The patient journey with chronic urticaria in Brazil: a real-life study

Introduction: In large, diverse countries like Brazil, geographic disparities and healthcare barriers can significantly affect the chronic urticaria (CU) patient journey and disease outcomes. This study evaluated the real-world burden, regional disparities, and treatment patterns of CU in Brazil. Methods: This cross-sectional study surveyed 388 physician-confirmed CU patients across all Brazilian regions between June 2022 and December 2023, assessing clinical features, diagnostic latency, disease control (UCT), treatments, and quality of life. Results: The cohort was 92% female with 79.1% reporting angioedema. Northeast patients faced longer diagnostic delays (35.3% ≥ 2 years) and greater scarcity of specialized services than Southeast patients. “Diagnostic nomadism” was prevalent, with 41% consulting 3 to 5 physicians before diagnosis, and misdiagnosis affected 53.4%. Uncontrolled disease was alarmingly high (71.6%). Anti-IgE usage was higher in the South (34.9%) than in the Northeast (15.3%). Angioedema severely impacted sexual health and interpersonal relationships. Conclusion: CU imposes a severe burden in Brazil. To address the misdiagnosis trap and regional inequalities, we suggest expanding specialized care, implementing telemedicine in underserved regions, and enhancing medical education to ensure guideline adherence.