Publication:

Patterns and management outcomes of urticaria in a tertiary hospital setting

Background Urticaria is a common pruritic wheal disorder, with or without angioedema, classified as acute or chronic. Chronic urticaria often recurs, impairs quality of life, and requires stepwise antihistamine-based treatment. However, local data on disease patterns and treatment outcomes in Bangladesh remain limited.

Methods This observational study was conducted at the Department of Dermatology and Venereology, Railway General Hospital, CRB, Chittagong, Bangladesh, from January to December 2025. A total of 125 consecutive patients with urticaria were enrolled. Cases were classified as acute or chronic, with chronic urticaria further categorized into chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU), or mixed. Disease severity was assessed using UAS7. Treatment patterns and 4-week outcomes were recorded.

Results Of the patients, 58.4% were female and 51.2% were aged 20-39 years. Chronic urticaria accounted for 63.2% of cases, predominantly CSU (55.2%). Angioedema occurred in 30.4%, and generalized wheals in 73.6%. Triggers were unidentified in 32.0%, while stress (41.6%), foods (26.4%), drugs (22.4%), and infections (19.2%) were common. Atopy was present in 39.2% and thyroid disease in 12.0%. Moderate-to-severe UAS7 was observed in 54.4%, with 47.2% reporting sleep disturbance. All patients received second-generation antihistamines; 44.8% required up-dosing and 32.8% received short-term steroids. At 4 weeks (92.0% follow-up), 64.4% achieved complete or well-controlled status, 15.7% relapsed, and 12.0% reported adverse effects.

Conclusions Chronic urticaria, mainly CSU, predominated with moderate-to-severe activity at presentation. Most patients achieved symptom control within 4 weeks using stepwise antihistamine therapy, though up-dosing was frequently required and some remained uncontrolled or relapsed.