Analysis of primary treatment and prognosis of spontaneous urticaria.

Background: The prognosis of spontaneous urticaria in association with early treatment remains unclear. In this study, we retrospectively studied the prognosis of acute spontaneous urticaria in relation to age and treatments in a local clinic of dermatology.

Methods: Out of 5000 patients who visited an office dermatology clinic, clinical records of patients with spontaneous urticaria were extracted. Their prognosis and the relation to age and treatments were analyzed by the Kaplan-Meier method and generalized Wilcoxon test.

Results: Among 386 patients diagnosed with spontaneous urticaria, 284 patients (73.6%) began treatments within a week after the onset. Their non-remission rates after one week, four weeks and one year from the onset were 26.8%, 15.0% and 6.7%, respectively. The non-remission rates of patients who were 20-years-old or younger by one year after the onset of urticaria, were significantly lower than those of patients older than 20-years-old. No apparent relationship between remission rates and sex or the use of steroids was detected. However, the non-remission rates of urticaria treated with a standard dose of antihistamine were lower than that treated with additional medications.

Conclusions: Most patients who began treatments within one week from the onset remitted quickly. However approximately 7% of them continued to suffer from symptoms for more than a year. Such prolongation tended to be seen among patients who required other medications in addition to a standard dose of antihistamine.