Assessment of serum total immunoglobulin E levels as a biomarker of severity and duration of chronic spontaneous urticaria: A cross-sectional study

Dear Editor,

In July–December 2025 issue of the Indian Journal of Skin Allergy, Farouk et al.^[1] found that the total serum immunoglobulin E (IgE) levels were increased frequently among Egyptian patients with chronic spontaneous urticaria (CSU), which were correlated with a greater disease duration and severity. They concluded that serum IgE levels could be used as a biomarker to assess CSU patients.^[1] We believe that the implication of the study findings in clinical settings and research is challenged by the following crucial study limitation. To determine a value that signals the lowest threshold at which a specific disorder or health concern is imminent, the cutoff value (CoV) is typically employed. Referring to the predicted CoV quantified by describing a receiver operating characteristic (ROC) curve and measuring the area under the ROC (AUROC) is fundamental for using a particular biomarker in early detection and predicting the severity and stage progression of a specific disease, as well as implementing the necessary therapeutic lines.^[2,3] To facilitate the clinical usefulness of the study findings, depicting the ROC curve and estimating AUROC for the serum IgE levels biomarker under study to produce CoV with the best sensitivity and specificity were envisaged from Farouk et al.^[1]