Chronic urticaria--assessment and treatment.
BACKGROUND
Chronic urticaria is a common condition encountered in general practice and a frequent source of referral to the clinical immunologist, allergist and dermatologist.


OBJECTIVE
This article discusses the assessment and management of chronic urticaria in the general practice setting.


CONCLUSIONS
Chronic urticaria is defined as the occurrence of transient wheals lasting more than 6 weeks in duration. In 80% of cases, a cause is not identified and this is classified as chronic idiopathic urticaria. A physical trigger, vasculitis or systemic disease account for a smaller proportion of cases. Allergic causes are rarely responsible. A detailed history provides the most useful information in determining the presence of chronic urticaria and a possible aetiology. Apart from thyroid function tests and thyroid autoantibodies, other investigations should only be performed if clinically indicated. Second generation antihistamines are the mainstay of treatment and usually twice daily regimens are required for adequate control. H2 antagonists, doxepin and immunomodulation may be necessary in some patients.
Fernando
Suran
S
Department of Clinical Immunology, Royal North Shore Hospital, St Leonards, New South Wales. sfernando@nsccahs.health.nsw.gov.au
Broadfoot
Andrew
A
D002908:Chronic Disease; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage / Q000627:therapeutic use*; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D012307:Risk Factors; D014581:Urticaria / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology
D039563:Histamine H1 Antagonists, Non-Sedating; D006635:Histamine H2 Antagonists