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Some epidemiological studies and case reports suggest that internal parasite infections (<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>) can cause <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content>. Here, we provide a systematic overview of published findings on the prevalence and relevance of <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content> and we discuss possible pathomechanisms. The prevalence of <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content> was investigated by 39 independent studies and comorbidity reportedly ranged from 0 to 75.4% (two\u2010thirds of these studies reported infection rates of 10% or less). The prevalence of <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> in adult and pediatric <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content> patients ranged from 0% to 75.4% and from 0% to 37.8%, respectively. <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content> patients were more often diagnosed with protozoa and had a significantly higher risk of toxocariasis seropositivity and <jats:italic>Anisakis simplex<\/jats:italic> sensitization when compared to healthy controls. Patients with chronic urticaria more frequently had seropositivity of fasciolosis, <jats:italic>Anisakis simplex<\/jats:italic> sensitization, and the presence of <jats:italic>Blastocystis hominis<\/jats:italic> allele 34 (<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>3) as compared with control subjects. In 21 studies, efficacy of treatment with antiparasitic drugs ranged from 0 to 100% (35.7% of 269 <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content> patients benefitted). In 9 (42.8%) of 21 studies, more than 50% of efficacy was observed. The reported rate of urticaria comorbidity in <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> patients in 18 independent studies is 1\u201366.7%. Urticaria including <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content> might be a quite common symptom of strongyloidiasis and blastocystosis. Pathogenic mechanisms in <jats:styled-content style=\"fixed-case\">CSU<\/jats:styled-content> due to <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> may include specific IgE, Th2 cytokine skewing, eosinophils, activation of the complement, and the coagulation systems.<\/jats:p>","DOI":"10.1111\/all.12818","type":"journal-article","created":{"date-parts":[[2015,12,9]],"date-time":"2015-12-09T17:59:38Z","timestamp":1449683978000},"page":"308-322","source":"Crossref","is-referenced-by-count":103,"title":["Chronic spontaneous urticaria and internal parasites \u2013 a systematic review"],"prefix":"10.1111","volume":"71","author":[{"given":"P.","family":"Kolkhir","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Sechenov First Moscow State Medical University Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Balakirski","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital of Aachen Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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