The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria
Open accessAbstract
This update and revision of the international guideline for urticaria was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA²LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), the European Dermatology Forum (EDF; EuroGuiDerm), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology with the participation of 64 delegates of 50 national and international societies and from 31 countries. The consensus conference was held on 3 December 2020. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell–driven disease that presents with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous or inducible urticaria is disabling, impairs quality of life, and affects performance at work and school. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert‐guided and evidence‐based diagnostic and therapeutic approaches for the different subtypes of urticaria.
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Guideline-based treatment of urticaria includes a specific escalation algorithm to achieve complete symptom control.
“For this reason, the guideline-based treatment of urticaria includes a specific escalation algorithm to achieve complete symptom control [4].”
From Acceptance and perceived usefulness of digital health services in the management of chronic urticaria: a survey of patients and physicians (2025) · cites this paper as [4]
Angioedema occurs in up to 40% of cases of chronic urticaria.
“Angioedema also occurs in up to 40% of cases [1–4].”
From Acceptance and perceived usefulness of digital health services in the management of chronic urticaria: a survey of patients and physicians (2025) · cites this paper as [4]
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“Angioedema also occurs in up to 40% of cases [1–4].”
- Authors
- Zuberbier, T., Abdul Latiff, A. H., Abuzakouk, M., Aquilina, S., Asero, R., Baker, D., Ballmer‐Weber, B., Bangert, C., Ben‐Shoshan, M., Bernstein, J. A., Bindslev‐Jensen, C., Brockow, K., Brzoza, Z., Chong Neto, H. J., Church, M. K., Criado, P. R., Danilycheva, I. V., Dressler, C., Ensina, L. F., Fonacier, L., Gaskins, M., Gáspár, K., Gelincik, A., Giménez‐Arnau, A., Godse, K., Gonçalo, M., Grattan, C., Grosber, M., Hamelmann, E., Hébert, J., Hide, M., Kaplan, A., Kapp, A., Kessel, A., Kocatürk, E., Kulthanan, K., Larenas‐Linnemann, D., Lauerma, A., Leslie, T. A., Magerl, M., Makris, M., Meshkova, R. Y., Metz, M., Micallef, D., Mortz, C. G., Nast, A., Oude‐Elberink, H., Pawankar, R., Pigatto, P. D., Ratti Sisa, H., Rojo Gutiérrez, M. I., Saini, S. S., Schmid‐Grendelmeier, P., Sekerel, B. E., Siebenhaar, F., Siiskonen, H., Soria, A., Staubach‐Renz, P., Stingeni, L., Sussman, G., Szegedi, A., Thomsen, S. F., Vadasz, Z., Vestergaard, C., Wedi, B., Zhao, Z., & Maurer, M.
- Affiliations
- Humboldt-Universität zu Berlin (DE)
- Allergy & Immunology Centre Pantai Hospital Kuala Lumpur Kuala Lumpur Malaysia
- Cleveland Clinic Abu Dhabi (AE)
- Mater Dei Hospital (MT)
- Ambulatorio di Allergologia Clinica San Carlo Paderno Dugnano (MI) Italy
- Baker Allergy Asthma and Dermatology Portland Oregon USA
- Clinic for Dermatology and Allergology Kantonsspital St. Gallen St. Gallen Switzerland
- Medical University of Vienna (AT)
- Montreal Children's Hospital (CA)
- University of Cincinnati (US)
- University of Southern Denmark (DK)
- Technical University of Munich (DE)
- University of Opole (PL)
- Division of Allergy and Immunology Department of Pediatrics Federal University of Paraná Curitiba Brazil
- Faculdade de Medicina do ABC (BR)
- Federal Medical-Biological Agency (RU)
- Division of Allergy Clinical Immunology and Rheumatology Department of Pediatrics Federal University of São Paulo São Paulo Brazil
- New York University (US)
- Division of Dermatological Allergology Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Division of Immunology and Allergic Diseases Department of Internal Medicine Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
- Universitat Autònoma de Barcelona (ES)
- DY Patil Deemed to be University (IN)
- Unidade Local de Saúde de Coimbra (PT)
- Guy's Hospital (GB)
- Vrije Universiteit Brussel (BE)
- Bielefeld University (DE)
- Centre hospitalier universitaire de Québec (CA)
- Hiroshima University (JP)
- Medical University of South Carolina (US)
- Medizinische Hochschule Hannover (DE)
- Technion – Israel Institute of Technology (IL)
- Koç University (TR)
- Siriraj Hospital (TH)
- Hospital Médica Sur (MX)
- University of Helsinki (FI)
- The Royal Free Hospital (GB)
- National and Kapodistrian University of Athens (GR)
- Smolensk State Medical University (RU)
- University of Groningen (NL)
- Nippon Medical School (JP)
- University of Milan (IT)
- Primera Cátedra de Clínica Médica Hospital de Clínicas de la Facultad de Ciencias Médicas‐Universidad Nacional de Asunción Asunción Paraguay
- Hospital Juárez de México Mexico City Mexico
- Johns Hopkins University (US)
- University Hospital Zurich (CH)
- Division of Pediatric Allergy and Asthma Hacettepe University Faculty of Medicine Ankara Turkey
- Kuopio University Hospital (FI)
- Department of Dermatology and Allergology Tenon Hospital APHP Sorbonne University and Cimi‐Paris Inserm 1135 Paris France
- Department of Dermatology University Medical Center Mainz Mainz Germany
- University of Perugia (IT)
- St. Michael's Hospital (CA)
- University of Debrecen (HU)
- University of Copenhagen (DK)
- Aarhus University Hospital (DK)
- Peking University First Hospital (CN)
- Corresponding author
- Zuberbier, Torsten
- ORCID
- Zuberbier, Torsten
- Abdul Latiff, Amir Hamzah
- Abuzakouk, Mohamed
- Asero, Riccardo
- Bangert, Christine
- Ben‐Shoshan, Moshe
- Bernstein, Jonathan A.
- Bindslev‐Jensen, Carsten
- Brockow, Knut
- Brzoza, Zenon
- Church, Martin K.
- Criado, Paulo R.
- Danilycheva, Inna V.
- Dressler, Corinna
- Fonacier, Luz
- Gaskins, Matthew
- Gelincik, Aslı
- Giménez‐Arnau, Ana
- Godse, Kiran
- Gonçalo, Margarida
- Grattan, Clive
- Grosber, Martine
- Hamelmann, Eckard
- Hide, Michihiro
- Kaplan, Allen
- Kapp, Alexander
- Kessel, Aharon
- Kocatürk, Emek
- Kulthanan, Kanokvalai
- Larenas‐Linnemann, Désirée
- Lauerma, Antti
- Magerl, Markus
- Makris, Michael
- Meshkova, Raisa Y.
- Metz, Martin
- Micallef, Daniel
- Mortz, Charlotte G.
- Nast, Alexander
- Pawankar, Ruby
- Pigatto, Paolo D.
- Ratti Sisa, Hector
- Saini, Sarbjit S.
- Schmid‐Grendelmeier, Peter
- Sekerel, Bulent E.
- Siebenhaar, Frank
- Siiskonen, Hanna
- Soria, Angele
- Stingeni, Luca
- Sussman, Gordon
- Szegedi, Andrea
- Thomsen, Simon Francis
- Vadasz, Zahava
- Vestergaard, Christian
- Wedi, Bettina
- Zhao, Zuotao
- Maurer, Marcus
- Venue
- Allergy
- Publisher
- Wiley
- Published
- 2021-10-20
- Volume
- 77
- Issue
- 3
- Pages
- 734-766
- ISSN
- 0105-4538 (ISSN-L)
- 1398-9995
- OpenAlex
- W3200862524
- Cited by
- 1,263
- References
- 2
- Citations by year
- 2026: 255 · 2025: 303 · 2024: 287 · 2023: 261 · 2022: 144 · 2021: 8 · 2013: 3
- FWCI
- 131.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Allergy (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by-nc)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- HAL (submittedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Digital Collections portal (Koç University) (submittedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion, other-oa)
- Publikationsdatenbank der Fraunhofer-Gesellschaft (Fraunhofer-Gesellschaft) (submittedVersion, other-oa)
- Työväentutkimus Vuosikirja (submittedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion, other-oa)
- PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion)
- Fraunhofer-Publica (Fraunhofer-Gesellschaft) (submittedVersion)
- Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by-nc)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by-nc)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Japan Society for the Promotion of Science (21K08346)
- Topics
- Health Sciences › Medicine › Rheumatology › Urticaria and Related Conditions
- Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- urticaria, chronic spontaneous urticaria, inducible urticaria, angioedema, urticaria classification, urticaria diagnosis, urticaria management, mast cell activation, quality of life
- MeSH terms
- Angioedema, Asthma, Chronic Disease, Humans, Quality of Life, Urticaria, Prevalence
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