Fuente: PubMed "hive" Dermatitis. 2026 May 28:17103568261455284. doi: 10.1177/17103568261455284. Online ahead of print.ABSTRACTBACKGROUND: Atopic comorbidities are common in chronic spontaneous urticaria (CSU), yet their impact on clinical presentation and omalizumab response remains poorly defined.OBJECTIVE: To compare clinical profiles and omalizumab treatment outcomes in CSU patients with atopic dermatitis (AD) and other atopic comorbidities (OACs).METHODS: This single-center retrospective study included 381 CSU patients treated with ≥3 doses of omalizumab (300 mg/4 weeks) and followed ≥6 months (January 2023-March 2025). Based on the presence or history of atopic comorbidities, patients were stratified into 3 groups: CSU with AD (CSU-AD, n = 76), CSU with OACs (CSU-OACs, n = 93), and CSU with no atopic comorbidities (CSU-NA, n = 212). Clinical features, treatment response (efficacy, speed, and adverse events), and-among 12-month completers-dose reduction/discontinuation and drug survival rates were analyzed.RESULTS: Of all enrolled patients, 44.4% had comorbid allergic diseases. CSU-OACs patients had earlier onset (P = 0.033) and higher angioedema prevalence (P = 0.042); CSU-AD showed higher baseline UAS7 (P = 0.031). Overall omalizumab response rates did not differ significantly among the 3 groups (P = 0.115), but a significantly higher portion of faster-response speed was observed in CSU-OAC (P = 0.019). Adverse events were significantly higher in CSU-OACs (P = 0.004), especially injection-site reactions (P = 0.033) and systemic effects (eg, headache and fatigue; P = 0.025). Drug survival was significantly higher in the CSU-OAC vs. CSU-NA group (P = 0.007).CONCLUSION: CSU-AD differs only in higher baseline activity, otherwise resembling CSU-NA in treatment response and drug survival. CSU-OACs exhibit not only distinct features such as earlier onset, higher angioedema risk, faster response, and higher drug survival but also more adverse events, indicating that CSU-OAC requires individualized management. Larger multicenter studies are needed to further define the impact of AD and OACs in CSU.PMID:42210615 | DOI:10.1177/17103568261455284