INTRODUCTION
Chronic urticaria (CU) is defined by the presence of wheals and/or angioedema for at least six weeks1. CU is subtyped into inducible (CIndU) and spontaneous (CSU) forms, based on the existence or absence, respectively, of a specific trigger eliciting symptoms1. Several assessment tools are validated for evaluating disease control and severity in adult CU2. Although none of these tools have been validated in children with CU, current pediatric guidelines state that the urticaria activity score over seven days (UAS7) may be used to evaluate pediatric CU3-5.
The Dermatology Life Quality Index (DLQI) is a tool that has been extensively validated for the assessment of dermatologic diseases, including CU, in adults6,7. The pediatric version of the DLQI, termed the Children’s DLQI (CDLQI), is a ten-item questionnaire assessing the impact of dermatologic diseases on various aspects of life over the past seven days8. Each question is assigned scored from zero to three, with higher scores representing greater disease severity8. The CDLQI is valid for in children aged 4 to 16 years, and is available in a cartoon version for younger children9. Although not specifically validated for use in pediatric CU, the CDLQI has been thoroughly validated to assess various other dermatologic diseases8,10, and has been used to assess pediatric CU11-13. Another assessment tool, the Urticaria Control Test (UCT), is a four-item questionnaire retrospectively querying on CU disease control over the prior four weeks14. Each item is assigned a score from zero to four, with higher scores representing improved disease control14. A cut-off of ≤11 was determined to optimally indicate poorly-controlled disease in adults14. Validation of the UCT for use in CSU and CIndU in adults demonstrated high internal validity, convergent validity, known-groups validity, and accuracy14. Current EAACI/GA²LEN/EuroGuiDerm/APAAACI guidelines recommend the use of the UCT in the assessment of CU disease control in adults15. Our previous work employing the UCT in children revealed that a UCT score ≥12 at study entry was associated with higher disease resolution in pediatric CIndU patients16. However, the UCT remains to be formally validated in children.
We sought to validate the UCT in a cohort of children with CU by assessing the internal consistency, convergent validity with the CDLQI, known-groups validity, and screening accuracy.