Natural course of physical and chronic urticaria and angioedema in 220 patients

BACKGROUND: Information about spontaneous remission of chronic urticaria is limited. OBJECTIVE: To investigate the natural course of urticaria, we followed up 220 adults in a prospective study. METHODS: Patients were followed up for 1 to 3 years to evaluate interventions, to detect latent causes, and to study the natural course of urticaria. The diagnosis was made by detailed history-taking as well as laboratory and provocation tests. RESULTS: Thirty-five percent of all patients were free of symptoms after 1 year. In 28.9% of patients, symptoms had decreased. Spontaneous remission occurred in 47.4% of the patients in whom no cause of their urticaria and/or angioedema could be identified and in only 16.4% of the patients with physical urticaria. A cause could be identified in 53.1% of the patients. Thirty-six percent of the patients had idiopathic urticaria. Chronic idiopathic urticaria combined with physical urticaria occurred in 10.9%. CONCLUSION: In general, the prognosis for spontaneous remission is reasonable, with the exception of the subgroup (33.2%) with physical urticaria