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Urticaria and angioedema.

Amin Kanani1, Stephen D Betschel2, Richard Warrington3

  • 11Division of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, BC Canada.

Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
|September 29, 2018
PubMed
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Urticaria and angioedema are common conditions. While antihistamines treat urticaria, angioedema requires identifying triggers, especially bradykinin-mediated types, for effective management.

Area of Science:

  • Dermatology
  • Allergy and Immunology
  • Pharmacology

Background:

  • Urticaria (hives) and angioedema (subcutaneous swelling) are common conditions, often classified as acute or chronic.
  • Histamine type 1 (H1)-receptor antihistamines are the primary treatment for urticaria.
  • Angioedema can occur independently and is categorized as histamine-mediated or non-histamine-mediated (bradykinin-driven).

Purpose of the Study:

  • To review the causes, diagnosis, and management of urticaria and isolated angioedema.
  • To highlight the distinct diagnostic and therapeutic approaches for urticaria versus angioedema.
  • To differentiate between histamine-mediated and bradykinin-mediated angioedema.

Main Methods:

  • Review of current medical literature on urticaria and angioedema.
Keywords:
Acquired angioedemaAcute urticariaAngioedemaChronic spontaneous urticariaChronic urticariaHereditary angioedemaInducible urticariaUrticaria

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  • Analysis of diagnostic criteria and treatment strategies.
  • Comparison of management approaches for different types of angioedema.

    • Main Results:

    • Second-generation antihistamines are the mainstay for urticaria.
    • Angioedema management focuses on trigger avoidance; bradykinin-mediated forms (hereditary, acquired, drug-induced) require specific attention.
    • Laryngeal involvement in bradykinin-mediated angioedema poses a risk of fatal asphyxiation.

    Conclusions:

    • Urticaria and angioedema require different diagnostic and therapeutic strategies.
    • Accurate differentiation between histamine- and bradykinin-mediated angioedema is crucial for appropriate management.
    • Early recognition and intervention, especially for severe angioedema, are vital.