The EAACI/GA(2)LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update

Abstract

This guideline is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2)LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. the life-time prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. in addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). ; Charite, Allergy Ctr Charite, Dept Dermatol & Allergy, D-10117 Berlin, Germany ; Med Univ Graz, Dept Dermatol, Graz, Austria ; Clin San Carlo, Allergy Clin, Paderno Dugnano, MI, Italy ; Univ Southern Denmark, Odense Univ Hosp, Dept Dermatol & Allergy Ctr, Odense, Denmark ; Med Univ Silesia, Allergol & Clin Immunol Katowice, Dept Internal Dis, Zabrze, Poland ; Univ Genoa, IRCCS AOU SanMartino, Genoa, Italy ; Universidade Federal de São Paulo, Dept Clin Immunol & Allergy, São Paulo, Brazil ; Univ Autonoma Barcelona, Hosp Mar Parc Salut Mar, E-08193 Barcelona, Spain ; Dr DY Patil Med Coll & Hosp, Dept Dermatol, Navi Mumbai, India ; Fac Med, Dermatol Clin, Coimbra, Portugal ; Univ Hosp, Coimbra, Portugal ; Guys & St Thomas Hosp NHS Fdn Trust, St Johns Inst Dermatol, London, England ; Ctr Appl Res Allergy Quebec, Quebec City, PQ, Canada ; Hiroshima Univ, Inst Biomed & Hlth Sci, Dept Dermatol, Hiroshima, Japan ; Med Univ S Carolina, Dept Med, Div Pulm & Crit Care Med, Charleston, SC USA ; Hannover Med Sch, Dept Dermatol & Allergy, Hannover, Germany ; Pantai Hosp Kuala Lumpur, Dept Paediat, Kuala Lumpur, Malaysia ; Univ Hosp Tenon, Dept Dermatol & Allergy, Paris, France ; Johns Hopkins Asthma & Allergy Ctr, Baltimore, MD USA ; Ctr Medicodocente Trinidad, Allergy & Clin Immunol Dept, Caracas, Venezuela ; Univ Hosp, Dept Dermatol, Allergy Unit, Zurich, Switzerland ; Univ Manitoba, Dept Pediat & Child Hlth, Winnipeg, MB R3T 2N2, Canada ; Univ Manitoba, Dept Immunol, Winnipeg, MB, Canada ; Univ Med Ctr Mainz, Dept Dermatol, Mainz, Germany ; Univ Toronto, Div Allergy & Clin Immunol, Toronto, ON, Canada ; Technion, Fac Med, Bnai Zion Med Ctr, Haifa, Israel ; Univ Bari, Dept Biomed Sci & Human Oncol, Unit Dermatol & Venereol, Bari, Italy ; Peking Univ, Hosp 1, Dept Dermatol, Beijing 100871, Peoples R China ; Universidade Federal de São Paulo, Dept Clin Immunol & Allergy, São Paulo, Brazil ; Web of Science