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urticaria
URTICARIA
Treatment Guideline Chart
Urticaria is characterized by the appearance of wheals (hives) and/or angioedema.
The intensity of the pruritus varies but may be severe enough to disrupt sleep, work or school.
It is classified acute if the urticaria has been present for ≤6 weeks and chronic if >6 weeks. It can be spontaneous (no definite triggering factor) or inducible (a specific definite triggering factor is identified).
It can be triggered by immunological or non-immunological mechanism.

Urticaria References

  1. Kennedy MS. Comprehensive care in the allergy/asthma office: evaluation of chronic eczema and urticaria and angioedema. Immunol Allergy Clin North Am. 1999;19(1):19-33
  2. Alper BS. SOAP: solutions to often asked problems. Choice of antihistamines for urticaria. Arch Fam Med. 2000 Aug;9(8):748-751. http://www.ncbi.nlm.nih.gov/pubmed/?term=Alper+BS%09Choice+of+antihistamines+for+urticaria. PMID: 10927716
  3. Baxi S, Dinakar C. Urticaria and angioedema. Immunol Allergy Clin North Am. 2005 May;25(2):353-367. http://www.ncbi.nlm.nih.gov/pubmed/?term=Baxi+S%2C+Dinakar+C%09Urticaria+and+angioedema. PMID: 15878460
  4. Amar SM, Dreskin SC. Urticaria. Prim Care. 2008 Mar;35(1):141-157. doi: 10.1016/j.iac.2005.03.003. PMID: 18206722
  5. Blauvelt A, Hwang ST, Udey MC. 11. Allergic disorders: allergic and immunologic diseases of the skin. J Allergy Clin Immunol. 2003 Feb;111(2 Suppl):S560-S570. http://www.ncbi.nlm.nih.gov/. PMID: 12592302
  6. Chow SK. Management of chronic urticaria in Asia: 2010 AADV consensus guidelines. Asia Pac Allergy. 2012 Apr;2(2):149-160. doi: 10.5415/apallergy.2012.2.2.149. Accessed 16 Sep 2013. PMID: 22701866
  7. Grattan C, Humphreys F, on behalf of the British Association of Dermatologists Therapy Guidelines and Audit Subcommittee. Guidelines for evaluation and management of urticaria in adults and children. Br J Dermatol. 2007 Dec;157(6):1116-1123. http://www.ncbi.nlm.nih.gov/pubmed/18021095. PMID: 18021095
  8. Grattan C, Powell S, Humphreys F. Management and diagnostic guidelines for urticaria and angio-oedema. Br J Dermatol. 2001 Apr;144(4):708-714. http://www.ncbi.nlm.nih.gov/pubmed/?term=11298527. PMID: 11298527
  9. Greaves M. Chronic urticaria. J Allergy Clin Immunol. 2000 Apr;105(4):664-672. http://www.ncbi.nlm.nih.gov/pubmed/10756214. PMID: 10756214
  10. Grattan CE, Sabroe RA, Greaves MW. Chronic urticaria. J Am Acad Dermatol. 2002 May;46(5):645-657. http://www.ncbi.nlm.nih.gov/pubmed/12004303. PMID: 12004303
  11. Kaplan A. Clinical practice. Chronic urticaria and angioedema. N Engl J Med. 2002 Jan;346(3):175-179. http://www.ncbi.nlm.nih.gov/pubmed/11796852. PMID: 11796852
  12. Greaves MW. Antihistamines. Dermatol Clin. 2001 Jan;19(1):53-62. http://www.ncbi.nlm.nih.gov/pubmed/11155586. PMID: 11155586
  13. Konstantinou GN, Asero R, Ferrer M, et al. EAACI taskforce position paper: evidence for autoimmune urticaria and proposal for defining diagnostic criteria. Allergy. 2013 Jan;68(1):27-36. doi: 10.1111/all.12056. PMID: 23157716
  14. Monroe E, Finn A, Patel P, et al. Efficacy and safety of desloratadine 5 mg once daily in the treatment of chronic idiopathic urticaria. J Am Acad Dermatol. 2003 Apr;48(4):535-541. http://www.ncbi.nlm.nih.gov/pubmed/?term=12664016. PMID: 12664016
  15. Leung DY, Boguniewicz M. Advances in allergic skin diseases. J Allergy Clin Immunol. 2003 Mar;111(Suppl 3):S805-S812. http://www.ncbi.nlm.nih.gov/pubmed/?term=Leung+DY%2C+Boguniewicz+M%09Advances+in+allergic+skin+diseases. PMID: 12618747
  16. Muller BA. Urticaria and angioedema: a practical approach. Am Fam Physician. 2004 Mar;69(5):1123-1128. https://www.aafp.org. PMID: 15023012
  17. Poonawalla T, Kelly B. Urticaria - a review. Am J Clin Dermatol. 2009;10(1):9-21. doi: 10.2165/0128071-200910010-00002. Accessed 21 Jan 2011. PMID: 19170406
  18. Nichols K, Cook-Bolden F. Allergic skin disease: major highlights and recent advance. Med Clin Am. 2009 Nov;93(6):1211-1224. doi: 10.1016/j.mcna.2009.08.004. PMID: 19932327
  19. Zuberbier T. A summary of the new international EAACI/GA(2)LEN/EDF/WAO guidelines in urticaria. World Allergy Organ J. 2012 Jan;5(Suppl 1):S1-S5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488932/pdf/waoj-5-S1.pdf. PMID: 23268477
  20. Zacharisen MC. Pediatric allergy and immunology: pediatric urticaria and angioedema. Immunol Allergy Clin North Am. 1999 Dec;19(2):363-382. doi: 10.1016/S1081-1206(10)62866-9. PMID: 10619346
  21. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EACCI/GA2LEN/ EDF/WAO guideline: management of urticaria. Allergy. 2009 Oct;64(10):1427-1443. http://www.ncbi.nlm.nih.gov/pubmed/19772513. PMID: 19772513
  22. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EACCI/GA2LEN/ EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy. 2009 Oct;64(10):1417-1426. http://www.ncbi.nlm.nih.gov/pubmed/19772512. PMID: 19772512
  23. Zuberbier T, Maurer M. Urticaria: current opinions about etiology, diagnosis and therapy. Acta Derm Venerol. 2007;87(3):196-205. http://www.ncbi.nlm.nih.gov/pubmed/?term=17533484. PMID: 17533484
  24. Habif TP. Urticaria. Clinical Dermatology. 5th ed. Pennsylvania: Mosby, Elsevier; 2010
  25. MedWormhttp://www.medworm.com/rss/index.php/Allergy-%26-Immunology/3/http://www.medworm.com/rss/medicalfeeds/specialities/Allergy-Immunology.xml
  26. MedWorm http://www.medworm.com/rss/index.php/Dermatology/12/ http://www.medworm.com/rss/medicalfeeds/specialities/Dermatology-News.xml
  27. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  28. Khan DA. Chronic urticaria: standard management and patient. UpToDate. http://www.uptodate.com/online/content/topic.do?topicKey=urticari/6548&selectedTitle=4%7E150&source=search_result. Sep 2010. Accessed 20 Dec 2010.
  29. Khan DA. Chronic urticaria: treatment of refractory symptoms. UpToDate. http://www.uptodate.com/contents/chronic-urticaria-treatment-of-refractory-symptoms#H5.August. Aug 2013. Accessed 16 Sep 2013.
  30. Bingham C. New onset urticaria: epidemiology, clinical manifestations, and etiologies. UpToDate. http://www.uptodate.com/. 17 Sep 2010. Accessed 20 Dec 2010.
  31. American Academy of Allergy, Asthma and Immunology. Omalizumab: well tolerated and effective in refractory chronic idiopathic/spontaneous urticaria. AAAAI. https://www.aaaai.org/. Jul 2013. Accessed 16 Sep 2013.
  32. Linscott MS, Crawford MB. Urticaria. eMedicine. http://www.emedicine.com/emerg/topic628.htm.Monroe. 12 Jun 2006. Accessed 12 Jun 2006.
  33. Powell RJ, Leech SC, Till S, et al; British Society for Allergy and Clinical Immunology. BSACI guideline for the management of chronic urticaria and angioedema. Clin Exp Allergy. 2015 Mar;45(3):547-565. doi: 10.1111/cea.12494. Accessed 8 Jan 2016. PMID: 25711134
  34. Antia C, Baquerizo K, Korman A, et al. Urticaria: a comprehensive review. J Am Acad Dermatol. 2018 Oct;79(4):617-633. doi: 10.1016/j.jaad.2018.01.023. Accessed 13 Mar 2019. PMID: 30241624
  35. Asero R. New-onset urticaria. UpToDate. http://www.uptodate.com. 2019.
  36. Khan DA. Chronic spontaneous urticaria: standard management and patient education. UpToDate. http://www.uptodate.com. 2019. Accessed 13 Mar 2019.
  37. Khan DA. Chronic spontaneous urticaria: treatment of refractory symptoms. UpToDate. http:// www.uptodate.com. 2019. Accessed 13 Mar 2019.
  38. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018 Jul;73(7):1393-1414. doi: 10.1111/all.13397. Accessed 11 Feb 2019. PMID: 29336054
  39. Zuberbier T, Bernstein JA. A comparison of the United States and international perspective on chronic urticaria guidelines. J Allergy Clin Immunol Pract. 2018 Jul;6(4):1144-1151. doi: 10.1016/j.jaip.2018.04.012. PMID: 29779967
  40. Zuberbier T, Bindslev-Jensen C, Canonica W, et al. EAACI/GA2LEN/EDF guideline: definition, classification and diagnosis of urticaria. Allergy. 2006 Mar;61(3):316-320. PMID: 16436140
  41. Australasian Society of Clinical Immunology and Allergy (ASCIA). Position paper - chronic spontaneous urticaria (CSU). ASCIA. https://www.allergy.org.au/. 2020.
  42. Maurer M, Eyerich K, Eyerich S, et al. Urticaria: Collegium Internationale Allergologicum (CIA) update 2020. Int Arch Allergy Immunol. 2020 Mar;181(5):321-333. doi: 10.1159/000507218. Accessed 15 Feb 2021. PMID: 32224621
  43. Magerl M, Altrichter S, Borzova E, et al. The definition, diagnostic testing, and management of chronic inducible urticarias – The EAACI/GA²LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy. 2016 Jun;71(6):780-802. doi: 10.1111/all.12884. Accessed 28 Jan 2022. PMID: 26991006
  44. Zuberbier T, Latiff AHA, Abuzakouk M, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2021 Sep 18. doi: 10.1111/all.15090. Accessed 24 Jan 2022. PMID: 34536239
  45. Kaplon H, Chenoweth A, Crescioli S, et al. Antibodies to watch in 2022. MAbs. Jan-Dec 2022;14(1):2014296. doi: 10.1080/19420862.2021.2014296. PMID: 35030985
  46. Bernstein JA, Lang DM, Khan DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. 2014 May;133(5):1270-1277. http://www.aaaai.org. PMID: 24766875
  47. 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. Allergy. 2014 Jul;69(7):868-887. doi: 10.1111/all.12313. PMID: 24785199
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