What is the role of physical challenge testing in the evaluation of acute urticaria (hives)?

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

Physical urticaria can be confirmed with physical challenge tests. These involve the application of the suspected stimuli (heat, pressure, light, vibration, scratching [dermographism], cold [ice cube]) to the skin. Exercise testing can also be performed to diagnose cholinergic urticaria. Ice cube test findings are typically negative in patients with familial cold autoinflammatory syndrome. With the exception of testing for dermographism, these tests are usually performed only by specialty centers.


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