Relationship of NSAID-hypersensitivity and Chronic Urticaria. Clinical Implications

Sánchez, J., Caraballo, A. & Diez, S.  Curr Treat Options Allergy 13, 15 (2026). https://doi.org/10.1007/s40521-026-00419-1

Abstract

Purpose of Review

In this review, we conducted a literature search seeking to better understand the relationship between chronic spontaneous urticaria (CSU) and nonsteroidal anti-inflammatory drugs hypersensitivity (NSAID-hypersensitivity) associated with NSAID exacerbated cutaneous diseases (NECD), its clinical course, and gain insight into the answers to clinical questions.

Recent Findings

CSU and NSAID cutaneous reaction interaction

The coexistence of CSU and NSAID-hypersensitivity specially NECD has been well documented. However, many questions remain unanswered: Why does this coexistence occur?

Which condition appears first? If CSU is controlled, can the patient tolerate NSAIDs? If urticaria disappears, does NSAID-hypersensitivity remit as well?

Summary

Although limited, current evidence shed light on potential immunological mechanisms and clinical course of these diseases and allow for the proposal of possible management algorithms that consider NSAID-hypersensitivity remission in urticaria.

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