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Urticaria

Todd A. Wical, DO and Katie L. Westerfield, DO, IBCLC, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A cutaneous lesion or lesions involving edema of the epidermis and/or dermis presenting with rapid onset and pruritus, returning to normal skin appearance within 24 hours

  • Pathophysiol...

DIAGNOSIS

HISTORY

Rapid onset; individual lesions resolve in <24 hours, pruritus 
ALERT

Important to rule out underlying anaphylaxis in those patients presenting with acute onset of urticaria (1),(2)[...

TREATMENT

ISSUES FOR REFERRAL

Referral to an allergist, immunologist, or dermatologist for recalcitrant cases, especially if lesions consistently remain present for >24 hours 

GENERAL MEASURES

The mai...

ONGOING CARE

PROGNOSIS

  • Resolution of acute symptoms: 70% <72 hours

  • Chronic urticaria: 35% symptom-free in a year; another 30% will see symptom reduction.

REFERENCES

1
Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Aller...

ADDITIONAL READING

  • Maurer M, Weller K, Bindslev-Jensen C, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA2LEN task force report. Allergy.  2011;66(3):317–330. [View Abstract on...

CODES

ICD10

  • L50.9 Urticaria, unspecified

  • L50.1 Idiopathic urticaria

  • L50.8 Other urticaria

  • L50.2 Urticaria due to cold and heat

  • L50.6 Contact urticaria

  • L50.0 Allergic urticaria

  • L50.5 Cholinergic urticaria

  • L50....

CLINICAL PEARLS

  • Urticaria occurs rapidly and individual lesions resolve within 24 hours, although multiple crops of lesions can occur in stages.

  • Mainstay of therapy is to avoid identified triggers.

  • Anti...

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