Acute and Chronic Urticaria Diagnosis and Management Taking into Account Their Differences

Salman, A., Porras, N.M. & Gimenez-Arnau, A.M. Curr Treat Options Allergy 10, 130–147 (2023). https://doi.org/10.1007/s40521-023-00333-w

Abstract

Purpose of review

Urticaria is a frequent disorder that can present with erythema, edema, and pruritus involving the skin and mucous membranes. Early diagnosis and proper management of the urticaria according to the type (i.e., acute vs chronic) is of utmost importance to reduce the burden of the disease and prevent psychosocial comorbidities. In this review, we aim to summarize the diagnosis and management of acute and chronic urticaria with emphasis on the differences.

Recent findings

Autoimmune mechanisms (type I or type IIb autoimmunity) have been recently defined in the pathogenesis of chronic spontaneous urticaria. Despite the high rates of symptom control in both acute and chronic urticaria with the existing treatment options, new treatments are still needed in a subset of patients. Promising treatment targets in CSU include Bruton’s tyrosine kinase, Siglec-8, or IL-4/13.

Summary

Therapeutic management of acute and chronic urticaria is still challenging despite the highly effective treatments. In addition to symptomatic treatment, elicitation of the pathogenesis of both forms of urticaria and clear understanding of the nature of the disease by the patient are essential. Urticaria has still a high impact on the patients’ quality of life warranting the studies on the pathogenesis, novel treatment options, and the factors determining which patients with acute urticaria will likely develop chronic urticaria.

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