Urticaria. The diagnostic challenge of hives

Hives pose a diagnostic challenge to physicians. With an acute episode, a careful look for possible triggers and relief of symptoms with H1 antihistamines are usually sufficient. For both urticaria and angioedema, the most helpful diagnostic tool may be a carefully taken medical history, including a family history. When a patient's urticaria lasts for more than 6 weeks, further physical and laboratory evaluation is warranted. Treatment of chronic urticaria generally involves the use of antihistamines first. Corticosteroids are to be avoided, if possible.