. Allergopedia

Dictionary of Allergies .. Urticaria

Urticaria, Κνίδωση. Urticaria is a relatively common autoimmune/autoreactive skin disorder that may severely impair quality of life. Although rarely life-threatening, widespread urticaria and its associated angioedema can be an extremely disabling and difficult-to-treat condition. Patients may suffer symptoms such as pruritus and disfigurement due to wheals for years or decades. Urticaria is caused by cutaneous mast-cell degranulation attributed to immunological, non-immunological, and idiopathic causes.

The last decade has seen some notable advances in the understanding of the etiology and pathogenesis of common forms of urticaria and their management. Furthermore, the wide diversity in urticaria subtypes has been identified and this reflects a partial understanding of the causes or factors that trigger it as well as the molecular and cellular mechanisms that are involved in its physiopathology[1].

After the urticaria subtype is defined, potential triggers should be sought including persistent bacterial infections (Helicobacter pylori, streptococci, staphylococci, Yersinia, parasites) pseudoallergic reactions (acetylsalicylic acid, rarely food additives) and/or autoreactive mechanisms (autologous serum test). Identified trigger factors should be avoided or eradicated, as this is the most successful therapeutic approach.

Treatment of most urticaria subtypes is difficult and besides H1 antihistamines neither standardized nor evidence-based. Low-sedating H1 antihistamines represent the mainstay of treatment, as they have a better therapeutic index and pharmacodynamic properties than older agents. In severe cases their dose has to be increased which is off-label use. The evidence base for treatment alternatives is totally insufficient and the risk-benefit profile of each off-label used drug should be carefully considered [2].

•    Patients will know where their disease is coming from and they don't have to worry about things like food etc.

•    Physicians know that these patients are hard to treat because they need more antihistamines to achieve the same levels of symptom control.

•    Patients may have their disease for a longer dura­tion of time.

•    Patients show more commonly other autoimmune disorders and should be checked for autoantibodies.



1. Khalaf AT, Li W, Jinquan T.Current advances in the management of urticaria. Arch Immunol Ther Exp (Warsz). 2008 Mar-Apr;56(2):103-14. Epub 2008 Mar 31.


2. Wedi B.Urticaria.J Dtsch Dermatol Ges. 2008 Apr;6(4):306-17.

Γκέλης Ν.Δ. - Λεξικό Αλλεργίας - Εκδόσεις ΒΕΛΛΕΡOΦΟΝΤΗΣ - Κόρινθος 2013

Gelis Ν.D. - Dictionary of Allergies - VELLEROFONTIS Publications - Corinth 2013