In urticaria – colloquially called hives – (synonyms: Hives; nettle rash; acute urticaria; allergic urticaria; cholinergic urticaria; chronic urticaria; chronic recurrent urticaria; chronic spontaneous urticaria (CsU); dermatography; dermatographic urticaria; skin allergy due to cold; skin allergy due to heat; skin allergy of unknown etiology; heat urticaria; idiopathic urticaria; cold urticaria; contact urticaria; nonallergic urticaria; periodic-recurrent urticaria; periodic-recurrent urticaria; wheal rash; wheal fever; wheal addiction; thermal urticaria due to heat; thermal urticaria due to cold; urticaria; urticaria cholinergica; urticaria factitia; urticaria mechanica; urticaria; urticaria due to food; urticaria due to plants; urticaria due to vibration; urticarial dermographism; urticarial exanthema; heat urticaria; ICD-10 L50. : Urticaria) is a disease characterized by edematous efflorescences (wheals of the skin/mucous membrane). Urticaria is a common skin disease. One can distinguish the following forms of urticaria (according to ICD-10) according to the cause:
- Allergic urticaria with excessive Ig-E formation; belongs to the polygenic inherited atopic diseases.
- Cholinergic urticaria – hives caused by sweating or intense exertion.
- Chronic urticaria
- Idiopathic urticaria – hives whose cause is unclear.
- Contact urticaria – urticarial reaction after contact with an agent.
- Periodic/recurrent urticaria
- Urticaria due to cold/heat
- Urticaria factitia – hives due to mechanical irritation.
- Urticaria mechanica (pressure urticaria)
- Urticaria solaris – urticaria triggered by solar radiation.
Urticaria can be macroscopically divided into different forms (see below “Symptoms – Complaints”). Furthermore, urticaria can be distinguished two main groups: spontaneous and inducible forms of urticaria (combinations are possible). According to the course, urticaria is divided into acute and chronic forms:
- Acute course form
- Acute spontaneous urticaria (ASU; symptom duration of < 6 weeks).
- Chronic course (symptom duration of ≥ 6 weeks) is subdivided as follows.
- Chronic inducible urticaria (CINDU).
- Chronic spontaneous urticaria (CSU)
For more information, see Pathogenesis – Etiology.
Chronic spontaneous urticaria (csU) can be further subdivided into:
- Chronic continuous spontaneous urticaria with daily episodes.
- Chronic-recurrent spontaneous urticaria with episodic course, alternating wheal episodes with symptom-free intervals.
In up to two-thirds of patients, no specific cause of urticaria can be determined. Gender ratio: Women are more often affected by chronic urticaria than men (2: 1). Girls are affected about as often as boys. Frequency peak: Acute urticaria occurs predominantly in the 3rd and 4th decade of life. Chronic urticaria is more likely to manifest in older age. The lifetime prevalence (disease incidence throughout life) is 20% (in Germany). The prevalence of chronic urticaria is 0.5-1%. In children and adolescents, the prevalence is approximately between 2 and 7 %. In allergic patients the prevalence is higher, 3-34.5 % and in allergic children 1.5-16.3 %. Course and prognosis: In most cases, urticaria heals within a few days without sequelae. Acute urticaria usually does not persist for more than 6 weeks. In symptom-free intervals, it can also occur relapsing (recurring).In prolonged and severe disease, a search for the cause is necessary. The chronic form can last for months to years. It is often accompanied by pruritus (itching). The prognosis is worse the longer the affected person suffers from it.
