CHRONIC URTICARIA – HOW TO DIAGNOSE?

Chronic urticaria diagnosis is almost exclusively based on patient’s report of the condition to the doctor. That’s why it is so important to have all facts concerned to your condition in mind, and to bring pictures, if available.

Laboratory tests are of little – if any – value for diagnostic, because the various acute or chronic urticaria types are seldom caused by other diseases.

Chronic induced urticaria (physical, cholinergic, aquagenic, and/or contact)

The patient must be submitted to a challenge test targeted to the suspected type of urticaria. For example: when a cold-induced chronic urticaria is suspected, the healthcare professional can use the ice cube test.

Chronic spontaneous urticaria

According to current scientific guidelines, only a few simple blood tests (total blood count and blood chemistry) must be requested, which may be suggestive of some health impairment in the patient. Too many tests and/or complex tests are not required, except if patient’s history is suggestive of other conditions. Laboratory tests are not useful for diagnosis and determining the best therapy for urticaria. Allergy tests should not be requested, because allergies do not lead to chronic urticaria.

References:
J Allergy Clin Immunol. 2014 May;133(5):1270-7
Allergy. 2014 Jul; 69(7):868-87
Acta Derm Venereol 2017; 97: XX–XX; Epub ahead of print Jun 28, 2016
Allergy.  2009: 64: 1715–1721 _ 2009
Immunol Allergy Clin N Am 34 (2014) 53–72