Demographic and Comorbidity Associations in Chronic Spontaneous Urticaria: A Retrospective Analysis

Background: Chronic Spontaneous Urticaria (CSU) is a painful and often distressing dermatologic condition characterized by recurring wheals and intense pruritus that significantly impair patients’ quality of life. Despite substantial research efforts, the exact etiology and pathophysiological mechanisms underlying CSU remain elusive. Objective: This study aimed to investigate demographic patterns in patients with CSU and identify key comorbidities, with a particular focus on Herpes Simplex Virus-2 (HSV-2) and Vitamin D deficiency. By highlighting these associations, we sought to deepen clinical understanding and encouraged future research to elucidate potential causal pathways. Methods: In this single-institution retrospective analysis conducted at Montgomery Allergy and Asthma, 195 patient charts were reviewed. Patients were included if they were aged 18 or older and had a documented clinical diagnosis of CSU. Demographic data—such as age, sex, and race—were recorded, as were comorbidities and specific laboratory findings (HSV-2 serology and 25-hydroxy Vitamin D). Deficiency of Vitamin D was defined as serum levels below 30 ng/mL. Results: Of the 195 patients, 35 (17.9%) were male and 160 (82.1%) were female. The racial distribution was 47.2% African American, 45.1% Caucasian, 6.2% Asian, and 1.5% Hispanic. Among 88 patients tested for HSV-2, 46 (52.27%) were positive, with a larger proportion being female (90.7%). Vitamin D levels were assessed in 116 patients, of whom 84 (72.41%) were deficient. We examined the comorbidity association between vitamin D deficiency and HSV-2 positive status as a possible causation relationship. The test yielded a χ² = 0.44 and a p = 0.50 indicating that there is no statistically significant association between vitamin D deficiency and HSV-2 positivity in the cohort study. Conclusion: HSV-2 positivity and Vitamin D deficiency emerged as prominent findings in this patient cohort, however, the association of these two comorbidities was not found. While causative relationships were not determined, this study underscores the need for broader, multicenter investigations to clarify immune and inflammatory processes potentially linking these comorbidities to CSU.