The EAACI/GA2LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update

TLDR

Urticaria is a frequent mast‑cell driven disease with a lifetime prevalence of ~20 % for acute forms, and chronic spontaneous urticaria impairs quality of life and work/school performance, making it a severe allergic disease; this guideline is a joint initiative of EAACI, GA(2)LEN, EDF, WAO and 21 national/international societies. The guideline aims to define and classify urticaria, incorporating recent insights into its causes and pathomechanisms, and to provide evidence‑based diagnostic and therapeutic recommendations for its subtypes. It was developed through a systematic literature review graded by GRADE and a structured consensus conference held in Berlin on 28–29 November 2012. The guideline received acknowledgment and acceptance from the European Union of Medical Specialists (UEMS).

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).