Assessment of Quality of Life in Children with Chronic Urticaria using the Children's Dermatology Life Quality Questionnaire Index (CDLQI): A Retrospective Cohort Study.

Abstract

Background Chronic urticaria (CU) negatively impacts children's quality of life (QoL), yet data on pediatric CU remain limited. This study assessed CU's impact on QoL using the Children's Dermatology Life Quality Index (CDLQI). Methods Children (4-16 years) with CU were recruited and completed standardized questionnaires on demographics, CU type, management, and comorbidities. Chart review assessed laboratory data. Patients also completed the Urticaria Control Test (UCT), Urticaria Activity Score over 7 days (UAS7), and CDLQI at study entry. Multivariable logistic regression identified factors associated with clinically poor QoL. Results Seventy-four children (median age =10) were recruited: 39 (52.7%) had chronic spontaneous urticaria (CSU), 21 (27.0%) had chronic inducible urticaria (CIndU), and 14 (16.2%) had both. Most children (n=54; 72.9%) reported a clinically satisfactory (CDLQI ≤ 5), while 20 (27.0%) reported a clinically poor QoL (CDLQI > 5). Factors associated with clinically poor QoL included older age at symptom onset (aOR =1.04; 95% CI=1.01-1.05), elevated C-reactive protein (CRP >5mg/L) (aOR=1.49; 95% CI=1.04-2.13), and history of atopic dermatitis (aOR=1.59; 95% CI=1.18-2.13). In younger children (aged 4 - 10), cold urticaria was associated with clinically poor QoL (aOR=1.44; 95% CI=1.07, 2.00). Conclusion Older age at symptom onset, elevated CRP, atopic dermatitis and cold urticaria are associated with clinically poor QoL in children with CU. These findings highlight the need for targeted interventions, such as psychosocial support and education, to improve patient outcomes.