Not all urticaria is due to allergic reactions - Sean M Fox


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Acute Urticaria and Anaphylaxis: Differences and Similarities in Clinical Management

Initial treatment of acute urticaria should focus on the short-term alleviation of pruritus and reduction of wheals. The literature on the management of acute urticaria is rare, probably because the condition is too often self-limited. Current guidelines recommend modern second-generation H1-antihistaminess...

In patients with poor response to antihistamines, a brief course of oral corticosteroids might also be required while attempting to eliminate suspected triggers and develop an effective treatment plan

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 Acute Urticaria and Anaphylaxis: Differences and Similarities in Clinical Management

Acute urticaria is a common condition that presents with wheals and/or angioedema. However, these symptoms are also frequent in anaphylaxis, a life-threatening reaction that should be immediately diagnosed and treated. In both, mast cells play a central role in the physiopathology.


We review acute urticaria (<6 weeks in duration). We review the recent international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. In addition, we review some of the controversy regarding the administration of steroids for acute urticaria.

BC Emergency Medicine Network

May be associated with angioedema, as in the case of histamine-mediated reactions including anaphylaxis. Common causes of urticaria: Allergic reactions (food, medications, arthropods). Infection (viral, bacterial, parasitic). Direct Non-allergic Mast Cell activation (radiocontrast, foods, stinging nettle, medications e.g. NSAIDs, narcotics). Systemic Disease (autoimmune disorders, vasculitis, malignancy). Scombroid Syndrome (ingestion of improperly stored fish): Tuna mackerel, mahi mahi, sardine, anchovy...

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