Immunopathogenesis and Pathophysiological Manifestations of Urticaria in Patients of Basrah Province, Iraq

Urticaria is a common inflammatory skin disorder characterized by transient wheals, erythema, and sometimes angioedema, with important physical, emotional, and social consequences. This cross-sectional study assessed the demographic, clinical, and quality-of-life impact of urticaria in comparison with healthy controls among the population of Basrah province, Iraq. A total of 59 participants were enrolled, including 30 patients with urticaria and 29 controls. The age range was 10–48 years, with median ages of 21 years in the patient group and 24 years in the control group. Females were more frequently affected than males among patients (63.3% vs. 36.7%). Clinically, the most common presentation was red spots involving the extremities, face, and neck [60%], followed by red swelling and large patches (33.3%). Although most patients had visible lesions, 6.7% showed no obvious skin signs at examination. Sensory symptoms were frequent, with 50% reporting itching accompanied by pain, burning, or tingling, and 36.7% experiencing severe itching alone. Severe skin discomfort was reported by 80% of patients. Urticaria also had a marked impact on daily functioning, as 76.7% experienced sleep disturbance, 90% reported difficulty concentrating, and some described anxiety or tension related to symptom recurrence. Dietary restriction was reported by a subset of patients due to perceived food-related symptom aggravation. Correlation analysis showed strong links between sleep disturbance and nocturnal awakening, as well as significant associations among sleep problems, concentration difficulty, nervousness, and skin discomfort. These findings indicate that urticaria imposes a substantial burden beyond the skin, affecting sleep, cognition, emotional well-being, and daily activities.