How is it Diagnosed?
Urticaria, or hives, is primarily diagnosed clinically based on a detailed patient history
and physical examination. The condition is characterized by the sudden appearance of
red, raised, itchy welts on the skin that typically resolve within 24 hours. Diagnosis
includes identifying the pattern (acute or chronic), possible triggers (foods, medications,
infections, stress, temperature), and associated symptoms like angioedema.
There are no specific tests for urticaria itself, but routine blood tests (CBC, ESR, CRP)
may help rule out underlying infections or autoimmune disorders. In chronic or recurrent
cases, thyroid function tests, ANA, or specific IgE tests may be ordered. Skin prick
testing or serum-specific IgE may identify allergens in suspected allergic urticaria.
In physical urticarias (e.g., cold, pressure, cholinergic), provocation tests (ice cube test,
exercise challenge) are performed. Chronic spontaneous urticaria often has no
identifiable cause and is diagnosed after ruling out differential diagnoses like vasculitis,
which requires a skin biopsy.