Chronic Urticaria

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About Chronic Urticaria

Chronic urticaria is a dermatologic condition characterized by recurrent episodes of raised, pruritic wheals (hives) that persist for more than six weeks. It affects approximately 1-5% of the population and can significantly impact quality of life due to unpredictable flare-ups and associated symptoms like angioedema.

Pathophysiology

The condition involves mast cell degranulation and histamine release, leading to increased vascular permeability and wheal formation. While acute urticaria is often triggered by allergens, chronic urticaria is typically non-allergic and may involve autoimmune mechanisms, with many cases being idiopathic despite extensive workup.

Clinical Reasoning

Diagnosis is primarily clinical based on the characteristic appearance of wheals and duration of symptoms exceeding six weeks. Treatment focuses on antihistamine therapy as first-line management, with consideration of underlying autoimmune causes and trigger avoidance when identifiable triggers are present.

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. International EAACI/GA²LEN/EuroGuiDerm/APAAACI Guideline for Chronic Urticaria. Allergy. https://doi.org/10.1111/all.15090
  4. Chronic Urticaria Practice Parameter. JACI: In Practice. https://doi.org/10.1016/j.jaip.2021.12.013

Related Topics

Urticaria & AngioedemaAnaphylaxisAngioedemaAllergic RhinitisAtopic Dermatitis