top of page

Urticaria

Urticaria presents as small, itchy lumps on the skin, associated with a patchy erythematous rash. It occurs as mast cells release histamine and other pro-inflammatories into the skin, which may be part of an allergic reaction or an autoimmune reaction.


Acute Urticaria

This is triggered by Mast cell stimulation, which includes:

  • Allergens

  • Contact with chemicals, latex or stinging nettles

  • Medications

  • Viral infections

  • Insect bites

  • Rubbing of the skin

“Urticaria” © James Heilman, MD CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/)

Chronic Urticaria

This is an autoimmune condition where autoantibodies target and stimulate mast cells to release histamine.


It's classified further into:

  • Chronic idiopathic - Recurrent episodes that occur without a clear underlying cause or trigger

  • Chronic inducible - Induced by certain triggers, such as:

    • Sunlight

    • Temperature change

    • Exercise

    • Strong emotions

    • Hot or cold weather

    • Pressure (Dermatographism)

  • Autoimmune - Associated with an underlying autoimmune condition, such as SLE

“Typical presentation of chronic spontaneous urticaria. Image used with permission from ECARF” © Allergyresearch CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

Management

  • Antihistamines - Fexofenadine (1st line for chronic urticaria)

    • Cetirizine and promethazine are other options

  • Oral steroids may be considered as a short course for severe flares

  • In very severe cases, refer to a specialist for treatment



bottom of page