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Chronische Urtikaria

Prävalenz, Verlauf, Prognosefaktoren und Folgen

Chronic urticaria

Prevalence, course, prognostic factors and impact

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Zusammenfassung

Die chronische Urtikaria (CU) gehört zu den häufigsten Krankheitsbildern in der Dermatologie. Aktuelle Studien zeigen eine Punktprävalenz zwischen 0,5 und 1% in der Gesamtbevölkerung mit einem Übergewicht an Frauen. Prinzipiell können alle Altersgruppen und Bevölkerungsschichten betroffen sein. Allerdings gibt es eine Häufung in der 3. und 4. Lebensdekade. Nach Definition der aktuellen Leitlinien besteht eine chronische Urtikaria dann, wenn Quaddelbildung und/oderAngioödeme spontan und für länger als 6 Wochen auftreten. Epidemiologische Studien belegen, dass die Mehrheit der Betroffenen über Monate, oft Jahre, unter den Beschwerden leidet. Negativ auf die Dauer der Erkrankung scheinen sich das Vorkommen von Angioödemen, das zeitgleiche Bestehen einer physikalischen Urtikaria, Positivität im autologen Serumtest und eine hohe Krankheitsschwere auszuwirken. Studien zur Lebensqualität zeigen, dass CU-Patienten ähnlich stark unter der Erkrankung leiden wie Menschen mit einer ausgeprägten koronaren Herzkrankheit. Neben den rein körperlichen Symptomen erleben die Patienten auch Einschränkungen bei alltäglichen Tätigkeiten und im Sozialleben. Zudem ist der Schlaf oft stark beeinträchtigt, und die Patienten leiden überdurchschnittlich häufig an psychiatrischen Begleiterkrankungen. Um Missverständnisse und Frustration bei der Betreuung zu vermeiden, ist es wichtig, die Patienten mit ihrer Erkrankung in all ihren Dimensionen wahr- und ernst zu nehmen. Das Ziel der Therapie von CU-Patienten sollte es sein, komplette Beschwerdefreiheit zu erreichen.

Abstract

Chronic urticaria (CU) is one of the most frequent diseases in the field of dermatology. Recent studies have shown a point prevalence between 0.5 and 1% in the total population with a predominance of females. In general, all age groups and all classes of the population can be affected. An incidence peak has been found in the third and fourth decades. According to the current guidelines, CU is characterized by the spontaneous occurence of wheals and/or angioedema for more than 6 weeks. However, epidemiological studies have revealed that the majority of patients suffer for several months, or frequently years. Disease duration is likely to be longer in case of angioedema, a combination with physical urticaria, positivity in the autologous serum skin test (autoreactivity) and a high disease severity. Studies on the impairment of quality of life have been shown that many CU patients suffer as strong from their disease as patients with coronary artery disease. Apart from pure physical symptoms, patients experience restrictions in daily life activities and social life. In addition, sleep disturbances are common and CU patients frequently exhibit psychiatric comorbidities. To avoid frustration in care, it is important to perceive all different dimensions of CU that impact the patient’s life and to take the patients and their disease seriously. The aim of therapy should be to obtain total symptom control.

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Authors and Affiliations

  1. Klinik für Dermatologie, Venerologie und Allergologie, Allergie-Centrum-Charité, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    K. Weller, S. Altrichter, E. Ardelean, K. Krause, M. Magerl, M. Metz, F. Siebenhaar & M. Maurer

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  1. K. Weller
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  2. S. Altrichter
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  3. E. Ardelean
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  4. K. Krause
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  6. M. Metz
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  7. F. Siebenhaar
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  8. M. Maurer
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Weller, K., Altrichter, S., Ardelean, E. et al. Chronische Urtikaria. Hautarzt 61, 750–757 (2010). https://doi.org/10.1007/s00105-010-1933-8

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