Aeroallergen sensitization in chronic spontaneous urticaria

To investigate the prevalence and distribution of aeroallergen sensitization in adult patients with chronic spontaneous urticaria (CSU), compared to a control group with allergic rhinitis (AR).

This retrospective cross-sectional study included 158 CSU and 166 AR patients examined between October 15, 2023, and July 1, 2025. Demographics, clinical features, skin prick test (SPT) results for common aeroallergens (house dust mites, pollens, molds, animal danders), and hematological markers (e.g., basophil/eosinophil counts, total IgE) were examined.

The CSU group was significantly older than controls (p<0.001), and female sex was similarly dominant in both groups (p=0.296). Aeroallergen sensitization was less frequent in CSU (39.24%) than AR (100%; p<0.001), with house dust mite (20.89% vs. 43.98%; p<0.001) and pollen (11.39% vs. 34.94%; p<0.001) detected as the primary allergens. Multiple sensitizations were also less common in the CSU group (5.06% vs. 21.08%; p<0.001). In terms of comorbidities, asthma was rarer among individuals with CSU (0.63% vs. 14.46%; p<0.001). Basophil (p<0.001) and eosinophil counts (p<0.001) were significantly lower in CSU, while total IgE levels were similar but trended lower in CSU (p=0.159).

Aeroallergen sensitization is less prevalent in CSU than AR, suggesting limited atopic involvement in this population, in contrast to several studies in the literature. Optimizing CSU management in this context will necessitate accurate assessment of sensitization profiles, since atopic characteristics appear to be heterogeneous.