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Urticaria and angioedema: diagnosis and evaluation
1Department of Dermatology, University of Michigan Medical Center, Ann Arbor 48109.
Journal of the American Academy of Dermatology
|July 1, 1991
Summary
Extensive workups for urticaria are generally not recommended early on. Angioedema, often occurring with urticaria, requires a distinct diagnostic approach and may indicate a worse prognosis.
Area of Science:
- Dermatology
- Immunology
Background:
- Urticaria often resolves spontaneously, making early extensive workups unnecessary.
- Angioedema can accompany urticaria, potentially worsening the prognosis.
- Distinguishing between urticaria and angioedema is crucial due to differing diagnostic and treatment pathways.
Purpose of the Study:
- To outline appropriate diagnostic workup strategies for urticaria and angioedema.
- To differentiate the clinical presentation and prognosis of urticaria versus angioedema.
- To highlight specific diagnostic considerations for angioedema, including hereditary angioedema.
Main Methods:
- Review of clinical presentation and diagnostic criteria for urticaria and angioedema.
- Comparison of lesion characteristics, duration, and affected skin layers.
- Discussion of workup protocols based on clinical suspicion and patient presentation.
Main Results:
- Urticarial lesions typically resolve within 2-4 hours, affecting superficial dermis.
- Angioedema lesions can persist up to 72 hours, involving deeper skin layers.
- Chronic angioedema warrants investigation for conditions like hereditary angioedema.
Conclusions:
- Diagnostic workup for urticaria should be guided by clinical suspicion and patient urgency.
- Angioedema requires a broader differential diagnosis, including hereditary angioedema.
- Prompt and accurate diagnosis is essential for effective management of urticarial conditions.
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