Urticaria describes a local or generalised superficial swelling of the skin

Aetiology

• The most common cause of urticaria is allergy although non-allergic causes are seen

Clinical features

• Pale, pink raised skin
• Variously described as 'hives', 'wheals', 'nettle rash'
• Pruritic

Management

• Non-sedating antihistamines (e.g. loratadine or cetirizine) are first-line
  • NICE Clinical Knowledge Summaries suggest continuing these for up to 6 weeks following an episode of acute urticaria
• A sedating antihistamine (e.g. chlorphenamine) may be considered for night-time use (in addition to day-time non-sedating antihistamine) for troublesome sleep symptoms
• Prednisolone is used for severe or resistant episodes