[Therapy of acute and chronic urticaria and of Quincke's edema]

Urticaria is a rather common, often vexing skin disease, characterized by evanescent, pruritic, erythematous wheals, and sometimes by giant hives (angioedema). The cause of chronic urticaria remains unknown in 75 to 80 percent of the cases. Its pathogenesis is related to the activation of tissue mast cells by many immunologic or non-immunologic mechanisms, resulting in a release of biologically active products. The therapeutic possibilities in practice are discussed. Non-sedative antihistaminic drugs of the H1 type (Terfenadine, Astemizole, Loratidine and Cetirizine) are the main stay in the treatment of urticaria. In case of failure the sedative non-selective antihistaminics from the old generation are used. Particular emphasis is given the possibilities to combining various antiallergic drugs. The combination of a H1 and H1 antihistamine can be effective in individual patients.