Evaluation, diagnosis and management of chronic urticaria.

BACKGROUND Urticaria produces weals, which are itchy and can affect the quality of life and social functioning of an affected patient. There are several different subtypes of urticaria. This article focuses on chronic urticaria. OBJECTIVE This article details the approach to assessment and management of chronic urticaria. DISCUSSION Chronic urticaria is characterised by the occurrence of weals, which occur on a daily basis for more than 6 weeks. Clinical history and physical examination alone are sufficient to establish a diagnosis. Non-sedating histamine H1 receptor antagonists are the first-line treatment and are effective in 60% of patients. These may be supplemented with histamine H2 receptor antagonists. The use of second and third-line treatments is also discussed.