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Urticaria

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Key Points 2 Î Acute urticaria and angioedema are differentiated from chronic urticaria (CU) based on the duration of illness. Urticaria and angioedema with duration of <6 weeks is termed acute urticaria. Î If urticaria of <6 weeks' duration has features suggesting it might progress to a chronic illness, such patients should be periodically re-evaluated until a diagnosis is clarified. Î Acute urticaria and angioedema should be differentiated from anaphylaxis. • Urticaria/angioedema associated with signs and symptoms in organs other than the skin, such as the pulmonary tract (wheezing and cough), gastrointestinal system (vomiting and diarrhea), nervous system (dizziness and loss of consciousness), or cardiac system (changes in blood pressure or heart rate), can occur in patients with anaphylaxis. Î Epinephrine should be prescribed if the diagnosis of anaphylaxis has not been excluded. Acute Urticaria and Angioedema Î Acute urticaria and angioedema are differentiated from chronic urticaria and angioedema (CUA) based on duration of illness. (D) Î Acute urticaria and angioedema should be differentiated from anaphylaxis. (D) Î Acute urticaria and angioedema are often but not always related to mast cell and basophil activation from multiple triggers, which include IgE- and non–IgE-mediated mechanisms. (LB) Î Acute urticaria and angioedema are more frequently associated with identifiable conditions. When this disorder becomes chronic, it is less likely to be associated with an identifiable cause. (D) Î Although skin biopsy is not indicated in most cases of acute urticaria and angioedema, it might occasionally be useful for differentiating this condition from other inflammatory disorders. (C) Î Common causes of acute urticaria and angioedema, including medications and foods, should be identified by a detailed history and eliminated, if possible. (C) Acute, Chronic and Physical Urticaria and Angioedema

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