Acute Urticaria Guidelines

Updated: Sep 18, 2023
  • Author: Henry K Wong, MD, PhD; Chief Editor: Michael A Kaliner, MD  more...
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Joint Guidelines

The European Academy of Allergy and Clinical Immunology/Global Allergy and Asthma European Network/European Dermatology Forum/Asia Pacific Association of Allergy Asthma Clinical Immunology (EAACI/GA2LEN/EDF/WAO) panel consensus released an updated guideline in 2022 on the management of urticaria including a treatment algorithm for symptomatic management of chronic spontaneous urticaria. [5]

The guideline recommends a limited workup rather than more extensive diagnostic screening tests.

Second-generation H1-antihistamines are recommended as a first-line treatment for chronic urticaria. If the patient does not respond to this treatment, the guideline recommends increasing the dosage up to four times. Omalizumab is recommended for patients who remain unresponsive to antihistamines after the dose is increased. Ciclosporin is recommended for those who remain unresponsive to both antihistamines and omalizumab.

The guideline recommends against the long-term use of systemic corticosteroids in chronic urticaria, although a short course may be considered for patients with acute exacerbation of their symptoms.