IMMUNE RESPONSE

The pathophysiology of CSU is not completely clear, but it is known that mast cells and their degranulation are central1…

...and elements of the type 2 immune response are involved.1 These include:2,3

Eosinophil

Basophil

Th2 cell

ILC2

…and signaling mediators, notably IgE, IgG, and type 2 cytokines4–7

IL-4

IL-13

IL-5

IL-31

Histamine

There is heterogeneity in the mechanisms triggering mast cell degranulation
Mast cell degranulation can occur via different mechanisms:*

*These mechanisms may also be characterized as autoimmune/type IIb (IgG anti-IgE/IgG anti-FcɛRI) or autoallergic/type I (IgE to self-antigens). CSU, chronic spontaneous urticaria; FcεRI, fragment constant (of Ig) receptor; Ig, immunoglobulin; IL, interleukin; ILC, innate lymphoid cell; Th2, T helper 2

Global prevalence of CSU is 0.5–1%4,5

Most patients diagnosed are 20–40 years old4

CSU is more common in adults than in children6

Twice as many women are affected as men4,7

Cytokine production

Before degranulation

After degranulation

CHRONIC-SPONTANEOUS-URTICARIA-(CSU)

DERMATOLOGY

<h2>CSU TREATMENT SHOULD CONTROL DISEASE SIGNS AND SYMPTOMS</h2>
The aim of CSU treatment is to improve patient quality of life through1,2:

Controlling signs and symptoms of CSU

Therapies with a favorable safety and tolerability profile

EAACI/EDF treatment guidelines recommend a four-step approach to treatment1,2

Type 2 mediators beyond IgE may be therapeutic targets for CSU
Despite the use of antihistamines and anti-IgE treatments, some patients are not adequately controlled.3-5 More advanced and specific targeted therapies are needed for safe and effective treatment of these patients
Type 2 inflammation has been suggested to play a role in the disease features and underlying mechanisms of CSU6–8
*As an alternative to anti-IgE therapy CSU, chronic spontaneous urticaria; EAACI, European Academy of Allergology and Clinical Immunology; EDF, European Dermatology Forum; H1AH; histamine 1 receptor antihistamine; Ig, immunoglobulin.

Chronic spontaneous urticaria (csu)

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Chronic Spontaneous Urticaria is an Immune-Mediated Inflammatory Skin Disease