Supplementary Material for: Acute Urticaria: Symptoms, Causes, and Evaluation of Phenotypes Prone to Chronicity

Introduction: Urticaria is a condition that is characterized by the development of wheals (hives), angioedema, or both. If symptoms persist for less than 6 weeks, it is classified as acute urticaria (AU), and if they persist for longer than 6 weeks, it is classified as chronic urticaria (CU). Disease activity is evaluated using validated patient-reported outcome measures (PROMs) such as the 7-day urticaria activity score (UAS-7) and urticaria control test (UCT). In this study, we aimed to determine whether there was a difference between patients with chronic and recovered urticaria in terms of age, sex, symptoms, disease severity, disease control, and triggering factors by following patients with AU for 6 months. Methods: The routine tests were requested at the first admission of the patients. If previously examined, anti-thyroid peroxidase (anti-TPO), anti-nuclear antibody, etc. were recorded. After the first examination, the patients were evaluated again using a visual analogue scale (VAS), UCT, UAS-7 and medication scores (MSs) in the 1st, 3rd, and 6th months. Results: One hundred nine (F/M: 80/29) patients were included in the study. Twenty-seven patients had a previous history of AU, 22 of these patients were evaluated as having recurrent AU, and five became chronic during follow-up. Urticaria continued in 22 of 82 patients who presented with first-attack AU in the 3rd month and 17 in the 6th month. We had a chronicity rate of 24.7%. It was determined that having positive anti- TPO increased the risk of chronic urticaria 1.69 times. A statistically significant improvement was found in the mean VAS, UCT, UAS-7 and MSs scores evaluated in the 1st, 3rd, and 6th months of patients with CU compared with baseline. Conclusion: Acute urticaria is a common disease and usually heals in a short time without becoming chronic. Studies on the causes of chronicity are limited. Testing anti-TPO in patients presenting with AU may be useful in terms of disease course and risk of chronicity.引言：荨麻疹是一种以风团、血管性水肿或二者同时出现为特征的疾病。若症状持续时长不足6周，则归类为急性荨麻疹（AU）；若持续时长超过6周，则归类为慢性荨麻疹（CU）。疾病活动度需通过经过验证的患者报告结局指标（PROMs）进行评估，例如7天荨麻疹活动度评分（UAS-7）与荨麻疹控制测试（UCT）。 本研究旨在通过对急性荨麻疹患者进行为期6个月的随访，对比慢性荨麻疹患者与已康复荨麻疹患者在年龄、性别、症状、疾病严重程度、疾病控制情况以及诱发因素方面的差异。 方法：患者首次就诊时需完成常规检验。若患者此前已接受过相关检查，则记录其抗甲状腺过氧化物酶（anti-TPO）、抗核抗体等检验结果。首次检查后，分别于第1、3、6个月，采用视觉模拟评分法（VAS）、UCT、UAS-7以及用药评分（MSs）对患者进行再次评估。 结果：本研究共纳入109例患者（女性/男性：80/29）。其中27例患者既往有急性荨麻疹病史，该27例患者中，22例被评估为复发性急性荨麻疹，另有5例在随访期间进展为慢性荨麻疹。在82例首次发作急性荨麻疹的患者中，有22例患者在第3个月时仍有荨麻疹症状，17例患者在第6个月时仍有症状。本研究的慢性化率为24.7%。研究发现，抗甲状腺过氧化物酶阳性可使慢性荨麻疹的发病风险增加1.69倍。与基线水平相比，慢性荨麻疹患者在第1、3、6个月评估的平均VAS、UCT、UAS-7及用药评分均有统计学意义上的显著改善。 结论：急性荨麻疹是一种常见疾病，通常可在短时间内自愈，不会进展为慢性荨麻疹。目前关于慢性化病因的研究较为有限。对急性荨麻疹患者检测抗甲状腺过氧化物酶，或许有助于判断疾病病程与慢性化风险。