What should be the focus of history for suspected acute urticaria (hives)?

Updated: Mar 21, 2018
  • Author: Henry K Wong, MD, PhD; Chief Editor: Michael A Kaliner, MD  more...
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Determining whether the lesions have an allergic (IgE) or nonallergic (non-IgE) basis is helpful in the management of the patient. A complete thorough medical and travel history is important to provide clues to urticaria resulting from a new infectious or medical problem. Questions asked to determine possible allergic and nonallergic causes include the following:

  • Are the hives associated with any foods? Have any new foods been added to the diet?

  • Is the patient taking any regular medications, or have any new medicines been started? In particular, ask about aspirin, NSAIDs, antibiotics, over-the-counter (OTC) medications, herbs, and supplements.

  • Does the patient have any recent or chronic infections?

  • Are the hives caused by any physical stimuli (eg, heat, cold, pressure, vibration)?

  • Does the patient have any chronic medical conditions?

  • Is the urticaria associated with any substances that are inhaled or come in contact with the skin (which may occur in an occupational setting)?

  • Is the urticaria associated with insect bites or stings?

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