The Frequency of Chronic Widespread Pain and Its Impact on Quality of Life in Patients with Chronic Spontaneous Urticaria

Background and aims Chronic spontaneous urticaria (CSU) is a chronic, common and debilitating disease and associated with severely impaired quality of life (QoL). The main aims of this study are to explore the presence of Chronic Widespread Pain (CWP) in patients with CSU and to reveal the possible associations between CWP and CSU on the clinical features, laboratory markers and urticaria activity scores with QoL. Methods We assessed the 91 patients with CSU for CWP in a tertiary outpatient clinic. CWP (pain in four or more out of five bodily regions, i.e. the four quadrants and axially at least for three months) was assessed in a rheumatology outpatient clinic in patients with CSU. We also analyzed the test results of anti-nuclear antibody (ANA), blood sedimentation rate, CRP (C-reactive protein), B12, total IgE, and anti-TPO. Patients were assessed for their onset and duration of disease, comorbidities, occurrence of angioedema and history of atopy, and nocturnal pruritus with disturbed sleep. Patients disease activity were assessed by the urticaria control test (UCT), urticaria activity score (UAS) and visual analog scale of physician and patient’s global assessment. Furthermore, patients completed a questionnaire to assess the quality of life (QoL) for dermatologic diseases. Results Of the 91 patients with CSU assessed for CWP, 23 (25.3%) were positive. CWP +ve patients with CSU had significantly higher physician global assessment score (p=0.003), Patients global assessment score (p=0.005), UAS (p=0.046), dermatologic QoL (p<0.001) and lower UCT (p=0.005) scores. Nine of 23 CWP +ve patients had asthma (39.1%) as a comorbidity (p=0.008). Conclusions The presence of CWP in patients with urticaria may have a negative impact on the quality of life of the patients and disease scores