OBJECTIVES: Chronic urticaria (chronic hives) can be inducible or spontaneous (CSU). Data supporting the impact of CSU on patients and comparisons with other dermatological diseases are scarce. This study evaluated the burden of illness associated with CSU relative to psoriasis (PsO) among adults across 5 European countries (EU) and the United States (US). METHODS: Data from respondents with a diagnosis of chronic hives (as proxy for CSU) or PsO were collected from the National Health and Wellness Survey (NHWS) in the EU (2010-2013) and US (2010-12). Humanistic burden was measured using SF-12v2 (2010-11) or SF-36v2 (2012-13) and health utility score (SF-6D). Self-reported anxiety, depression and sleep difficulty were also assessed. Comorbidity was measured using Charlson Comorbidity Index (CCI). Bivariate analysis (t-tests for continuous and chi-square tests for categorical variables) was used to compare CSU patients vs. PsO patients in EU and US, respectively. RESULTS: Study included 1,516 patients with CSU (769 EU; 747 US) and 12,964 patients with PsO (7,857 EU; 5,107 US). CSU patients had lower (worse) mean mental (40.8 vs. 44.6) and physical component scores (45.2 vs. 47.4) and SF-6D score (0.64 vs. 0.69), than PsO patients (p<0.001 for all) in EU. Lower scores for CSU patients were also reported in US (44.7 vs. 47.0, 43.8 vs. 45.5 and 0.67 vs. 0.70, respectively, p<0.001 for all). More CSU than PsO patients reported anxiety (45.4% vs.30.4%), depression (26.9% vs. 20.4%) and sleep difficulties (55.7% vs. 42.6%) both in EU and US (41.6% vs. 30.4%, 38.8% vs. 27.7%, and 49.9% vs. 40.3%, respectively) (p<0.001 for all). Comorbidity burden was higher for CSU than PsO in EU (CCI=0.90 vs. CCI=0.50, respectively) and US (CCI=1.05 vs. CCI=0.78) (both, p<0.001). CONCLUSIONS: CSU is associated with significant detrimental impact on quality of life comparable or greater burden relative to PsO in EU and US.