Urticaria

Differential diagnosis

  • Acute
    • Allergies – foods, medicines
    • Viral infections
    • Physical stimuli – rubbing, chemicals
  • Chronic
    • Autoimmune
    • Inducible
    • Idiopathic
  • Others
    • Pemphigoid – blisters
    • Eczema – dryness
    • Dermatitis Herpetiformis – Coeliac disease, bowel symptoms

 

Data gathering

  • Red flags – mouth swelling, breathing problems
  • Others – itchy, red, raised areas – self limit within minutes to hours
  • Examine

 

Clinical management

  • Investigations
    • Bloods – FBC, U+E, LFT, TFTs, ESR
  • Explanation
  • Treatment
    • Lifestyle – avoid overheating, stress, alcohol, caffeine, medicaitons (NSAIDs, ACE-I)
    • Medications – topical menthol 1%, antihistamines (high dose, sedative), PO steroids, immunosuppressants
  • Followup / Safety-net
    • Refer to dermatology – prick testing, IgE testing