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

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

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

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

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.

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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

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