Chronic urticaria and hormones: Is there a link?

Area of Science:

• Dermatology
• Immunology
• Endocrinology

Background:

• Limited data exists on sex hormone influence in chronic urticaria (CU), unlike its established role in bradykinin angioedema (AE).
• Understanding hormonal impacts is crucial for managing CU, particularly in women.

Purpose of the Study:

• To investigate the effect of sex hormones and reproductive factors on symptoms in women with various forms of chronic urticaria (CU).
• This includes chronic spontaneous urticaria (CSU), isolated histaminic AE, and inducible urticaria (IU).

Main Methods:

• A cross-sectional study involved interviewing 200 women with CU across nine French centers.
• Dermatologists used an online questionnaire to assess the impact of reproductive factors (puberty, contraception, pregnancy) and hormonal treatments on CU course.

Main Results:

• Puberty did not significantly influence CU onset or course for most women.
• Pregnancy worsened CU symptoms in four out of 16 women.
• Hormonal contraception aggravated CU in a minority (10%) of women, primarily those with CSU.
• Isolated histaminic AE showed no dependency on female sex hormones.

Conclusions:

• Sex hormones appear to trigger CU symptoms in a small subset of women.
• Considering hormonal factors is important for optimizing patient management strategies for chronic urticaria.