10
Figure 2. Evaluation of Chronic Urticaria
1. Patient presents with history suggestive of chronic urticaria and/or angioedema
3. Consider
medications, C1-
INH syndromes,
or conditions that
mimic angioedema
7. Consider
appropriate
challenge testing
for physical
urticaria.
9. If skin biopsy is
diagnostic for
vasculitis, manage
vasculitis. If
biopsy negative
go to box 10.
11. Evaluate and
manage specific
conditions.
5. Consider
alternative
diagnoses
(See Differential
Diagnosis)
12.
• Management of
chronic urticaria/
angioedema.
(See Treatment).
• Periodic
reassessment for
underlying etiology
and response to
therapy.
2. Does patient
have angioedema?
4. Is history,
review of systems,
and physical examination
consistent with the
diagnosis?
8. Does the
history or physical
examination suggest
vasculitis?
10. Are
history, physical
examination, and/or
basic laboratory tests
indicative of an
underlying cause?
NO
NO
NO
NO
YES
YES
YES
YES
YES
Acute, Chronic and Physical Urticaria
and Angioedema
6. Does the
history suggest
physical urticaria? Is
there a physical component
to the urticaria and/or
angioedema?
Diagnostic
Treatment
NO
