The burden of chronic urticaria in Portuguese patients: a patient-reported observational study

Chronic urticaria (CU) is characterised by the recurrent appearance of wheals, angioedema, or both, persisting for more than six weeks. Despite its recognised impact on quality of life (QoL), the health and social burden of CU remains poorly characterised in Portugal. This cross-sectional, patient-reported study characterised CU in Portuguese patients recruited through APUrtica, the national patient association, and assessed its personal and social impact. Because more engaged and more severely affected patients were over-represented, estimates were post-stratified by disease severity using the AWARE distribution. The mean Urticaria Activity Score (UAS7) was 12.8 (SD 13.6), the mean Dermatology Life Quality Index (DLQI) was 9.0 (SD 6.3), and the mean time to diagnosis was 2.7 years (SD 4.0). Angioedema accompanied CU in 68.7% of patients and 47.0% reported comorbid allergic conditions. Anxiety (60.6%), frustration (55.6%), and sleep difficulties (35.9%) were common. Patients with severe disease had higher DLQI scores than mild-to-moderate patients (12.2 vs. 8.1, p = 0.001). Antihistamines were the most widely used treatment (74.8%), and biologicals were used by 31.3%. In this self-selected sample, these exploratory findings indicate a substantial, multidimensional burden and generate hypotheses about diagnostic delay, psychological impact, and access to care.