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.