Centre of Evidence of Dermatology Best practice guidelines

Guidelines chronic spontaneous urticaria Updated on Introduction


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Back to decision-making tree Print last updated on 21/09/2020

A chronic inflammatory skin disease

Clinically, urticaria is a papular, erythematous, pruritic and transient rash. It can be superficial (superficial dermal oedema) and/or deep (dermal-hypodermal angioedema).

Chronic spontaneous urticaria (CSU) is defined as urticaria occurring in daily or near-daily flare-ups for at least 6 weeks, without external stimulus, and which cannot be reproduced by provocation tests.

Differential diagnoses

The main differential diagnoses of urticaria are (non-exhaustive list): pseudo-urticarial vasculitis, urticaria pigmentosa (mastocytosis), bradykinin-mediated angioedema, auto-inflammatory diseases.

Disease progression

CSU lasts between 1 and 4 years; treatment helps to control the symptoms but a some patients are still symptomatic after 10 years. The goal of treatment is to reduce or to suppress urticarial symptoms and improve patient quality of life.

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