20.500.12556/DiRROS-32349 Guideline-recommended inflammatory testing in symptomatic dermographism a real-world study Guideline-recommended inflammatory testing in symptomatic dermographism: a real-world study Introduction: Symptomatic dermographism (SD) is the most common form of chronic inducible urticaria and is increasingly recognized as a burdensome disease. The 2026 international urticaria guideline recommends eliciting dermographism and threshold testing for diagnosis and includes differential blood count and erythrocyte sedimentation rate or C-reactive protein (CRP) as an extended diagnostic work-up in patients with SD. However, the clinical usefulness of these inflammatory tests in SD remains incompletely characterized.Methods: In this retrospective real-world cohort study, we examined whether routine inflammatory markers provide interpretable signals in SD, using chronic spontaneous urticaria (CSU) as a reference comparator and serum protein electrophoresis-derived markers, including the inflammatory protein ratio (IPR) ([alpha-1 + alpha-2]/albumin × 100), as exploratory measures of inflammation. We included 726 patients with available serum protein electrophoresis (SPE) data: 579 with CSU only, 107 with SD only, and 40 with both diagnoses. Patients with both CSU and SD were excluded from the primary binary comparison, leaving 686 patients for the main CSU-only versus SD-only analysis.Results: Compared with CSU, SD showed lower CRP (median [IQR]: 1.40 [0.70–3.30] vs. 2.10 [0.90–5.50] mg/L; p = 0.003) and higher basophil counts (0.04 [0.03–0.05] vs. 0.03 [0.02–0.05] × 109/L; p < 0.001), both of which remained significant after false discovery rate correction. SD patients were younger than CSU patients (39.0 [32.0–49.0] vs. 45.0 [35.0–58.0] years; p = 0.001). In age- and sex-adjusted logistic regression models, higher CRP and lower basophils remained associated with CSU. IPR did not differ significantly between SD and CSU but correlated strongly with CRP in both SD- and CSU-only patients (rho = 0.551 and rho = 0.550, respectively; both p < 0.001).Discussion: Overall, these results show that some interpretable inflammatory signals are present in SD, but they do not clearly explain why these markers should be measured routinely in SD. complete blood count chronic inducible urticaria chronic spontaneous urticaria inflammatory biomarkers real-world cohort serum protein electrophoresis symptomatic dermographism celotna krvna slika kronična spodbujena urtikarija kronična spontana urtikarija vnetni biološki označevalci kohorta iz resničnega sveta elektroforeza serumskih beljakovin simptomatski dermografizem true false true Frontiers Research Foundation, 2010- Frontiers in immunology Angleški jezik Slovenski jezik © 2026 Bizjak-Suran and Stojanovič. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Neznano 2026-09-08 09:53:53 2026-09-08 09:53:55 2026-09-09 03:47:07 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 6. 8. 2026; 7 str. [article no.] 1901562 Vol. 17 6 Avg 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2026-06-05 2026-07-22 2026-08-06 616.514-071 1664-3224 10.3389/fimmu.2026.1901562 287145475 https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1901562/full 1 76b701f3-ab5a-11f1-b028-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=50591 RAZ_Bizjak-Suran_Mojca_2026.pdf RAZ_Bizjak-Suran_Mojca_2026.pdf 1 D2FF5AF9DFBEC63F9068A4D64E4E79A6 6727fc0102e1b3b53e02f47d8274f3b7b1764c0a36cd5ec115f8f8c8328cfd66 e160bc7d-ab5b-11f1-b028-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=50592 Univerzitetna klinika za pljučne bolezni in alergijo Golnik 0 0 0