Urticaria is defined by extremely itchy weals (hives), which may or may not be accompanied by erythematous flares. Urticaria is derived from the common stinging nettle Urtica dioica found throughout Europe. Urticaria can be acute or chronic, inducible or spontaneous. 

A weal (or wheal) is a transient skin-colored or pale skin swelling that is typically surrounded by erythema and lasts between a few minutes and 24 hours. 

Urticaria and angioedema can coexist. Angioedema is a more severe swelling of the skin or mucous membranes. 

 

Urticaria classification 

The duration of urticaria is classified. 

  • Acute urticaria (lasting 6 weeks and frequently subsiding within hours to days)
  • Chronic urticaria (lasting more than six weeks, with daily or episodic weals)

 

Chronic urticaria can occur spontaneously or in response to an irritant. Both types are possible to coexist. 

Urticaria classification 

Chronic urticaria is comprised of the following: 

  • Dermographism  
  • Cold urticaria 
  • Cholinergic urticaria 
  • Contact urticaria 
  • Delayed pressure urticaria 
  • Solar urticaria 
  • Heat urticaria 
  • Vibratory urticaria 
  • Vibratory angioedema 
  • Aquagenic urticaria 

 

Urticaria (Hives) 

Clinical manifestations 

Urticarial weals can be as small as a few millimeters in diameter or as large as several centimetres in diameter, white or red in color, with or without a red flare. Each weal may last from a few minutes to several hours and may take on a different shape. Weals may be circular in shape or take the form of rings, a map-like pattern, or massive patches. 

Urticaria can affect any part of the body and is typically widespread. 

Angioedema is more frequently focal. It is most frequently found on the face (particularly the eyelids and perioral areas), hands, feet, and genitalia. This condition may affect the tongue, uvula, soft palate, or larynx. 

Serum sickness caused by blood transfusions and serum sickness-like reactions caused by certain medications result in acute urticaria, bruising, fever, swollen lymph glands, joint pain, and swelling. 

Weals appear approximately 5 minutes after the stimulus and last for a few minutes or up to an hour in chronic inducible urticaria.  

Weals are characterized by the following characteristics: 

  • Linear in dermographism 
  • Tiny in cholinergic urticaria  
  • Confined to contact areas in contact urticaria. 
  • Diffuse rash in cold urticaria 
  • If large areas of skin are affected, fainting may occur (potentially dangerous if swimming in cold water). 
  • In chronic spontaneous urticaria, the weals are more persistent, but each individual lesion resolves within 24 hours. They may occur during specific hours of the day. 

Dermographism  

  • Cold urticaria 
  • Cholinergic urticaria 
  • Contact urticaria 
  • Delayed pressure urticaria 
  • Solar urticaria 
  • Heat urticaria

 

What are the clinical manifestations of urticaria? 

Urticarial weals can range in diameter from a few millimeters to several centimeters, are white or red in color, and may or may not have a red flare. Each weal lasts between a few minutes and several hours and can take on a unique shape. Weals can be circular or shaped like rings, a map-like pattern, or massive patches. 

Urticaria can manifest itself in any area of the body and is frequently widespread. 

Angioedema is a more common type of edema. The face (particularly the eyelids and perioral areas), hands, feet, and genitalia are the most frequently affected areas. The tongue, uvula, soft palate, or larynx may be affected by this condition. 

Acute urticaria, bruising, fever, swollen lymph glands, joint pain, and swelling are all symptoms of serum sickness caused by blood transfusions and serum sickness-like reactions caused by certain medications. 

Weals begin approximately 5 minutes after the stimulus and can last several minutes or up to an hour in chronic inducible urticaria. The following characteristics define weals: 

  • Dermographism is linear, cholinergic urticaria is tiny and contact urticaria is confined to contact areas. 
  • Diffuse in cold urticaria—fainting may occur if large areas of skin are affected (potentially dangerous if swimming in cold water). 
  • The weals are more persistent in chronic spontaneous urticaria, but each individual lesion resolves within 24 hours. They may occur at certain times of the day. 

At Doral health and Wellness, the expert for skin diseases is available.  

A dermatologist is a physician who specializes in the diagnosis and treatment of skin, hair, and nails. Due to the daily exposure of your skin to sunlight, air, pollution, chemicals, and other irritants, it is prone to rashes, inflammation, and even cancer. Hair and nail problems can be caused by infection, illness, hormonal imbalance, or aging. A dermatologist is trained to diagnose and treat medical conditions affecting the skin, hair, and nails, as well as surgical procedures. Certain dermatologist specialists perform cosmetic surgery as well. 

Make an appointment with a Doral dermatologist today to have your conditions diagnosed by the best dermatologists in New York.