To the Editor: Symptomatic dermographism (SDerm) is the most common form of physical urticaria with a prevalence of up to 5%.1 SDerm is characterized by itchy wheals that occur in response to friction, for example, after rubbing or scratching of the skin, and usually last for 1 to 2 hours.2 SDerm commonly lasts for years and significantly impairs quality of life (QOL).2 The underlying cause of SDerm is unknown, and the trigger is difficult, if not impossible, to avoid. ...symptomatic treatment with antihistamines is the first-choice treatment. ...omalizumab in doses of 150 and 300 mg resulted in a high rate of complete and partial responders in patients with SDerm and a pronounced overall reduction in disease activity and QOL impairment in these patients. There were no evident differences between omalizumab and placebo, other than their viscosity. Because of this, a separate and independent unblinded study team prepared and injected the study medication. Statistical analysis The UFO study is the first clinical trial of the efficacy and safety of omalizumab in SDerm. ...no pretrial sample size calculation was performed.