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Chronic urticaria.

B A Burrall¹, G M Halpern, A C Huntley

¹Department of Dermatology, University of California, Davis School of Medicine.

The Western Journal of Medicine

|March 1, 1990

Summary

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Urticaria, a common skin condition, affects many people. Chronic urticaria, lasting over six weeks, often has unknown causes and is treated with antihistamines.

Area of Science:

Dermatology
Immunology

Background:

Urticaria affects 15-20% of the population.
Chronic urticaria, defined as eruptions lasting over 6 weeks, frequently lacks an identifiable cause in over 75% of cases.
Urticaria and angioedema can arise from both immunologic and non-immunologic pathways.

Purpose of the Study:

To provide an overview of various urticaria subtypes.
To discuss diagnostic and treatment considerations for urticaria and angioedema.

Main Methods:

Review of different types of urticaria including urticarial vasculitis, contact urticaria, mastocytosis, physical urticarias (dermatographism, cholinergic, localized heat, cold, aquagenic), and vibratory angioedema.
Discussion of treatment strategies for chronic idiopathic urticaria.

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Main Results:

Specific evaluation and treatment are necessary for distinct urticarial conditions.
Chronic idiopathic urticaria is typically managed with antihistamines, with choices (sedating or non-sedating) dependent on eruption timing.
Some patients may need combination therapy with H1 and H2 antagonists or parenteral corticosteroids.

Conclusions:

Effective management of urticaria involves recognizing specific subtypes and tailoring treatment.
Antihistamines are the mainstay for chronic idiopathic urticaria, with advanced therapies available for refractory cases.