Chronic spontaneous urticaria: diagnosis, treatment, and management

Chronic spontaneous urticaria (CSU) is a disabling condition in which recurrent wheals, with or without angioedema, occur for over 6 weeks. CSU occurs in up to 1% of the general population at any time and, on average, lasts 2–5 years in duration. Standard therapy for CSU includes second-generation antihistamines and omalizumab. However, 25%–50% of patients are refractory to these treatments. CSU profoundly impairs patients’ quality of life and has a substantial societal impact, including significant health care costs and decreased work productivity. These factors underscore the importance of health care providers to be familiar with the diagnosis and management of this condition. This article reviews the epidemiology, pathogenesis, aggravating factors, clinical manifestations, diagnostic assessment, and treatment of CSU.