An Approach to Urticaria

Urticaria is one of the most common skin diseases. Although urticaria has a characteristic clinical morphology, it can be challenging to diagnose, particularly given the evanescent nature of lesions, which often are not present at the time of the clinic visit. Furthermore, hives are elicited by triggers that the patient may have trouble identifying, which can lead to an obscured history, inadequate trigger recognition and avoidance, poor disease control, and frustration for both the patient and physician. This column will provide residents with an overview of several etiologies of this sometimes challenging condition, tips for identifying triggers or underlying causes, and key elements of the patient's history and physical examination.