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

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