Urticaria & Angioedema

Key points

• Urticaria: transient itchy weals (< 24 h each); acute < 6 weeks, chronic > 6 weeks (usually no external cause found).
• Management: non-sedating antihistamines (up-dosing in chronic); avoid triggers (NSAIDs, ACE inhibitors).
• Angioedema: deeper swelling (lips, tongue, airway) — emergency if airway involved.
• ACE-inhibitor angioedema: can occur any time after starting — stop ACE-i, do NOT substitute ARB without caution.
• Hereditary angioedema: C1-esterase inhibitor deficiency — recurrent attacks, normal C4 low; treated with C1-INH concentrate/icatibant (not antihistamines/steroids).

Decision points in this pathway

• Lip/tongue/airway swelling?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.