Clinical Evaluation of Inpatients With Acute Urticaria

Abstract

Background and Design: To determine the clinical and etiological features of inpatients with acute urticaria and angioedema and to assess the need for laboratory tests. Material and Methods: We recruited 105 patients with acute urticaria and angioedema who were admitted to our inpatient unit. The lesions and the characteristics of the patients were analyzed. Routine diagnostic tests including complete blood count, thyroid function tests, hepatitis panel, stool parasite, total IgE levels, cultures, erythrocyte sedimentation rate, C-reactive protein, anti-nuclear antibody, and posterior anterior lung X-ray were ordered. A psychiatric consultation was obtained, when needed. The results were analyzed with SPSS 15.0 statistical software. Results: Among 105 patients, 28 (26.7%) had urticaria, 7 (6.7%) had angioedema, and 70 (66.70/0) suffered from both urticaria and angioedema. The most common accompanying symptoms were itching (91.40%) and burning (34.3%). The most common systemic symptoms were fatigue (15.2%) and headache (12.4%). The lesions usually appeared in the evening hours (24.8%). Twenty-five patients were waking up due to itching during the night. Some lesions were associated with physical activities. Systemic diseases accompanied the lesions in 12 patients (11%). In terms of etiological factors, 33 patients (22.5%) had infections. Food- related lesions were encountered in 14 (13%) patients. Thirty patients (28.5%) had history of medication use. Stress was detected in 37.1% of the patients; anxiety was diagnosed in 3% of patients. The stool was positive for parasites in 10 (9%) patients. Conclusion: Acute urticaria is a benign disorder. Although the underlying cause of urticaria can not always be identified, infections and medications are the most common causes. A comprehensive and detailed history is very important to discover the underlying cause. The diagnostic tests should be ordered according to the patient's history. Conducting diagnostic tests without considering the medical history of the patient leads to waste of time and resources. (Turkderm 2011; 45:179-83)