Global burden of urticaria: systematic analysis of prevalence, incidence, and DALYs from 1990 to 2021 with projections to 2036

Background: Urticaria, a chronic skin condition marked by itchy wheals, significantly affects quality of life. However, the latest comprehensive global epidemiological data on urticaria remain sparse, particularly regarding regional disparities and temporal trends in disease burden. Methods: This study aimed to systematically evaluate the global burden of urticaria from 1990 to 2021, providing updated insights into its epidemiological trends and future trajectories. Data on incidence, prevalence, and Disability-Adjusted Life Years (DALYs) were extracted from the Global Burden of Disease (GBD) 2021 study, covering 204 countries and territories. We employed Age-Period-Cohort (APC) modeling to analyze temporal trends, decomposition analysis to assess contributions of population growth and epidemiological changes, and an Autoregressive Integrated Moving Average (ARIMA) model to project disease burden up to 2036. All rates were age-standardized to facilitate comparisons across regions and over time. Results: From 1990 to 2021, global urticaria prevalence number increased by 38.6%, incidence number by 37.8%, and DALYs by 40.2%. The highest burden was observed in Central Europe, while Western Europe reported the lowest rates. Females and children under ten showed higher prevalence and incidence rates. DALYs growth in low socio-demographic index (SDI) regions was primarily driven by population growth, while high SDI regions experienced a decline. Projections indicate a slight increase in prevalence and incidence by 2036. Conclusions: The data suggest a complex interaction of environmental and socio-economic factors affecting urticaria distribution. This study highlights global trends, regional differences, and driving factors of urticaria, providing a scientific basis for targeted public health interventions and resource allocation.