Even though a lifetime prevalence of acute urticaria is as high as 20% in the general population, relapsing or persistent urticaria is rare(1). Chronic urticaria is defined as daily urticaria with or without angioedema (swelling) for a duration of six weeks or more.
Chronic urticaria can be physically triggered by cold, heat, pressure, sun, vibration or water or can be an allergic reaction due to food, airborne or even drug allergy. Chronic urticaria may also be a manifestation of a systemic disease (autoimmune disease such as Lupus, thyroid disease such as Hashimoto), parasitic stool infection or it can be idiopathic. In our allergy offices located in Jupiter and Palm City, we start with a thorough history, then we perform a physical exam and allergy skin tests by the puncture and intradermal method. We also pursue extensive selective and screening laboratory tests including stool studies in order to identify the cause of the urticaria. In rare cases, chronic urticaria may be idiopathic and may last several years with no specific cause.
REFERENCE: Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2)LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: The 2013 revision and update. Allergy 69:868-887, 2014.