Chronic Inducible Urticaria (CIndU)/Physical Urticaria

Authors: Kathryn Smiley, PA-C and Kathleen Luskin, MD

Editor: Kathleen Luskin, MD

Overview

• Chronic inducible urticaria (CIndU), also called physical urticaria, is a group of chronic urticarias characterized by the appearance of recurrent wheals and/or angioedema in response to specific environmental triggers [1]

• CIndU’s are considered a subset of chronic urticaria, and can be comorbid with chronic spontaneous urticaria (CSU)

• Multiple types of physical triggers can be present in a given patient, and some subtypes require the presence of multiple triggers to produce symptoms [1-3]

Epidemiology

• The pooled prevalence rate across all CIndU subtypes is approximately 13%, with

dermographism, cholinergic urticaria and cold urticaria being the most common [3]

• Average duration of CIndU is 2-12 years; about 1/3 of patients resolve by 5 years,

especially with dermographism subtype [3, 4]

• The presence of CIndU alone or when comorbid with CSU is associated with a longer duration compared to CSU alone [3]

• All types of urticaria, except for cholinergic, are more common in females [3]