This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA2LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
The International Guideline for the Definition, Classification, Diagnosis and Management of Urticaria / T. Zuberbier, Z. Abdul Hameed Ansari, A.H. Abdul Latiff, M.M. Abuzakouk, M.S. Agcaoili-De Jesus, R.C. Agondi, M. Al-Ahmad, A.A. Alangari, H. Alhameli, C.D. Alonso Bello, S. Alshareef, S. Al-Tamemi, S. Altrichter, H. Al Wahshi, S. Aquilina, M. Araújo, R. Arnaout, R. Asero, B. Ballmer-Weber, C. Bangert, A. Bauer, M. Ben-Shoshan, J.A. Bernstein, C. Bindslev-Jensen, M. Bizjak, I. Boccon-Gibod, H. Bonnekoh, L. Bouillet, K. Brockow, Z. Brzoza, M. Bulatović Ćalasan, A. Bulkhi, T. Buttgereit, A. Bygum, T. Caballero, O. Calderon, R. Campos, M. Cancian, E. Carne, M.A. Castor, I. Cerecedo, T. Çetinarslan, I. Cherrez-Ojeda, N. Chkhikvadze, H.J. Chong-Neto, K. Choo, G. Christoff, C. Chu, K. Ciupka, N. Conlon, C. Costa, T. Craig, P. Criado, I. Danilycheva, R. Darlenski, E. De Arruda Chaves, L. De Montjoye, M.S. Doutre, A. Du-Thanh, D. Ebo, S. Elkhalifa, S. Elmariah, T. El-Shanawany, L.F. Ensina, R. Ertaş, R. Fachini Jardim Criado, M. Ferrer, S. Ferrucci, J.S. Fok, D. Fomina, L. Fonacier, G. Fouda, I. Francescantonio, A. Fukunaga, C.A. Galvan Calle, E. Garcia, K. Gáspár, A. Gelincik, S. Geng, K. Godse, M. Gonçalo, M. Gotua, C. Grattan, M. Grosber, G. Guidos Fogelbach, M. Guilarte, R. Guillod, E. Hamelmann, J. Hawkes, K. Hayama, R. Heuer, M. Hide, W. Hoetzenecker, N. Inomata, H. Kang, A. Kaplan, A. Kapp, M. Karam, A. Kasperska-Zajac, C.H. Katelaris, A. Kessel, M. Khoshkhui, B. Kim, T. Kinaciyan, E. Kocatürk, M. Kolacinska-Flont, P. Kolkhir, G.N. Konstantinou, M. Kosnik, D. Krasowska, K. Kulthanan, M.S. Kumaran, I. Kuprys-Lipinska, M. Labrador, J.I. Larco, D. Larenas-Linnemann, E. Latysheva, E. Lazaridou, P.H. Li, H. Lima, U. Lippert, M. Magerl, M. Makris, J. Alves Marcelino, A.V. Marzano, I. Medina, R. Meshkova, D. Micallef, R. Mohammed Ali, C.G. Mortz, M. Munoz, H.N.G. Oude Elberink, A. Nakonechna, I. Nasr, A. Nast, E. Netchiporouk, E. Nettis, S. Nieto, I. Ogueta Canales, T. Okas, R.L. Orfali, E. Özkaya, C. Parisi, A. Pennitz, R. Pawankar, M.P. Pereira, J. Peter, E. Petkova, P.D. Pigatto, I. Podder, T. Popov, G. Porebski, P. Pyatilova, G.D. Ramon, H.A. Ratti Sisa, M. Recto, K. Ress, K. Ridge, M. Riedl, C. Ritchie, N. Rosario Filho, I. Rosmaninho, M. Rudenko, M. Rukhadze, K. Rutkowski, V. Sabato, U.M. Sahiner, S. Saini, F. Saleh Al Sabbagh, A. Salman, F. Salvo, J. Sanchez, A. Santucci, S. Schliemann, P. Schmid-Grendelmeier, B.E. Sekerel, F. Serpa, F. Sheikh, J. Sheikh, H. Shendi, F. Siebenhaar, M. Sonomjamts, A. Soria, B. Sousa Pinto, M. Staevska, P. Staubach, M. Stephan, K. Stevanovic, L. Stingeni, M. Stobiecki, Ö. Su Küçük, G. Sussman, A. Szegedi, S. Takahagi, A. Tanaka, N. Teovska Mitrevska, S.F. Thomsen, E. Toubi, F. Tsatsou, M. Turk, Z. Vadasz, A. Valerieva, S. Valle, M.V. Doorn, B. Veleiro Perez, C.E. Vera Ayala, C. Vestergaard, R.J. Vieira, C.W. Maruta, B. Wedi, R.N. Werner, E.W.Y. Yap, P. Xepapadaki, Y. Xiang, Y. Ye, P. Yong, G. Yosipovitch, A.Z.J. Zalewska-Janowska, C. Zeyen, Z. Zhao, M. Metz, A.M. Giménez-Arnau. - In: ALLERGY. - ISSN 1398-9995. - (2026 Feb 06), pp. 1-51. [Epub ahead of print] [10.1111/all.70210]
The International Guideline for the Definition, Classification, Diagnosis and Management of Urticaria
A.V. Marzano;C. Parisi;S. Saini;
2026
Abstract
This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA2LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
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