An algorithm for the diagnosis and treatment of chronic inducible Urticaria, 2024 update

Maurer, M., Bonnekoh, H., Grekowitz, E. et al.  Allergy. 2024 https://doi.org/10.1111/all.16250

How to diagnose chronic inducible urticarias. 

The definition and classification of chronic inducible urticariaChronic inducible urticaria (CIndU) is defined by pruritic wheal formation and/or angioedema in response to a definite and specific trigger.1, 2 CIndUs account for 20–30% of all cases of chronic urticaria, that is, urticaria that lasts longer than 6 weeks. Wheals and angioedema, in most types of CIndU, usually occur within 10 min after exposure to the trigger and resolve within 1–3 h after cessation of exposure, except for delayed pressure urticaria (DPU), where symptoms do not appear until hours after exposure to trigger and last up to 24 h. CIndU subtypes are characterized and classified by their specific triggering stimulus, that is, physical and non-physical triggers. Physical stimuli are mechanical friction (symptomatic dermographism), exposure to cold (cold urticaria, ColdU), to heat (heat Urticaria), to components of solar radiation (solar urticaria), pressure (DPU), or vibration (vibratory angioedema). Non-physical stimuli include physical activity (cholinergic urticaria), contact with water (aquagenic urticaria) or to specific agents (contact Urticaria).3 In the absence of the specific trigger, symptoms do not develop in CIndU. A discussion of atypical subtypes of CIndU is provided in the supplement...

The three Ms of managing chronic inducible urticaria (CIndU): Measure, Mitigate, and Medicate.

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