WORLDWIDE survey shows chronic urticaria prevalence estimates differ, and physicians may underestimate sleep, activity, and impact.
Chronic Urticaria Prevalence Estimates Diverge
Chronic urticaria (CU) is a mast cell mediated skin disease that can persist for weeks to months and disrupt daily life. In the UCARE CU-PAPER study, researchers surveyed physicians worldwide to understand how clinicians estimate CU prevalence and clinical impact, then compared those perceptions with published literature.
A cross-sectional questionnaire was distributed through the Urticaria Centers of Reference and Excellence (UCARE) network to 198 centers and forwarded to general practitioners. Overall, 234 physicians from 46 countries completed the survey. Participants were 54.3% female, with a median age of 48.5 years.
Chronic Urticaria Burden Centers on Sleep and Mental Status
Physicians reported that chronic spontaneous urticaria (CSU) typically begins around age 30, while chronic inducible urticaria (CIndU) begins around age 25. Median estimated prevalence of chronic urticaria was 2.5% in adults and 1.0% in pediatric patients.
When asked which parts of life are most affected, physicians pointed to sleep as the leading domain for CSU, physical activities for CIndU, and mental status as a major concern for both CSU and CIndU. These estimates underscore that the burden of chronic urticaria extends well beyond visible wheals and itch.
UCARE Versus Non UCARE Views in Primary Care
Responses differed meaningfully by practice setting. Compared with physicians working at UCARE sites, non UCARE physicians reported a higher median estimate of adult CU prevalence (4.5% versus 2.0%). Non UCARE respondents also estimated a lower median proportion of CSU among CU patients (60.0% versus 70.0%), and a lower share of CSU cases with severe impact (30.0% versus 50.0%). UCARE physicians also reported greater confidence in their prevalence and burden estimates.
Why Estimation Gaps Matter
Overall, physician perceptions generally aligned with literature, but the authors warn that non UCARE clinicians may overestimate prevalence while underestimating disease burden. The study highlights an ongoing need for chronic urticaria awareness and education, particularly in settings where most patients are first assessed, to support timely recognition of impact and more effective management.
Reference: Kern BM et al. Physician estimation of the prevalence and clinical impact of chronic urticaria: results of the global, multicenter UCARE CU-PAPER study. Front Allergy. 2026;6:1732893.
