Chronic Urticaria & Angioedema

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About Chronic Urticaria & Angioedema

Chronic urticaria and angioedema are persistent allergic conditions characterized by recurrent hives and deep tissue swelling lasting more than 6 weeks. These conditions significantly impact quality of life and require systematic evaluation to identify potential triggers and underlying causes.

Pathophysiology

Mast cell degranulation releases inflammatory mediators including histamine, leukotrienes, and prostaglandins, causing increased vascular permeability and vasodilation. In chronic cases, this process becomes self-perpetuating through autoimmune mechanisms, complement activation, or persistent antigenic stimulation leading to ongoing inflammation.

Clinical Reasoning

Diagnosis requires careful history-taking to identify potential triggers, physical examination to assess lesion characteristics, and laboratory testing to rule out systemic causes. Management focuses on antihistamine therapy, trigger avoidance, and in severe cases, immunosuppressive agents or biologics like omalizumab to control symptoms and prevent complications.

References

  1. Urticaria. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK538196/
  2. EAACI/GA²LEN/EDF/WAO Urticaria Guideline. Allergy 2022. https://doi.org/10.1111/all.14773
  3. Angioedema. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK538489/
  4. WAO/EAACI Angioedema Guidelines. WAO J 2022. https://doi.org/10.1186/s40413-021-00375-9
  5. International EAACI/GA²LEN/EuroGuiDerm/APAAACI Guideline for Chronic Urticaria. Allergy. https://doi.org/10.1111/all.15090
  6. Chronic Urticaria Practice Parameter. JACI: In Practice. https://doi.org/10.1016/j.jaip.2021.12.013
  7. WAO/EAACI Guideline for Hereditary Angioedema. WAO Journal. https://doi.org/10.1186/s40413-022-00540-4

Related Topics

Chronic UrticariaUrticaria & AngioedemaAngioedema