Urticaria

Question 1

Urticaria

Answer 1

Small itchy lumps that appear on the skin

May be associated with a patchy erythematous rash

Maybe associated with angioedema or flushing of skin

Question 2

Types of urticaria

Answer 2

Acute

Chronic

Question 3

Pathophysiology of urticaria

Answer 3

Caused by the release of histamine and other pro-inflammatory chemicals by mast cells in the skin.

This may be part of an allergic reaction in acute urticaria or an autoimmune reaction in chronic idiopathic urticaria

Question 4

Causes of Acute Urticaria

Answer 4

Allergies to food, medications or animals

Contact with chemicals, latex or stinging nettles

Medications

Viral infections

Insect bites
Dermatographism (rubbing of the skin)

Question 5

Acute urticaria

Answer 5

Typically triggered by something that stimulates the mast cells to release histamine

Question 6

Chronic Urticaria

Answer 6

Autoimmune condition where autoantibodies target mast cells and trigger them to release histamines and other chemicals

Question 7

Types of chronic urticaria

Answer 7

Chronic idiopathic urticaria

Chronic inducible urticaria

Autoimmune urticaria

Question 8

Chronic idiopathic urticaria

Answer 8

Recurrent episodes of chronic urticaria without a clear underlying cause or trigger

Question 9

Chronic inducible urticaria

Answer 9

Episodes of chronic urticaria that can be induced by certain triggers, such as:

Sunlight
Temperature change
Exercise
Strong emotions
Hot or cold weather
Pressure (dermatographism)

Question 10

Autoimmune urticaria

Answer 10

Associated with an underlying autoimmune condition such as SLE

Question 11

Management of urticaria

Answer 11

Antihistamines

Chronic urticaria - fenoxfenadine

Referral to specialist:
- Anti-leukotrienes - montelukast

• Omalizumab, which targets IgE
• Cyclosporin

Question 12

Management for severe flares

Answer 12

Oral steroids