Natural course and prognostic factors of chronic urticaria in Korean children: A single center experience

Background: Chronic urticaria (CU) has an adverse effect on academic achievement and psychosocial development in children. Objective: We aimed to investigate the natural course of CU and to identify relevant factors associated with a poor CU prognosis in Korean children. Methods: We retrospectively analyzed 253 children with episodes of wheals or angioedema at least 3 times a week that persisted for at least 6 weeks. Clinical data and laboratory results were obtained from medical records and parental telephone interviews. Kaplan-Meier survival analysis and log rank tests were performed to assess the median time to remission of CU and prognostic factors. Results: Median age at onset was 5.0 years (interquartile range, 2.5-9.1) and median follow-up period was 7.6 months (interquartile range, 3.9-19.7). Of 253 patients, 68.8% had chronic inducible urticaria and 31.2% had chronic spontaneous urticaria. Physical urticaria was the only cause of chronic inducible urticaria, and the most common physical urticaria was dermographism. Median duration to remission of CU was 10.2 months (95% confidence intervals, 8.0-12.5 months). Kaplan-Meier analysis revealed that 33.4%, 53.0%, and 71.2% of children were in remission at 6, 12, and 24 months, respectively, after the onset of CU. The presence of allergic sensitization was significantly associated with a poor CU prognosis in univariable and multivariable analyses (P = 0.010 and P = 0.014, respectively). Conclusion: Half of children with CU were in remission 10.2 months after onset. Allergic sensitization was a risk factor associated with longer duration CU.