All Things Urticaria – Learning about urticaria with Prof. Dr. Torsten Zuberbier

UCARE, the Global Allergy and Asthma Excellence Network for Urticaria

Since 2020 this podcast is an invaluable resource for health care professionals, and anyone interested in learning more about urticaria. In the first 97 episodes, Prof. Marcus Maurer († 31.07.2024) is joined by colleagues for in-depth discussions on the latest research and opinion on the pathogenesis and treatment of urticaria. Prof. Torsten Zuberbier has taken on this role. All opinions expressed are those of the faculty. This content should not be taken as medical advice and is for informational purposes only. Learn more about the network and its activities here: https://ucare-network.com/

  1. Visualizing Urticaria Worldwide

    28. JAN.

    Visualizing Urticaria Worldwide

    In this episode of the GA²LEN Urticaria Podcast, Professor Torsten Zuberbier is joined by Professor Simon Francis Thomsen from Denmark to introduce an exciting new global initiative within the UCARE network: WOW – Wheals and Angioedema of the World.  The WOW project aims to create a worldwide, representative online image repository of urticaria and angioedema across all skin types, ethnicities, and continents. The initiative addresses a major challenge in everyday clinical practice: most patients do not present with visible wheals during clinic visits, despite experiencing severe symptoms at other times of the day.  They discuss:  🔹 Why are patient-taken images crucial in urticaria care? 🔹 How can photographs improve diagnosis, monitoring, and treatment decisions? 🔹 What can we learn from the shape, size, duration, and evolution of wheals? 🔹 How could images, registries, biobanks, and digital tools be combined in the future?  The discussion highlights how smartphones have already changed patient behavior, with most patients documenting their symptoms themselves. Looking ahead, the episode explores how artificial intelligence, digital imaging, patient-reported outcomes, and environmental data could be integrated to better understand disease trajectories and personalize treatment. WOW represents a key step toward a more visual, data-driven, and patient-centered future in urticaria research and care.  Key Learnings from the Episode: Urticaria and angioedema are rarely visible during clinic visits despite severe patient burden.  Most patients already take high-quality images of their wheals using smartphones.  The WOW project will create a global, diverse image atlas of urticaria and angioedema.  Existing online images are often non-representative of different skin types and populations.  Sequential photos help assess wheal duration, evolution, and treatment response.  Wheal morphology may provide clues about underlying mechanisms and therapy response.  Digital images could be combined with registries, biobanks, and patient-reported outcomes.  Artificial intelligence may help identify patterns and predict disease course in the future.  Taking photos in consistent lighting and angles improves clinical usefulness.  Visual documentation strengthens communication between patients and physicians.  Chapters: 00:00 Introduction to Urticaria and Angioedema 03:47 The WOW Project: A Global Initiative 06:48 Patient Involvement: Capturing Images of Urticaria 09:49 Practical Tips for Patients on Taking Pictures 12:48 Integrating Data for Better Patient Outcomes 15:25 Future of Urticaria Research and Closing Thoughts Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here.     Feedback form: ATU: ⁠⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    19 Min.
  2. A New Era for Urticaria Treatment

    18.12.2025

    A New Era for Urticaria Treatment

    In this short, conference-based episode, Professor Torsten Zuberbier, President of Global Allergy and Asthma Excellence Network, speaks with Professor Kiran Godse from Mumbai, India, directly from the UCARE Urticaria Conference, sharing the latest breakthroughs in urticaria research and treatment.  The discuss:  🔹 What are the most important new developments in urticaria therapy? 🔹 How do BTK inhibitors change the way chronic urticaria is treated? 🔹 Why can these new drugs work in both autoimmune and autoallergic urticaria? 🔹 How can digital tools like the CRUSE App support patients and physicians?  Professor Godse highlights the rapid progress made over the past year, including the emergence of novel oral therapies that caneffectively control most forms of chronic urticaria. The discussion focuses on BTK inhibitors, which act inside the mast cell to block histamine release at its source, offering a new, convenient tablet-based treatment option. In addition, the episode emphasizes the growing role of digital patient tools, such as the CRUSE App, which help patients monitor disease activity and support personalized treatment decisions worldwide. Key Learnings from the Episode: Chronic urticaria consists of autoallergic and autoimmune subtypes, both of which can be targeted by new BTK inhibitors. BTK inhibitors block mast-cell signaling inside the cell, preventing histamine release and reducing symptoms effectively. New oral therapies offer once- or twice-daily tablet options, improving convenience and adherence for patients. Several new urticaria treatments have been approved globally, with wider availability expected soon. The CRUSE App enables patients to track disease activity and supports data-driven clinical decisions. Digital tools improve doctor–patient communication and help personalize treatment strategies. Global initiatives like UCARE are transforming urticaria care through research, education, and collaboration. The outlook for urticaria patients is increasingly positive, with more effective and accessible treatments emerging worldwide. Chapters: 00:00 Introduction to UCARE Conference 01:31 New Developments in Urticaria Treatment 03:22 Innovative Apps for Patient Management Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here.     Feedback form: ATU: ⁠⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    6 Min.
  3. Measuring What Matters: PROMs in Urticaria Care

    02.12.2025

    Measuring What Matters: PROMs in Urticaria Care

    In this episode of the GA²LEN (Global Allergy and Asthma Excellence Network) Podcast on Everything Urticaria, Professor Torsten Zuberbier talks with Dr. Karsten Weller, a leading expert and developer of patient-reported outcome measures (PROMs), about how these tools are transforming the management of urticaria and angioedema in both research and daily care.  The discuss:  🔹 What are PROMs and why are they essential in urticaria management?  🔹 How are they developed and validated scientifically?  🔹 Which tools should clinicians use in everyday practice?  🔹 What does the future hold for digital and app-based patient assessment?  Dr. Weller explains how PROMs such as the Urticaria Control Test (UCT) help physicians understand disease control directly from the patient’s perspective. He discusses the scientific process of developing and validating PROMs, the benefits of integrating them into digital tools like the CRUSE App, and how simple, standardized communication enhances care. Together, they explore the future of patient-centered assessment, from wearable technologies to the evolving language of quality-of-life measures.  Key Learnings from the Episode: PROMs capture the patient’s own perception of disease activity, control, and quality of life—crucial for fluctuating conditions like urticaria. The Urticaria Control Test (UCT) is a quick, validated 4-question tool recommended for every patient visit. PROM development follows a rigorous process including patient input, expert review, and validation studies. Tools like the Chronic Urticaria QoL Questionnaire (CU-Q2oL) and Angioedema QoL Questionnaire (AE-QoL) add depth when time allows. Digital apps such as the CRUSE App integrate PROMs into daily life and facilitate doctor–patient communication. Despite new technologies, the patient’s direct voice remains irreplaceable in capturing holistic well-being. The language of questionnaires must be periodically reviewed to stay clear and relevant across generations. PROMs promote standardized, efficient, and patient-centered care, empowering better decisions and stronger engagement. Chapters 00:00 Introduction to Patient-Reported Outcome Measures (PROMs) 03:23 The Development Process of PROMs 05:57 Practical Application of PROMs in Clinical Practice 08:40 The Future of Digital Tools in Patient Care 11:28 Language and Communication in Patient-Reported Outcomes 14:10 Final Thoughts and Conclusion Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here.     Feedback form: ATU: ⁠⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    20 Min.
  4. Why Do Hives Look the Way They Do?

    28.10.2025

    Why Do Hives Look the Way They Do?

    In this episode of the GA²LEN (Global Allergy and Asthma Excellence Network) Podcast on Everything Urticaria, Professor Torsten Zuberbier speaks with Professor Michihiro Hide from Hiroshima, Japan — a pioneer in urticaria research — about an unexpected connection between dermatology and mathematics.     The discuss:  🔹 Why do urticaria wheals form distinct shapes — round, annular, or geographic? 🔹 What controls how long a wheal lasts before fading? 🔹 Can mathematical formulas help explain the biology of hives? 🔹 What could this mean for diagnosis and treatment in the future?  Professor Hide shares how a collaboration with a mathematician led to the creation of a computational model that simulates wheal formation in silico, revealing five recurring urticaria patterns that correspond to clinical types such as cholinergic or chronic spontaneous urticaria. Together, the two professors explore how mast cells, basophils, endothelial cells, and coagulation factors interact through feedback loops to create (and stop) a wheal — and how this model could reshape our understanding of urticaria’s pathophysiology and treatment.    Key Learnings from the Episode  Urticaria’s shapes and lifespans can be mathematically modeled using Turing-inspired reaction-diffusion formulas.  Five recurring patterns of wheals emerged from simulations, mirroring real-world urticaria morphology.  Basophil-driven small dots (e.g., cholinergic urticaria) differ mechanistically from mast-cell-driven geographic wheals.  Wheals persist longer than histamine-only reactions, implying sustained mast-cell activation.  Urticaria develops through three stages — initiation, expansion, and resolution — governed by positive and negative feedback.  Understanding the inhibitory phase that stops mast-cell activation is a key future research frontier.  Mathematical modeling could help visualize and predict disease activity, opening paths for personalized therapy.  Collaboration between clinicians and mathematicians may lead to a new diagnostic and research paradigm in chronic urticaria.    Chapters  00:00 Introduction to Urticaria Research  02:03 Exploring the Mechanisms of Urticaria  06:25 Mathematical Approaches to Urticaria  10:30 Patterns and Predictions in Urticaria  15:37 Understanding Treatment Responses  19:07 Future Directions in Urticaria Research  Press release https://www.eurekalert.org/news-releases/1009793   References 1.    Seirin-Lee S, et al. A single reaction-diffusion equation for. the multifarious eruptions of urticaria. PLOS Computational Biology. 2020;16(1):e1007590 2.    Seirin-LeeS, et al. Mathematical-based morphological classification of skin eruptions corresponding to the pathophysiological state of chronic spontaneous urticaria.Communications Medicine. 2023;3(1):171. 3.    Seirin-Lee S, et al. Pathophysiological Mechanisms of the Onset, Development, and Disappearance Phases of Skin Eruptions in Chronic Spontaneous Urticaria, Bulletin of Mathematical Biology. 2025; 87, 1 Michihiro Hide has receivedlecture and/or consultation fees from Japan Tobacco, Kaken, Kyorin, KyowaKirin, Meiji Seiyaku, Mitsubishi Tanabe, Nippon Zoki, Novartis, Sanofi, Taiho,Teikoku and Yuhan. Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here.     Feedback form: ATU: ⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    21 Min.
  5. UDAY & New Guidelines: Empowering Patients Worldwide

    30.09.2025

    UDAY & New Guidelines: Empowering Patients Worldwide

    In this episode, Prof. Torsten Zuberbier (Global Allergy and Asthma Excellence Network President) welcomes Prof. Petra Staubach, urticaria expert from Germany, to talk about Urticaria Day (UDAY) — held each year on October 1st — and why awareness is just as important as science.  They discuss: 🔹 Why do we need a dedicated awareness day for urticaria? 🔹 What is the true burden of urticaria on patients and families? 🔹 How can physicians and patients improve communication and advocacy? 🔹 What do the new 2025 urticaria guidelines mean for treatment worldwide?  Together, they highlight the unmet needs of urticaria patients, the role of patient organizations, and the importance of empowering patients to speak openly about their burden. The discussion also previews the new treatment options in the 2025 guideline, including biosimilars of omalizumab, dupilumab, and remibrutinib.  Join us for this inspiring episode on why urticaria is a serious disease that deserves global awareness — and how new therapies and guidelines are changing the future.  Key Learnings from the Episode: Urticaria Day (UDAY) has been celebrated since 2014 to raise global awareness about the seriousness of urticaria. Despite perceptions of being “just hives,” urticaria causes major quality-of-life impairment: sleep disruption, depression, social isolation, and stigma. 84% of patients feel embarrassed to be seen with wheals or angioedema. Urticaria affects people of all ages, from children to the elderly, with equal burden. Physicians often underestimate disease control compared to patient perception, creating a communication gap. Patient honesty and empowerment are crucial: patients should describe the real impact of disease to their doctors. Patient organizations help bridge gaps, provide support, and increase awareness globally — but many countries still lack them. The 2025 urticaria guideline will emphasize: Early up-dosing of antihistamines (don’t wait months if ineffective). Omalizumab remains the global standard, now also with biosimilars. Dupilumab (already used in asthma/atopic dermatitis) and Remibrutinib (oral BTK inhibitor) enter the treatment landscape. Flexibility: co-administration with cyclosporine, consideration of costs, and tailoring to patient burden. The key message: Stay flexible, treat early, and adapt care to the patient’s real needs. Awareness & advocacy matter: urticaria’s burden is as high as ischemic heart disease — it must be taken seriously by society and healthcare systems. Chapters 00:00 Introduction to Urticaria Awareness 02:32 The Importance of Urticaria Day 05:16 Understanding the Burden of Urticaria 07:58 Communication Between Patients and Physicians 10:59 Future Treatment Options for Urticaria 14:05 Conclusion and Call to Action Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here. Feedback form: ATU: ⁠⁠⁠⁠⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    18 Min.
  6. Living with SD: from Triggers to Future Therapies

    09.09.2025

    Living with SD: from Triggers to Future Therapies

    In this episode, Sophia Neisinger welcomes Dr. Melba Muñoz, head of the Chronic Inducible Urticaria Program in Berlin, to discuss symptomatic dermographism (SD), the most common form of inducible urticaria.  They discuss: 🔹 What exactly is symptomatic dermographism, and why is it so burdensome for patients?  🔹 How common is SD, and what did the latest international prevalence study reveal?  🔹 How can tools like the FricTest help diagnose and assess SD?  🔹 Which treatments are available today—and which exciting therapies are on the horizon?  Dr. Muñoz shares insights on the challenges SD patients face in daily life, the importance of proper diagnosis, and why new therapies in clinical trials may soon change the landscape of treatment. She also highlights the need for awareness among both physicians and patients to reduce diagnostic delays and improve care.  Join us for this engaging conversation on how better diagnostics, treatment options, and awareness can transform the lives of SD patients.  Key Learnings from the Episode Definition: Symptomatic dermographism is a form of inducible urticaria where scratching or stroking on the skin leads to wheals, redness, and itch. Prevalence: International data suggest approximately 4% of the population may be affected, making it surprisingly common. Impact: Even daily activities like wearing clothes or combing hair can trigger symptoms, causing significant quality-of-life impairment. Diagnosis: The FricTest is a standardized tool to diagnose and measure SD activity, more reliable than ad-hoc methods like using a pen. Overlap: Around 30–40% of SD patients also present with chronic spontaneous urticaria (CSU). Treatment today: Only antihistamines are licensed; omalizumab may be used off-label (or in-label if CSU is present). Future therapies: Anti-KIT antibodies (barzolvolimab, briquilumab), oral KIT inhibitors, and BTK inhibitors (remibrutinib) show great promise. Diagnostic delays: Many SD patients experience long delays, partly due to lack of awareness and the perception that symptoms are "normal." Patient-reported tools: The Urticaria Control Test (UCT) and the new SD-Qual scale are validated instruments for assessing disease control and quality of life. Awareness: Education for general practitioners and patients is key, as many still use antihistamines incorrectly (on demand instead of regularly). Chapters  00:00 Introduction to Symptomatic Demographism  02:53 Understanding Symptomatic Demographism  04:49 Prevalence and Diagnosis of SD  06:54 Diagnostic Tools for SD  09:16 Treatment Options for SD  13:52 Challenges in Diagnosis and Awareness  18:40 Patient-Reported Outcomes and Future Directions  Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here. Feedback form: ATU: ⁠⁠⁠⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    24 Min.
  7. Urticaria in Children: Diagnosis, Triggers & Treatment

    12.08.2025

    Urticaria in Children: Diagnosis, Triggers & Treatment

    In this episode, Prof. Torsten Zuberbier welcomes Dr. Larissa Brandão, pediatric allergist from the Federal University of São Paulo, Brazil, to talk about chronic urticaria in children — a condition that is often misunderstood and underdiagnosed.  They discuss: 🔹 When does chronic urticaria typically begin in kids? 🔹 What role do infections or allergens, play? 🔹 Which treatments are available in public healthcare? 🔹 How do cold urticaria and cholinergic urticaria show up in warm climates? Dr. Brandão shares her clinical experience from Brazil, where many children with chronic urticaria also suffer from comorbidities like asthma and allergic rhinitis. She explains how treatment responses differ from adults and discusses the impact of restricted access to second-generation antihistamines. Join us for a practical and global look at what it takes to recognize, treat, and support children with chronic urticaria — especially in resource-limited settings.  Key Learnings from the Episode Chronic urticaria in children typically begins around age 7–8, with chronic spontaneous urticaria (CSU) being the most common subtype. In Brazil is the most common chronic inducible form; cold urticaria and cholinergic urticaria are also present but less frequent. Cold triggers in Brazil include ice cream, cold drinks, pools, and beaches — not ambient winter weather. Pediatric CSU patients often have comorbid atopic conditions, especially asthma and allergic rhinitis. Children tend to respond better than adults to standard or up-dosed second-generation antihistamines, but fatigue can be a common side effect. Loratadine is the only antihistamine widely available through Brazil’s public health system; desloratadine, bilastine, or fexofenadine are often unaffordable. Liver function monitoring is used for kids on high-dose loratadine. Omalizumab is rarely needed, but effective in more severe pediatric cases — especially those with comorbid asthma. Dupilumab is now licensed in Brazil for CSU in children aged 12+, and early reports show benefits for patients with both asthma and urticaria. Pseudoallergen-triggered symptoms (e.g. from candy, dyes, preservatives) are observed, and short-term elimination diets are used diagnostically. Cold urticaria can cause anaphylaxis, especially in pools — and adrenaline auto-injectors are recommended for high-risk children. Counseling on safety, including family education about temperature triggers, is essential for cold urticaria management. Brazilian UCARE centers use social media and in-clinic education to raise awareness and prepare for Urticaria Day (October 1) each year. Chapters 00:00 Introduction to Urticaria in Children 01:46 Understanding Chronic Urticaria in Children 03:33 Infections and Chronic Urticaria 05:13 Allergic Comorbidities in Children 06:27 Treatment Algorithms for Chronic Urticaria 08:32 Dietary Influences on Urticaria 12:09 Cold Urticaria and Safety Concerns 15:13 Advancements in Urticaria Treatment 17:30 Advocacy and Awareness for Urticaria Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here. Feedback form: ATU: ⁠⁠⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    20 Min.
  8. Itch & Urticaria: Mechanisms, Misconceptions & Hope

    15.07.2025

    Itch & Urticaria: Mechanisms, Misconceptions & Hope

    In this episode, Prof. Torsten Zuberbier welcomes Prof. Gil Yosipovitch, world-renowned itch researcher and dermatologist at the University of Miami, for an in-depth discussion on the science of itch in urticaria, and why histamine isn’t the full story.  They discuss: 🔹 Why do antihistamines fail in up to 40% of urticaria patients?  🔹 What is MRGPRX2, and why is it such a promising target for future treatments?  🔹 How do pain and itch differ neurologically — and why is itch harder to ignore?  🔹 What role do topical steroids, JAK inhibitors, and GABAergic drugs play?  Prof. Yosipovitch shares clinical and research insights on chronic itch mechanisms, highlighting how mast cells, nerves, cytokines, and ion channels interact to drive symptoms. The episode also explores why scratching can feel pleasurable, what makes urticaria itch unique, and how new therapies could revolutionize care.  Join us for a cutting-edge conversation on the future of urticaria treatment — and why individualized care is the most powerful approach of all.    Key Learnings from the Episode  Chronic urticaria itch is not purely histaminergic — up to 40% of patients don’t respond to antihistamines, indicating other mechanisms. MRGPRX2 is a key non-histaminergic itch receptor found on mast cells and possibly nerve fibers — and is overexpressed in many itch disorders. Scratching itch activates pleasure centers in the brain, but urticaria patients scratch less deeply than those with atopic dermatitis. Cold and heat don’t always inhibit itch — responses vary across diseases and individuals, involving channels like TRPM8. Steroids and JAK inhibitors modulate both histaminergic and non-histaminergic itch pathways. Long-term steroid use is still widespread, especially in the US — but leads to serious comorbidities. Gabapentin and SNRIs like mirtazapine are valid add-on options in selected chronic itch patients. New biologics and mast cell-targeting drugs (like CKIT inhibitors) are on the horizon and may transform treatment. Each patient is unique — clinicians must move beyond dogma and adjust treatments to the individual, not just the guideline. Chapters 00:00 Understanding Itch: The Science Behind Chronic Pruritus 03:02 The Role of MRGPRX2 in Itch Mechanisms 05:53 Pain vs. Itch: Exploring the Neural Pathways 09:03 Individual Patient Experiences: The Complexity of Itch 11:48 Treatment Approaches: Antihistamines and Beyond 15:11 Emerging Therapies: The Future of Itch Management Do you have suggestions for future episodes? Please provide feedback and offer your suggestions for future topics and expert selection here. Feedback form: ATU: ⁠⁠⁠⁠⁠https://forms.office.com/e/m6a2uEdsUH

    22 Min.
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Since 2020 this podcast is an invaluable resource for health care professionals, and anyone interested in learning more about urticaria. In the first 97 episodes, Prof. Marcus Maurer († 31.07.2024) is joined by colleagues for in-depth discussions on the latest research and opinion on the pathogenesis and treatment of urticaria. Prof. Torsten Zuberbier has taken on this role. All opinions expressed are those of the faculty. This content should not be taken as medical advice and is for informational purposes only. Learn more about the network and its activities here: https://ucare-network.com/

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