Urticaria

Question 1

What is urticaria also known as?

Answer 1

Hives

Question 2

What is urticaria?

Answer 2

A skin rash with red, raised, itchy bumps

Question 3

What are the timescales of urticaria?

Answer 3

Acute or chronic

Question 4

When does urticaria become chronic?

Answer 4

When it lasts over 6 weeks

Question 5

Is chronic urticaria common in children?

Answer 5

No, its rare

Question 6

What is the underlying cause of acute urticaria?

Answer 6

IgE mediated type-I hypersensitivity reaction

Question 7

What causes the skin lesion of urticaria?

Answer 7

Inflammatory reaction in the skin leading to leaky capillaries in the dermis resulting in oedema

Question 8

How doe the oedema of urticaria subside?

Answer 8

When the interstitial fluid is absorbed into the surrounding cells

Question 9

What are the causes of urticaria?

Answer 9

• Idiopathic
• Infections
• Dietary
• Drugs
• Plants
• Hereditary
• Urticarial vasculitis
• Physical urticarial
• Autoimmune

Question 10

What are some dietary causes of urticaria?

Answer 10

• Fish
• Shellfish
• Nuts
• Eggs

Question 11

What drugs can cause urticaria?

Answer 11

• Penicillin
• Aspirin
• NSAIDs
• ACE inhibitors

Question 12

What can cause physical urticaria?

Answer 12

• Water contact
• Exercise induced
• Vibratory
• Cold contact

Question 13

What autoimmune condition can cause urticaria?

Answer 13

SLE

Question 14

What are the risk factors for urticaria?

Answer 14

• Hay fever

- Asthma

Question 15

What is acute urticaria characterised by?

Answer 15

Short-lived, itchy wheals, angioedema or both

Question 16

How long do the wheals last in acute urticaria?

Answer 16

2-24 hours depending on cause

Question 17

What investigations are required in acute urticaria?

Answer 17

None

Question 18

What tests may be require in severe, chronic urticaria?

Answer 18

• FBC
• ESR
• TFT
• ANA
• LFT
• IgE
• Allergy testing
• Physical challenge

Question 19

What are the differentials of urticaria?

Answer 19

• Drug eruptions
• Stevens-Johnson syndrome
• Erythema multiforme

Question 20

How can urticaria be managed?

Answer 20

• Avoid trigger
• Non-sedating antihistamine
• Menthol 1% in aqeuos cream to sooth itch

Question 21

When may short-term prednisolone be indicated?

Answer 21

If child remains symptomatic on maximal antihistamine dose

Question 22

What other medications may be useful?

Answer 22

• H2 blocker
• Anti-leukotrienes
• Adrenaline

Question 23

When should a referral to dermatologist be made?

Answer 23

• Severe acute urticaria
• Failure of treatment
• Chronic urticaria lasting > 6 weeks