How is acute urticaria (hives) differentiated from other dermatologic conditions?

Updated: Mar 21, 2018
  • Author: Henry K Wong, MD, PhD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Although clinically distinctive, urticaria may be confused with a variety of other dermatologic diseases that can be similar in appearance and are pruritic, including atopic dermatitis (eczema), maculopapular drug eruptions, contact dermatitis, insect bites, erythema multiforme, pityriasis rosea, and others. Usually, however, the experienced clinician is able to distinguish these conditions from urticaria because of the lesions' hallmark appearance (see the images below), a lack of epidermal change, the intense pruritus, the presence of an advancing edge and a receding edge, the complete blanching of the lesions with pressure, and are the transient nature of the lesions. [1] (See Clinical Presentation.)

Urticaria associated with a drug reaction. Urticaria associated with a drug reaction.
Urticaria developed after bites from an imported f Urticaria developed after bites from an imported fire ant.
Local urticaria on a patient with latex allergy wh Local urticaria on a patient with latex allergy who was touched with a latex glove.

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