GUIDELINES IN DERMATOLOGY

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URTICARIA

Rabia Öztaş Kara1
Özgür Emek Kocatürk Göncü2

1Sakarya University, Faculty of Medicine, Department of Dermatology, Sakarya, Türkiye
2Koç University, Faculty of Medicine, Department of Dermatology, İstanbul, Türkiye

Öztaş Kara R, Kocatürk Göncü ÖE. Urticaria. In: Kutlubay Z, editor. Guidelines in Dermatology. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.165-178.

ABSTRACT

Urticaria is a common mast cell-mediated disease that can manifest as acute or chronic and is characterized by wheals, angioedema, or both. The lifetime prevalence of acute urticaria is approximately 20%. Chronic spontaneous or inducible urticaria significantly impacts individuals and healthcare systems due to its profound effects on quality of life. Chronic spontaneous urticaria is believed to have an autoimmune nature, with type I and type IIb autoimmune reactions playing a role in its pathogenesis. Understanding these mechanisms is crucial for elucidating the disease’s pathophysiology and developing effective treatment strategies. This guideline, developed based on current literature on urticaria, addresses the definition and classification of the disease and provides evidence-based diagnostic and therapeutic approaches for its various subtypes. The Urticaria Activity Score (UAS7) and the Urticaria Control Test (UCT), widely used in clinical practice, are essential for assessing disease activity and evaluating treatment efficacy. Treatment approaches range from antihistamines to immunosuppressive drugs. Second-generation H1 antihistamines are recommended as first-line therapy, while agents such as omalizumab and cyclosporine are reserved for refractory cases. The etiology of urticaria encompasses infections, autoimmune diseases, dietary triggers, and stress. However, many cases remain idiopathic. Innovative treatments targeting mast cell pathways and personalized approaches are gaining prominence. Additionally, integrating digital tools has enhanced management efficiency for both patients and physicians. This guide aims to assist physicians in evidence-based diagnostic and treatment processes. The physician should make the final decision regarding patient care, considering each patient’s individual characteristics.

Keywords: Mycosis fungoides; Primary cutaneous lymphoma; Guideline; Treatment; Diagnosis

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