In acute urticaria, the usage and benefits of corticosteroids are quite controversial. The objective of this study was to determine the factors which are related with relapses in patients with acute urticaria. A retrospective observational study was conducted comprising all patients with acute urticaria who had visited the angioedema reference center of Academic Public Hospitals, Saint-Antoine in Paris between January 2015 and June 2017. A diagnosis of acute urticaria in an adult patient was the study inclusion criterion. The urticaria was spontaneous. The primary result was relapse on the 7th day and the secondary result was relapse at sixth week. In all, 184 patients with a 1st episode of acute urticaria were also included. Many were female patients (66%) with a mean age of 42 ± 16 years.

Corticosteroid administration for acute urticaria treatment was used in 102 (55%) patients. In total, 85 (46%) patients had relapses after less than 7 days while 168 (91%) patients had relapses after more than 6 weeks.

The rate of corticosteroid administration was significantly higher in cases of relapse after less than 7 days in univariate analysis. There was no difference seen in relapse rates after more than 6 weeks. The independent factor related with relapses after less than 7 days was the administration of corticosteroids as treatment of acute urticaria in the multivariate analysis.

Thus, the incidence of corticosteroid administration for patients with acute urticaria was very high. An independent risk factor related with relapses after less than 7 days was corticosteroid administration.

Source: Maillet F, Wolff D, Soria A, et al. Factors associated with relapses among patients treated for acute urticaria. J Dermatol. 2019;46(5):383-388. doi:10.1111/1346-8138.14830