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Chronic Urticaria in Elderly-New Insights.

Rasha Khaliliya1, Ronit Confino-Cohen1, Idit Lachover-Roth1

  • 1Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

The Journal of Allergy and Clinical Immunology. in Practice
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PubMed
Summary

Chronic urticaria (CU) in older adults presents unique features like higher rates of autoimmunity and malignancy. Early specialist referral significantly improves outcomes for elderly patients with CU.

Keywords:
AngioedemaChronic urticariaElderly

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Area of Science:

  • Geriatric Medicine
  • Dermatology
  • Immunology

Background:

  • Chronic urticaria (CU) is common, but its presentation and management in older adults (≥65 years) are understudied.
  • Unique demographic and clinical profiles of medical conditions are observed in the elderly population.

Purpose of the Study:

  • To delineate the demographics, clinical characteristics, and comorbidities of elderly patients diagnosed with chronic urticaria.
  • To evaluate the outcomes and impact of specialist intervention for chronic urticaria in older adults.

Main Methods:

  • Retrospective, single-center study analyzing electronic medical records of patients aged 65 years and above diagnosed with CU.
  • Inclusion criteria focused on patients diagnosed with CU, distinguishing between chronic spontaneous urticaria (CSU) and chronic inducible urticaria.

Main Results:

  • 181 elderly patients (166 CSU, 15 chronic inducible urticaria) were identified; most CSU patients were female (72%).
  • Key comorbidities included autoimmunity (22.9%), malignancy (13.8%), and atopy (11.5%).
  • Specialist referral was associated with significant reductions in systemic steroid use, hospitalizations, and emergency/primary physician visits.

Conclusions:

  • Elderly patients with CU exhibit distinct characteristics, notably a higher prevalence of autoimmunity and malignancy compared to atopy.
  • Increased awareness of CU in the elderly population and timely referral to allergy specialists are crucial for improving patient outcomes.