{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:20:46Z","timestamp":1790263246151,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Chronic urticaria (CU) diagnosis includes the patient's clinical history and physical examination. However, atypical presentations or misdiagnosis can lead to diagnostic delay (DD).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The impact and contributing factors of DD in CU are unknown and were assessed in the present study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analysed data from CU adult patients from the international, multicenter Chronic Urticaria Registry (CURE).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 4332 CU patients, 61% had standalone chronic spontaneous urticaria (sCSU), 18% had \u2265\u20091 form of chronic inducible urticaria (CIndU), and 21% had a combination of both (CSU\u2009+\u2009CIndU). Diagnosis of CU was delayed in 24% of patients by at least 1\u2009year. CIndU patients showed a longer DD compared to those with sCSU or CSU\u2009+\u2009CIndU (median, [IQR]: 4, [0\u201322] vs. 1, [0\u20136] vs. 2, [0\u20139] months,\n p<\/jats:italic>\n \u2009<\u20090.001). Among CIndU patients, symptomatic dermographism (\n n<\/jats:italic>\n \u2009=\u2009264) and cholinergic urticaria (\n n<\/jats:italic>\n \u2009=\u2009103) patients had the longest DD compared to all other CIndU subgroups (median: 4\u2009months,\n p<\/jats:italic>\n \u2009=\u20090.005 for both). In CIndU patients, a longer DD was associated with having an additional CIndU (OR: 12.8,\n p<\/jats:italic>\n \u2009=\u20090.03), younger age, comorbidities, lower disease control, and lack of second\u2010generation H\n 1<\/jats:sub>\n \u2010antihistamine treatment. In CSU patients, a DD of \u2265\u20096\u2009months was associated with lower CSU activity (median weekly Urticaria Activity Score of 14 vs. 21,\n p<\/jats:italic>\n \u2009=\u20090.02) compared to that of DD <\u20096\u2009months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Diagnosis of CU is delayed in one out of four patients. Greater awareness of the guideline\u2010recommended CU classification, clinical presentation, and diagnostic work\u2010up can facilitate CU diagnosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cea.70215","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:47:06Z","timestamp":1768384026000},"page":"411-420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnostic Delay in Patients With Chronic Urticaria: Results From the Chronic Urticaria Registry (\n CURE<\/scp>\n )"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3386-4502","authenticated-orcid":false,"given":"Melba","family":"Mu\u00f1oz","sequence":"first","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"},{"name":"School of Medicine Lebanese American University Byblos Lebanon"},{"name":"Institut National de Sant\u00e9 Publique d'\u00c9pid\u00e9miologie Clinique et de Toxicologie\u2010Liban (INSPECT\u2010LB) Beirut Lebanon"},{"name":"Department of Primary Care and Population Health University of Nicosia Medical School Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Zajac","sequence":"additional","affiliation":[{"name":"European Center for Diagnosis and Treatment of Urticaria Medical University of Silesia Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria","family":"Fomina","sequence":"additional","affiliation":[{"name":"Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department Moscow Russian Federation"},{"name":"Department of Clinical Immunology and Allergology I.M. Sechenov First Moscow State Medical University (Sechenov University) Moscow Russian Federation"},{"name":"Department of Pulmonology Astana Medical University Astana Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Kovalkova","sequence":"additional","affiliation":[{"name":"Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bobrikova","sequence":"additional","affiliation":[{"name":"Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerelma","family":"Andrenova","sequence":"additional","affiliation":[{"name":"Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-0070","authenticated-orcid":false,"given":"Alicja","family":"Kasperska\u2010Zaj\u0105c","sequence":"additional","affiliation":[{"name":"European Center for Diagnosis and Treatment of Urticaria Medical University of Silesia Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Aulenbacher","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie Shirin","family":"Herzog","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Maria","family":"Grekowitz","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Buttgereit","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin Humboldt\u2010Universit\u00e4t zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Gim\u00e9nez\u2010Arnau","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital del Mar Research Institute, Universitat Pompeu Fabra Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1303-2422","authenticated-orcid":false,"given":"Nidia","family":"Planella\u2010Fontanillas","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital del Mar Research Institute, Universitat Pompeu Fabra Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pesque","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital del Mar Research 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Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farahzad Jabbari","family":"Azad","sequence":"additional","affiliation":[{"name":"Allergy Research Center Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raisa","family":"Meshkova","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Allergology Smolensk State Medical University Smolensk Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Savchenko","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Allergology Smolensk State Medical University Smolensk Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Makris","sequence":"additional","affiliation":[{"name":"Allergy Unit \u201cD. Kalogeromitros\u201d, 2nd Department, Dermatology and Venereology National and Kapodistrian University of Athens, \u201cAttikon\u201d University Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niki","family":"Papapostolou","sequence":"additional","affiliation":[{"name":"Allergy Unit \u201cD. 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A.","family":"van Doorn","sequence":"additional","affiliation":[{"name":"Department of Dermatology Erasmus MC Rotterdam the Netherlands"},{"name":"Centre for Human Drug Research Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Asero","sequence":"additional","affiliation":[{"name":"Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"Grattan","sequence":"additional","affiliation":[{"name":"Guy's Hospital, St John's Institute of Dermatology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-300X","authenticated-orcid":false,"given":"Simon Francis","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital Copenhagen Denmark"},{"name":"Department of Biomedical Sciences University of Copenhagen Copenhagen 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