Urticaria crónica y factores psicosociales: reconocimiento, diagnóstico y manejo

Chronic urticaria is a disease with low mortality, but with a great impact on patient’s daily life and a substantial psychosomatic element. A poor outcome in this disease is frequently associated with anxiety or depression disorders, which in turn causes a greater clinical involvement, in a vicious circle that often requires a biopsychosocial approach and an appropriate psychological assessment. The interruption of sleep by pruritus may be one of the greatest functional impacts in untreated urticaria. However, the use of sedating antihistamines is considered contraindicated at present, since they provoke a fragmented nocturnal sleep, increasing only daytime sleepiness. The introduction of anti-IgE biological therapies has substantially changed the perspectives of chronic urticaria patients refractory to other treatments, and has also decreased the functional effects of the associated psychological disorders.