Urticaria and Angioedema

Urticaria, also referred to as hives or wheals, is a common and distinctive reaction pattern. Hives may occur at any age; up to 20% of the population will have at least one episode. Hives may be more common in atopic patients. Urticaria is classified as acute or chronic. The majority of cases are acute, lasting from hours to a few weeks. Angioedema frequently occurs with acute urticaria, which is more common in children and young adults. Chronic urticaria (arbitrarily defined as episodes of urticaria lasting more than 6 weeks) is more common in middle-aged women.

Because most individuals can diagnose urticaria and realize that it is a self-limited condition, they do not seek medical attention.

The cause of acute urticaria is determined in many cases, but the cause of chronic urticaria is determined in only 5% to 20% of cases. Patients with chronic urticaria present a frustrating problem in diagnosis and management. History taking is crucial but tedious, and treatment is usually supportive rather than curative.

These patients are often subjected to detailed and expensive medical evaluations that usually prove unrewarding. Studies demonstrate the value of a complete history and physical examination followed by the judicious use of laboratory studies in evaluating the results of the history and physical examination.