Chronic spontaneous urticaria (CSU) is a common but poorly recognised skin condition affecting children and adults with an estimated prevalence of 1%. 1 It is characterised by unpredictable eruptions of itchy hives. Swelling of the skin or mucous membranes. These are known as angioedema is seen in approximately half of all cases. CSU is distressing for patients. It is associated with markedly impaired quality of life and psychological comorbidity. 2,3 This often neglected disorder has higher point prevalence in females. 4
Mast cell degranulation in CSU is multifactorial. Novel mechanisms at play include ‘autoallergy’ whereby IgE is directed against an element of self. Or by autoimmunity whereby IgG is directed against IgE or its receptor. 5 Our improved understanding of underlying pathology has helped us to differentiate this condition from other allergic diseases.
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