How should We Manage Adult Urticaria Patients in Family Medicine?

Abstract

Chronic urticaria is a common dermatological condition characterized by recurrent itchy wheals and/or angioedema lasting for more than six weeks. It is classified into chronic spontaneous urticaria (CSU), with no identifiable trigger, and inducible urticarias, which occur in response to specific physical or chemical stimuli. The disease predominantly affects women in early to middle adulthood and is associated with significant impairment in quality of life due to its chronic nature, psychological burden, and impact on daily activities. The pathogenesis involves mast cell activation, histamine release, and autoimmune mechanisms, including the presence of autoantibodies in a subset of patients. Diagnosis is primarily clinical, supported by laboratory investigations to exclude underlying causes. Treatment follows a stepwise approach starting with second-generation antihistamines and escalating to biologic therapy or immunosuppressive agents in refractory cases. Comprehensive management, including patient education and psychological support, is essential for improving outcomes and quality of life.