Urticaria

Urticaria 

Updated: 02/11/2021

© Jun Wang, MD, PhD

General features
  • Both acute (< 6 weeks) or chronic (> 6 weeks)
  • Commonly at pressure point 
  • Acute urticaria usually associated with infections, caterpillars and moths, foods and other allergens 
  • Chronic urticaria may be associated with autoimmune disorders, thyroid dysfunctions, underlying malignancy etc
Pathogenesis
  • Localized mast cell degranulation
  • Dermal microvascular hyperpermeability
Contraction of endothelial cells
Retraction of endothelial cells
Direct injury of endothelial cells
Endothelial injury mediated by leukocytes
Transcytosis or vesiculovacuolar pathway

Clinical features
Pathological findings
Management
  • Antihistamine, glucocorticoids, etc.
  • Epinephrine if laryngeal angioedema suspected
Prognosis
  • Acute urticarial
Usually resolve in 1-4 days
May progress rapidly to life-threatening angioedema and/or anaphylactic shock
  • Chronic urticaria
Variable prognosis, depending on comorbid disease and the response to therapy


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