In June 2014 a group of dermatologists met in Madrid to reflect on our specialty's role in managing a highly prevalent skin disease: chronic urticaria. The reflections were motivated by the advances in the diagnosis and therapeutic management of this condition that have emerged over the last 5 years. Patients with chronic urticaria develop wheals, angioedema, or both almost daily, and their disease flares are accompanied by specifically cutaneous symptoms such as itching.
Renewed interest in this chronic condition, which must always have been a concern for dermatologists, grew out of several scientific and societal events related to urticaria that occurred in 2014. For example, the first ever International Urticaria Day was declared. As a result of this attention, urticaria is now regaining the place it merits on the basis of prevalence, scientific interest, and socioeconomic impact. Guidelines for clinical management have recently been updated,1 and our understanding of the pathogenesis of this disease has advanced. Patient organizations have increased societal demand for greater attention to urticaria, particularly for the approval of safer and more effective therapies. The promise that patients can derive benefits from improved management of a condition that often leads to social isolation gives us, as specialists, an occasion to improve the care of both the skin and the patient. This opinion paper is the outcome of the group's reflections. The aim of the paper is to encourage dermatologists to improve their knowledge of chronic urticaria and its management in routine practice and to consider the possibility of creating a referral center. In the interest of linking national and international discourse on this disease to the dermatologist's experience of it in clinical practice, the paper gives an overview of advances in the diagnosis and management of chronic urticaria.
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