Table of contents
Acute urticaria
What's new
Added 2022 EAACI/GA²LEN/EDF/APAAACI, 2021 ACD, 2017 AAFP and 2014 AAAAI/ACAAI guidelines for the diagnosis and management of acute urticaria.
Background
Overview
Definition
Acute urticaria is a self-limited cutaneous condition characterized by transient, erythematous, and pruritic wheals or hives.
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Pathophysiology
Acute urticaria is caused by mast cell and basophil activation, leading to the release of histamine and other inflammatory mediators, which results in vasodilation and increased vascular permeability, leading to characteristic skin lesions. The activation of these cells can occur through multiple triggers, including IgE- and non-IgE-mediated mechanisms.
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Epidemiology
The prevalence of acute urticaria in the United Kingdom is estimated at 355 per 100,000 population.
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Disease course
Clinically, acute urticaria presents as itchy, raised welts that can appear anywhere on the body. These hives are transient, often moving from one area of the body to another. In some cases, acute urticarial lesions may display central clearing with an ecchymotic or hemorrhagic hue.
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Prognosis and risk of recurrence
The prognosis of acute urticaria is generally good, as it is typically a self-limiting condition that resolves within 6 weeks.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of acute urticaria are prepared by our editorial team based on guidelines from the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI/GA²LEN/EDF/EAACI 2022), the Australasian College of Dermatologists (ACD 2021), the American Academy of Family Physicians (AAFP 2017), and the American Academy of Allergy, Asthma & Immunology (AAAAI/ACAAI 2014)....
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Screening and diagnosis
Pathophysiology
As per AAAAI/ACAAI 2014 guidelines:
Recognize that acute urticaria and angioedema are often but not always related to mast cell and basophil activation from multiple triggers, which include IgE- and non-IgE-mediated mechanisms.
B
Recognize that acute urticaria and angioedema are more frequently associated with identifiable conditions.
B
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Differential diagnosis
Classification and risk stratification
Diagnostic investigations
Diagnostic procedures
Medical management
Antihistamines: as per AAFP 2017 guidelines, Administer second-generation H1RAs as first-line symptomatic therapy for urticaria.
A
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Corticosteroids
Leukotriene antagonists
Epinephrine autoinjectors