Topic: Urticaria
- When should I refer patients to a specialist and to what specialty should I send them?
Often referral is made when a trigger cannot be identified, or if it is felt to be a food or medication trigger and/or the symptoms persist for >6 weeks. Refer to a dermatologist or allergist–immunologist experienced in the evaluation and work-up of urticaria.
- When should treatment with corticosteroids or other nonstandard therapies be used to treat chronic urticaria?
Typically, these medications carry significant side effects and should be reserved for those patients in whom the urticaria is causing significant alterations in activities of daily living.
- When does a patient need to be hospitalized or observed during an episode of urticaria?
Concerning signs include extensive angioedema, respiratory symptoms such as stridor or wheezing, or nausea/vomiting. Symptoms of anaphylaxis should be treated with epinephrine and the patient observed for several hours to ensure that symptoms do not recur.
(Modified from 5-Minute Pediatric Consult book)