Urticaria, also known as hives, is a skin condition characterized by the appearance of red, itchy, and swollen welts on the skin.
It can be caused by a variety of factors, including allergic reactions, infections, and certain medications.
Diagnosing urticaria involves a combination of medical history, physical examination, and sometimes laboratory tests.
1. Medical history: The doctor will ask about the patient's medical history, including any known allergies, recent illnesses, and medications taken.
They will also inquire about the onset of symptoms, their duration, and any potential triggers.
2. Physical examination: The doctor will examine the skin for the presence of welts, their size, and distribution.
They may also check for other signs of an allergic reaction, such as swelling of the face, lips, or tongue.
3. Laboratory tests: In some cases, the doctor may order blood tests to check for the presence of allergies or infections.
Skin tests, such as a skin prick test or patch test, may also be performed to identify specific allergens.
4. Allergy tests: If the doctor suspects an allergic reaction, they may refer the patient to an allergist for further testing.
This may include skin prick tests, patch tests, or blood tests to identify specific allergens.
5. Differential diagnosis: The doctor will also consider other possible causes of the symptoms, such as other skin conditions or underlying medical conditions, and may order additional tests to rule these out.
6. Provocation tests: In cases of physical urticaria, where the hives are triggered by physical stimuli such as heat, cold, or pressure, the doctor may perform a provocation test to confirm the diagnosis.
This involves exposing the skin to the suspected trigger to see if a reaction occurs.
7. Autoimmune tests: In cases of chronic urticaria, the doctor may order tests to check for autoimmune disorders, as these can sometimes cause the condition.
8. Imaging tests: In rare cases, imaging tests such as an X-ray or CT scan may be ordered to rule out other conditions that may cause similar symptoms.
Overall, diagnosing urticaria involves a combination of medical history, physical examination, and sometimes laboratory tests.
The goal is to identify the underlying cause and determine the best course of treatment for the patient.
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Schoepke N, Doumoulakis G, Maurer M: Diagnosis of urticaria. Indian J Dermatol. 2013, 58 (3): 211-8.
Hochstadter EF, Ben-Shoshan M: Cold-induced urticaria: challenges in diagnosis and management. BMJ Case Rep. 2013, 2013 (): .
Ensina LF, Brandão LS, Neto HC, Ben-Shoshan M: Urticaria and angioedema in children and adolescents: diagnostic challenge. Allergol Immunopathol (Madr). 2022, 50 (S Pt 1): 17-29.
Silvestre Salvador JF, Giménez-Arnau AM, Gómez de la Fuente E, González Del Castillo J, Martínez Virto AM, Miguens Blanco I, Serra-Baldrich E, Llorens P: Managing urticaria in the emergency department: recommendations of a multidisciplinary expert panel. Emergencias. 2021, 33 (4): 299-308.
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