Urticaria Follow-up

  • Author: M Scott Linscott, MD, FACEP; Chief Editor: Pamela L Dyne, MD   more...
 
Updated: Apr 2, 2010
 

Further Inpatient Care

  • In general, patients with urticaria can be cared for on an outpatient basis unless their urticaria is severe and does not respond to antihistamine therapy or if they progress to laryngeal angioedema and/or anaphylactic shock, or have comorbidities that require inpatient therapy.
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Further Outpatient Care

  • Most patients with urticaria can be treated at home on H1 antihistamines (ie, diphenhydramine 50 mg q6h or hydroxyzine 50 mg q6h for 24-48 h) or, in refractory cases, use a combination of H1 and H2 antihistamines plus oral glucocorticoids.
  • If the patient has angioedema that is treated successfully in the ED, the patient should be sent home with an EpiPen prescription and told to keep it with him or her at all times and to use it if swelling of the lips, tongue, face develops or if his or her voice acutely become hoarse.
  • Consultation with or referral to a dermatologist, allergist, immunologist, or rheumatologist may be appropriate in cases of suspected urticarial vasculitis and in cases of chronic or recurrent urticaria.
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Deterrence/Prevention

  • Patients with urticaria should avoid any medication, food, or other allergen that has precipitated urticaria or other serious allergic reaction previously.
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Prognosis

  • The prognosis in acute urticaria is excellent, with most cases resolving within 1-4 days.
  • The prognosis in chronic urticaria is more guarded and depends upon the comorbid disease causing the urticaria as well as the response to therapy.
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Patient Education

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Contributor Information and Disclosures
Author

M Scott Linscott, MD, FACEP  Professor, Division of Emergency Medicine, Professor of Surgery (Clinical), University of Utah School of Medicine

M Scott Linscott, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, and Utah Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Steven A Conrad, MD, PhD  Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center

Steven A Conrad, MD, PhD is a member of the following medical societies: American College of Chest Physicians, American College of Critical Care Medicine, American College of Emergency Physicians, American College of Physicians, International Society for Heart and Lung Transplantation, Louisiana State Medical Society, Shock Society, Society for Academic Emergency Medicine, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Mark W Fourre, MD  Program Director, Department of Emergency Medicine, Maine Medical Center; Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD  Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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