Differential diagnosis between urticarial vasculitis and chronic spontaneous urticaria: An international Delphi survey
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- dc.contributor.author Krause, Karoline
- dc.contributor.author Bonnekoh, Hanna
- dc.contributor.author Jelden-Thurm, Jannis
- dc.contributor.author Asero, Riccardo
- dc.contributor.author Giménez Arnau, Anna Maria
- dc.contributor.author Cardoso, José C.
- dc.contributor.author Grattan, Clive
- dc.contributor.author Kocatürk, Emek
- dc.contributor.author Lippert, Undine
- dc.contributor.author Maurer, Marcus
- dc.contributor.author Metz, Martin
- dc.contributor.author Staubach, Petra
- dc.contributor.author Goncalo, Margarida
- dc.contributor.author Kolkhir, Pavel
- dc.date.accessioned 2024-05-03T05:53:43Z
- dc.date.available 2024-05-03T05:53:43Z
- dc.date.issued 2023
- dc.description.abstract Background: Urticarial vasculitis (UV) should be differentiated from chronic spontaneous urticaria (CSU) in patients initially presenting with recurrent wheals, although criteria for differential diagnosis remain ill-defined. Objectives: To set the goals, define criteria and unmet needs in UV diagnosis and differential diagnosis with CSU, and explore the possibility of coexistence of both diseases. Methods: Thirteen experts experienced in UV research participated in a Delphi survey of European Academy of Allergy and Clinical Immunology taskforce. This Delphi survey involved three rounds of anonymous responses to n = 32 questions with the aim to aggregate the experts' opinions and to achieve consensus. Urticaria specialists (n = 130, most from Urticaria Centers of Reference and Excellence) evaluated the consensus statements and recommendations in the fourth and final round. Results: The panel agreed that essential criteria to guide a skin biopsy in patients with recurrent wheals should include at least one of the following features: wheal duration >24 h, bruising/postinflammatory hyperpigmentation, and systemic symptoms. Leukocytoclasia and fibrin deposits were identified as a minimum set of UV histological criteria. As agreed by the panel members, CSU and normocomplementemic UV (NUV) may coexist in some patients. Conclusions: The use of established criteria for the diagnosis and differential diagnosis of UV in patients with recurrent wheals can help guide the diagnostic approach and prompt earlier treatment. Further studies should investigate whether CSU and NUV are different entities or part of a disease spectrum.
- dc.format.mimetype application/pdf
- dc.identifier.citation Krause K, Bonnekoh H, Jelden-Thurm J, Asero R, Gimenez-Arnau AM, Cardoso JC, et al. Differential diagnosis between urticarial vasculitis and chronic spontaneous urticaria: An international Delphi survey. Clin Transl Allergy. 2023 Oct;13(10):e12305. DOI: 10.1002/clt2.12305
- dc.identifier.doi http://dx.doi.org/10.1002/clt2.12305
- dc.identifier.issn 2045-7022
- dc.identifier.uri http://hdl.handle.net/10230/59976
- dc.language.iso eng
- dc.publisher Wiley
- dc.relation.ispartof Clin Transl Allergy. 2023 Oct;13(10):e12305
- dc.rights © 2023 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Chronic spontaneous urticaria
- dc.subject.keyword Chronic urticaria
- dc.subject.keyword Consensus
- dc.subject.keyword Diagnosis
- dc.subject.keyword Diagnostic criteria
- dc.subject.keyword Unmet needs
- dc.subject.keyword Urticarial vasculitis
- dc.title Differential diagnosis between urticarial vasculitis and chronic spontaneous urticaria: An international Delphi survey
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion