Physical urticaria: a common misdiagnosis

The incidence of urticaria, a symptom that accompanies many allergic disorders, is frequently reported to be low. However, an accurate estimate is difficult to determine as the condition is often unreported or misdiagnosed. Because the associated discomfort of urticaria is disproportionate to the seriousness of the condition, the lay public and health professionals alike tend to dismiss or overlook the need for a diagnostic workup and treatment options. Urticaria, however, can have a tremendous impact on the everyday life of the sufferer, and the significance of this condition warrants attention. In this paper, a brief overview of urticaria and its physiology is provided, followed by a discussion of the different types of physical urticarias. Assessment and diagnosis, cautions, guidelines, and techniques for the primary care provider are discussed.