Clinico-epidemiological profile and assessment of quality of life of patients with chronic spontaneous urticaria from tertiary care hospital: a cross-sectional study

Abstract

Urticaria is a severely pruritic and debilitating skin disorder having a profound impact on the quality of life. It can be classified as acute and chronic, which can be further classified as chronic spontaneous (CSU) and chronic inducible urticaria (CIndU). There is a notable scarcity of studies investigating the clinico-epidemiological profile of CSU and its impact on the quality of life. Objectives: This study was designed to investigate the clinico-epidemiological profile of patients with CSU, evaluate the severity of CSU using the urticaria activity score (UAS) and determine the impact of the illness on the quality of life using the dermatological quality of life index (DLQI). Materials and Methods: This observational cross-sectional study was conducted at the Department of Dermatology of a tertiary care hospital over a period of 1 year and included 120 patients with CSU. All data was collected using a pre-structured proforma. Results: The average age of the patients was 39.43 ± 12.26 years. 42 (35%) patients were males and 78 (65%) – females. The disease duration at presentation ranged from 2-120 months (mean of 17.76 ± 18.25). Hypertension and diabetes mellitus were the most prevalent comorbidities followed by hypothyroidism, depression, hyperthyroidism and bronchial asthma. Angio-edema was seen in 22 (18.33%) whereas atopy was associated in 18 patients (15.00%). The average UAS7 was 28.87 ± 7.26. Out of 120 patients, 46 (38.33%) were of moderate urticaria (UAS7 16-27) and 74 (61.67%) – severe urticaria (UAS7 28-42). Higher mean age at presentation (41.95 vs 35.39 years), higher proportion of females (66.21 vs 63.04%), longer disease duration at presentation (18.09 vs 17.22 months), higher UAS7 (33.31 vs 21.72) and higher prevalence of atopy and angioedema were seen among the severe compared to the moderate patient group. The average DLQI of patients with severe urticaria was significantly higher (18.61 ± 3.64) compared to the moderate group (12.57 ± 2.90), indicating a more severe impairment of routine activities and poorer quality of life in the severe urticaria group.