Urticaria

Question 1

Urticaria is mediated by cutaneous _______ cells in the superficial dermis.

Answer 1

mast

Question 2

Urticaria is also known as….

Answer 2

Hives

Question 3

What issue?
(1) Transient, edematous, red plaques vary in size and shape; typically round or oval. May become confluent and polycyclic.
(2) Lesions may be uniformly red, pink or flesh- colored or surrounded by a white or red halo.
(3) Dynamic: Plaques change in size and shape by peripheral extension, migrate and regress.
(4) Individual lesions last less than 24 hours.

Answer 3

Acute Urticaria

Question 4

What issue?
(1) Defined as urticarial or whealing of the skin for more than 6 weeks.
(2) In the majority of patients with chronic urticaria, an underlying disease will not be found.
(3) Affects all ages, but highest incidence is in young adults.

Answer 4

Chronic Urticaria (>6 weeks)

Question 5

Tx for urticaria

Answer 5

(1) All suspected triggers (drugs, food and drink, inhalants) should be discontinued.
(2) Antihistamines are typically administered initially; this includes:
–(a) H1 blockers such as Hydroxyzine 10-25 mg q 4-6 hours.
–(b) Non-sedating H1 blockers do not work as well, but are useful for daytime hours: Loratidine (Claritin) 10 mg, Cetirizine (Zyrtec) 5-10 mg and Fexofenadine (Allegra) 60-180 mg.
–(c) Prednisone can be given periodically and may work in people whose condition is difficult to treat with antihistamines alone.
(3) Epinephrine is administered for extensive, severe cases with intolerable itching.
(4) Topical steroids are generally not effective.

Question 6

True/False
Topical steroids are effective in managing urticaria

Answer 6

False

Question 7

Urticaria Differential Diagnosis

Answer 7

(1) Drug eruption
(2) Viral exanthema
(3) Bites (popular urticaria)
(4) Hereditary angioedema
(5) Anaphylaxis