Presentation (CTI)

OBJECTIVES: Chronic spontaneous urticaria (CSU) is the spontaneous occurrence of itch, wheals (hives), and/or angioedema lasting ≥6 weeks without an identifiable trigger. This study aimed to establish expert consensus on the epidemiology, diagnosis, and treatment patterns of CSU in Türkiye.
METHODS: A modified Delphi method was used. A structured questionnaire was distributed to ten dermatologists from academia. Responses were consolidated and analyzed, followed by a face-to-face consensus meeting to finalize the results.
RESULTS: Experts estimated the incidence and prevalence of chronic urticaria in Türkiye to be 500 and 2,000 per 100,000 population, respectively. CSU accounted for the largest proportion of cases (60%), followed by comorbid CSU and chronic inducible urticaria (30%). Most patients were older than 19 years (87%). The mean time from symptom onset to diagnosis was six months, and the average disease duration was four years. Approximately 70% of patients received treatment in public secondary and tertiary care centers. Around 50% of patients did not respond to standard-dose H1-antihistamines, with a mean treatment duration of 11 months. Experts also estimated that approximately 18% of patients did not respond to biologic therapy. The relapse rate following remission with biologic agents was estimated at 50%, with a mean time to relapse of eight months. Approximately 85% of biologic treatment costs were reimbursed by the Social Security Organization, while 5% were paid out-of-pocket and 10% were covered by private insurance.
CONCLUSIONS: Based on the experts’ opinions on the prevalence of the disease and census data, the estimated number of patients with CSU in Türkiye was 1,066,140 in 2025. CSU imposes a substantial clinical and economic burden, with most treatment costs covered by the Social Security Organization. These findings highlight the need for evidence-based policies to optimize disease management and healthcare resource allocation.