Chronic urticaria in primary health care: how aware are family physicians?

Chronic urticaria (CU) is a common dermatologic condition that significantly affects quality of life and is frequently first managed in primary care. This study aimed to evaluate the awareness, knowledge, and clinical practices of primary care physicians (PCPs) regarding CU management.

This cross-sectional study was conducted among PCPs working across Turkey. Data were collected through an online questionnaire distributed nationwide. The questionnaire assessed demographic characteristics, knowledge of CU diagnosis and treatment, and clinical attitudes and practices. Total knowledge scores (TKS) were calculated according to correct responses.

A total of 274 physicians participated in the study; 55.1% were female, and the mean age was 38.2 ± 9.2 years. Most participants reported recognizing urticarial lesions (82.5%) and correctly identified antihistamines as first-line treatment (90.1%). However, only 42.3% correctly distinguished acute from chronic and identified dose escalation of second-generation antihistamines as the recommended next treatment step in unresponsive cases. Awareness and use of omalizumab were limited (33.2%). Routine skin prick testing and pseudoallergen-restricted diets were still commonly recommended. Specialists had significantly higher TKS scores than general practitioners and resident physicians (p = 0.005). Professional experience was negatively associated with TKS (β = -0.175, p = 0.005). Although most physicians supported lifestyle modification and psychiatric referral when necessary, 65.0% reported feeling inadequate in the follow-up of CU patients.

Primary care physicians demonstrated a basic level of knowledge regarding CU; however, important gaps remain, particularly in treatment escalation, follow-up strategies, and appropriate use of diagnostic tests. These findings highlight the need for targeted educational interventions and guideline-based training to improve CU management in primary care.