Dr. Sachin Varma Answers FAQ's on Chronic Spontaneous Urticaria
What is Chronic Spontaneous Urticaria or CSU?
Chronic spontaneous urticaria (CSU) is a serious, chronic, and distressing skin condition that causes red, swollen, itchy and sometimes painful hives or welts on the skin. Globally, at any given time, the prevalence of CSU is anywhere between the range of 0.5% to 1%. The skin condition is diagnosed as chronic when the symptoms spontaneously present itself on the skin and reoccur daily for at least six weeks. It is described as a spontaneous urticaria when the symptoms are not triggered by any known or identified external factor.
What is the cause of Chronic Spontaneous Urticaria or CSU?
The causes of chronic spontaneous urticaria or CSU are plenty and include anything from chronic infections such as hepatitis B and C, EBV, herpes simplex, Helicobacter pylori, or parasites. Sometimes, autoimmune and connective tissue diseases such as systemic lupus erythematosus, rheumatoid arthritis, and dermatomyositis can also be the cause of CSU. Endocrine disorders like Hashimoto thyroiditis and Graves' disease and hormonal therapies like oral contraceptives can trigger CSU.
Malignancies, in particular lymphoproliferative disorders, multiple myeloma, and other gammopathies are also some of the factors that cause chronic spontaneous urticaria. Therefore, if you see any symptoms of this disease, you should immediately consult an expert dermatologist for further treatment and diagnosis.
Who is at risk for developing this disease?
While chronic spontaneous urticaria can affect both men and women, women are twice as prone as men to be diagnosed with the skin disease. You will find that most people first develop the symptoms of CSU between the ages of 20 and 40. According to certain reports and studies, chronic urticaria is more recurring in women, up to 70%.
What are the symptoms and complications of CSU?
There is no distinct external trigger for chronic spontaneous urticaria but there is a possibility that the autoimmune systems play a role here. If you find red hives or welts on your skin, constant itching, deep tissue swelling - all of it occurring spontaneously and persistent for six weeks or more, there is a good chance that you have CSU.
Complications are plenty and can affect the way you conduct yourself daily. While it is not proven that all of these complications affect everyone with CSU, they are more than likely to affect most individuals. Sleep deprivation, lack of energy, anxiety, depression, and social isolation can be some of the after-effects of CSU. To ensure you come out of it, it is essential that you get the right help. You should get in touch with an expert dermatologist as soon as you see the symptoms.
What is the optimal therapeutic approach to treat this disease?
The foremost approach for patients with chronic urticaria is the elimination of the eliciting stimulus. This could include foods, medications, and also contact allergens. However, complete elimination is unfortunately not possible for majority of patients with CSU since the precise stimulus is usually unknown. Therefore, the optimal treatment approach should aim at complete symptom control, as early as possible. Care should be taken to ensure the treatment is safe and improves patients' quality of life while also reducing the duration of the skin disease.
What are the treatment options available for Chronic Spontaneous Urticaria?
Currently, antihistamines are the most preferred treatment or the first line of therapy for chronic spontaneous urticaria. Depending on the patients' response, second and third line of therapy are suggested with higher dosages and combination drugs. There are also cases when the symptoms remain uncontrolled even after increasing the dosage of antihistamines, which is when another treatment option, i.e. corticosteroids are used. It is used only in extreme cases.