Materiały źródłowe

• #1 Hives and angioedema – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hives-and-angioedema/diagnosis-treatment/drc-20354914

  To diagnose hives or angioedema, your doctor will likely look at your welts or areas of swelling and ask about your medical history. You may also need blood tests or an allergy skin test. […] If your symptoms are mild, you may not need treatment. Hives and angioedema often clear up on their own. But treatment can offer relief from intense itching, serious discomfort or symptoms that persist. […] Treatments for hives and angioedema may include prescription drugs: Anti-itch drugs. The standard treatment for hives and angioedema is antihistamines that don’t make you drowsy. These medications reduce itching, swelling and other allergy symptoms. They’re available in nonprescription and prescription formulations. […] If antihistamines are not effective, your doctor might prescribe a drug that can calm an overactive immune system.

• #2 Hives and angioedema // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/hives-and-angioedema

  Hives and angioedema are usually treated with antihistamine medication. Angioedema can be life-threatening if swelling of the tongue or in the throat blocks the airway. […] If your symptoms are mild, you may not need treatment. Hives and angioedema often clear up on their own. But treatment can offer relief from intense itching, serious discomfort or symptoms that persist. […] Treatments for hives and angioedema may include prescription drugs: Anti-itch drugs. The standard treatment for hives and angioedema is antihistamines that don’t make you drowsy. These medications reduce itching, swelling and other allergy symptoms. They’re available in nonprescription and prescription formulations. […] For severe hives or angioedema, doctors may prescribe a short course of an oral corticosteroid drug such as prednisone to reduce swelling, inflammation and itching.

• #3 Urticaria and angioedema | Allergy, Asthma & Clinical Immunology | Full Text

  https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0288-z

  Urticaria (hives) is a common disorder that often presents with angioedema (swelling that occurs beneath the skin). […] Second-generation, non-sedating, non-impairing histamine type 1 (H1)-receptor antihistamines represent the mainstay of therapy for both acute and chronic urticaria. […] The mainstay of management for angioedema is to avoid specific triggers, if possible. For hereditary angioedema, there are specifically licensed treatments that can be used for the management of acute attacks, or for prophylaxis in order to prevent attacks. […] Strategies for the management of acute urticaria include avoidance measures, antihistamines and corticosteroids. For urticaria, antihistamines are the mainstay of therapy. […] Second-generation, non-sedating, non-impairing H1-receptor antihistamines (e.g., fexofenadine, desloratadine, loratadine, cetirizine, bilastine, rupatadine; see Table 2) are the mainstay of therapy for urticaria.

• #4 Urticaria and angioedema – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/844

  Antihistamines are the mainstay of therapy for both acute and chronic urticaria. For patients who do not respond to antihistamines, additional treatment options include omalizumab and immunomodulatory therapies. […] Specific treatments are available to abort acute attacks and for longer-term prophylaxis of hereditary angioedema.

• #5 Hives (Urticaria) and Angioedema Overview

  https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/hives-(urticaria)-and-angioedema-overview

  Hives and Angioedema Treatment Management […] The goals of treatment are to: Provide relief of itching Make hives more tolerable Provide complete resolution of your hives Medications will help your itching and reduce hives. Medications will not cure hives but can help to completely resolve them. Antihistamines are the best initial medication to treat your hives. Sometimes, a combination of several antihistamines or an increased dose of one antihistamine may be recommended. Older antihistamines such as Benadryl (sedating antihistamines) may cause you to get sleepy, cause dryness and only last for several hours. Newer non-sedating antihistamines are less likely to make you sleepy. They have fewer side effects and last much longer. Non-sedating antihistamines are often the first medication doctors will prescribe for your hives. High dosages, up to 4 times the recommended dose, are often well tolerated and can help control your itching. This will also help to prevent the use of other medications that may have more side effects. About 50% of chronic spontaneous urticaria (hives over 6 weeks with no identifiable cause) will respond to antihistamine as discussed above. For those who do not improve on antihistamines, 65% respond to omalizumab. Omalizumab is an FDA approved treatment of chronic urticaria. This medication is injected under the skin once a month. Corticosteroids, such as prednisone or prednisolone may help hives. These are not an ideal treatment for long-term use but may have a role to relieve severe symptoms for a few days. Your doctor will outline a treatment plan that allows you to increase treatment during an outbreak of hives or swelling and reduce medications when the hives or angioedema are not as bothersome. Chronic hives can last for many years but will often go away. Hives will resolve in half of patients within 1-2 years and 80-90% of patients will improve within 5 years. Even if a patients hives improve, it is not unusual to see the hives recur months to years later. […] Antihistamines commonly used to treat urticaria: […] Sedating antihistamines: hydroxyzine (Atarax), diphenhydramine (Benadryl) […] Non-sedating antihistamines: cetirizine (Zyrtec), levocetirizine (Xyzal), fexofenadine (Allegra), loratadine (Claritin), desloratadine (Clarinex)

• #6 Acute and Chronic Urticaria: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0601/p717.html

  Urticaria is caused by immunoglobulin E- and nonimmunoglobulin E-mediated release of histamine and other inflammatory mediators from mast cells and basophils. […] The mainstay of treatment is avoidance of triggers, if identified. The first-line pharmacotherapy is second-generation H1 antihistamines, which can be titrated to greater than standard doses. […] In refractory chronic urticaria, patients can be referred to subspecialists for additional treatments, such as omalizumab or cyclosporine. […] Second-generation H1 antihistamines are safe and effective symptomatic therapy for urticaria. […] If needed to control symptoms of urticaria, second-generation H1 antihistamines can be titrated to two to four times the normal dose. […] A short course of systemic corticosteroids may help control severe cases of urticaria.

• #6 Acute and Chronic Urticaria: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0601/p717.html

  Treatment of acute angioedema is largely the same as treatment for urticaria, although corticosteroids may be more commonly recommended. […] Most of the data on treatment of urticaria involve chronic cases. Current guidelines suggest a stepwise approach to treating chronic idiopathic urticaria. […] As with acute urticaria, the first step is second-generation H1 antihistamines. […] If symptomatic control is still not achieved, the third step is addition and titration of high-potency antihistamines as tolerated, such as hydroxyzine or the tricyclic antidepressant doxepin. […] The fourth step is referral to a subspecialist for use of immunomodulatory agents. […] For controlling flare-ups in chronic urticaria, a three- to 10-day burst of corticosteroids (prednisone or prednisolone up to 1 mg per kg per day) is sometimes used; long-term use is not recommended because of adverse effects.

• #7 Practical Management of New-Onset Urticaria and Angioedema Presenting in Primary Care, Urgent Care, and the Emergency Department

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8784078/

  The treatment of choice for acute idiopathic urticaria and chronic urticaria in and adults is cetirizine 10-40 mg/d and avoidance of heat, alcohol, and NSAIDs when the hives are active. […] When an NSAID is the suspected cause of angioedema, the therapy of choice is intramuscular epinephrine and antihistamines. Systemic corticosteroids are not helpful for angioedema caused by NSAID hypersensitivity and can cause morbidity. […] The acute treatment of a new episode of angioedema, where an NSAID is not the suspected cause or a specific known HAE or AAE syndrome that has an approved therapy has not been confirmed, is maintenance of the airway and watchful waiting. Do not use epinephrine or antihistamines in the setting of angioedema without itching or hives. The use of systemic corticosteroids for angioedema, with or without urticaria, is not helpful and causes morbidity.

• #7 Practical Management of New-Onset Urticaria and Angioedema Presenting in Primary Care, Urgent Care, and the Emergency Department

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8784078/

  A new episode of urticaria and/or angioedema can be an anxiety-inducing event for both the patient and the physician(s) seeing them in primary care, urgent care, or the emergency department. […] Acute idiopathic urticaria is treated with high-dose nonsedating antihistamines acute avoidance of alcohol and nonsteroidal anti-inflammatory drugs, and time. […] Most angioedema, without itching or hives, is idiopathic. Treatment is supportive care and time. Antihistamines, epinephrine, and systemic corticosteroids are completely ineffective in treating idiopathic or bradykinin-mediated angioedema. […] An epinephrine injector is rarely indicated in patients with acute idiopathic urticaria or chronic urticaria, with or without angioedema. […] Systemic corticosteroids do not help any of the symptoms associated with urticaria and may cause avoidable morbidity.

• #8 Hives and angioedema – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hives-and-angioedema/diagnosis-treatment/drc-20354914

  If you have the type of angioedema that runs in families, you may take medication to relieve symptoms and keep the levels of certain proteins in your blood at levels that do not cause symptoms. […] For severe hives or angioedema, doctors may prescribe a short course of an oral corticosteroid drug such as prednisone to reduce swelling, inflammation and itching. […] For a severe attack of hives or angioedema, you may need a trip to the emergency room and an emergency injection of epinephrine a type of adrenaline. If you have had a serious attack or your attacks recur despite treatment, your doctor may have you carry a penlike device that will allow you to self-inject epinephrine in emergencies.

• #9 Acute Urticaria Treatment & Management: Approach Considerations, Pharmacologic Therapies, Nonpharmacologic Therapies

  https://emedicine.medscape.com/article/137362-treatment

  The long-term use of systemic corticosteroids in chronic urticaria is not recommended, although a short course may be considered for patients with acute exacerbation of their symptoms. […] Most patients with urticaria can be treated with oral (PO) H1 antihistamines. Modern second-generation antihistamines are the first choice. Increasing the dose up to fourfold is permitted in patients who do not respond sufficiently to the standard dosing. For refractory cases, use a combination of H1 and H2 antihistamines. […] The efficacy of corticosteroids in acute urticaria remains controversial. In one study, acute urticaria improved more quickly in the group treated with prednisone than in the group treated with placebo. […] In adults, 40-60 mg daily of prednisone for 5 days is a reasonable therapeutic regimen. In children, the treatment is 1 mg/kg/d for 5 days. Tapering of the corticosteroid dose is not necessary in most cases of acute urticaria.

• #9 Acute Urticaria Treatment & Management: Approach Considerations, Pharmacologic Therapies, Nonpharmacologic Therapies

  https://emedicine.medscape.com/article/137362-treatment

  If angioedema is present with urticaria, epinephrine should be administered via the IM route. Remember that converting enzyme inhibitor (ACEI)-induced angioedema usually does not respond to epinephrine or most other common therapies, as it is not an IgE-mediated process. […] Cyclosporine has been shown to be effective in 2 double-blind placebo-controlled studies. […] Omalizumab (monoclonal antibody to IgE) is a recombinant biologic molecule effective for chronic urticaria based on two large positive phase III studies and is currently FDA approved for treatment of chronic urticaria. The role in acute urticaria has not been determined and further studies are needed.

• #9 Acute Urticaria Treatment & Management: Approach Considerations, Pharmacologic Therapies, Nonpharmacologic Therapies

  https://emedicine.medscape.com/article/137362-treatment

  Identify the etiology of the acute urticaria if possible. If an inciting agent can be identified, instruct the patient to avoid it. The major goal is to control the severity of acute urticaria lesions until the process resolves over 46 weeks. […] Inpatient therapy may be required rarely if the urticaria is severe and does not respond to antihistamine therapy, or if the patient’s condition progresses to laryngeal angioedema and/or anaphylactic shock. […] Second-generation H1-antihistamines are recommended as a first-line treatment for chronic urticaria. If the patient does not respond to this treatment, guidelines recommend increasing the dosage up to four times. Omalizumab is recommended for patients who remain unresponsive to antihistamines after the dose is increased. Ciclosporin is recommended for those who remain unresponsive to both antihistamines and omalizumab.

• #10 Hives and angioedema // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/hives-and-angioedema

  For a severe attack of hives or angioedema, you may need a trip to the emergency room and an emergency injection of epinephrine a type of adrenaline. If you have had a serious attack or your attacks recur despite treatment, your doctor may have you carry a penlike device that will allow you to self-inject epinephrine in emergencies.

• #11 Hives and angioedema – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hives-and-angioedema/symptoms-causes/syc-20354908

  Hives and angioedema are usually treated with antihistamine medication. Angioedema can be life-threatening if swelling of the tongue or in the throat blocks the airway. […] Most times, they are harmless, clear up within in a day and don’t leave any lasting marks, even without treatment. […] Severe angioedema can be life-threatening if swelling of the tongue or in the throat blocks the airway.

• #12 Angioedema – Immunology; Allergic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/angioedema

  For mast cell-mediated angioedema, medications that may relieve symptoms include H1 blockers. […] Prednisone 30 to 40 mg orally once a day is indicated for more severe reactions. […] For bradykinin-mediated angioedema, epinephrine, corticosteroids, and antihistamines have not been shown to be effective. […] Angioedema due to ACE inhibitor use usually resolves about 24 to 48 hours after stopping the medication. […] If symptoms are severe, progressing, or refractory, treatments used for hereditary or acquired angioedema can be tried. […] For idiopathic angioedema, a high dose of a nonsedating oral antihistamine can be tried. […] For symptomatic and adjunctive treatment, an antihistamine (eg, H1 blocker) and a systemic corticosteroid can relieve symptoms of mast cell-mediated angioedema; frozen plasma, C1 inhibitor concentrate, and/or ecallantide or icatibant may be tried if bradykinin-mediated angioedema is severe or refractory.

• #13 Urticaria and angioedema | Allergy, Asthma & Clinical Immunology | Full Text

  https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0288-z

  For patients with CSU who have not responded to 4 times the standard dose of second-generation antihistamines after a 2- to 4-week trial, omalizumab, an anti-IgE humanized monoclonal antibody, as add-on therapy is now considered the third-line option. […] First-line therapies for the treatment of acute attacks of HAE and AAE include: C1-INH replacement therapy, icatibant and ecallantide. […] Short-term prophylaxis (STP) refers to the practice of treating patients to reduce the risk of associated and consequent morbidity and mortality during a period of time when there may be an increased risk of having an attack of angioedema. […] Long-term prophylactic treatment refers to ongoing treatment of HAE aimed at minimizing the overall number, frequency and/or severity of attacks.

• #14 What’s New in the Treatment of Urticaria and Angioedema – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34112473/

  Chronic urticaria and angioedema are diseases often managed by Allergy and Immunology specialists. Recent international guidelines have outlined a stepwise approach to management of patients using dose escalation of second-generation antihistamines followed by use of omalizumab and finally cyclosporine in more refractory cases. […] In select patients (those with refractory chronic urticaria), nonbiologic alternative medications with anti-inflammatory or immunosuppressant activity may be considered. […] Optimal management of mast cell-mediated angioedema is less clear but is often managed similar to chronic spontaneous urticaria. […] Although bradykinin is thought to be a primary mediator for this type of angioedema, studies of targeted therapies have been generally disappointing. […] In contrast, several targeted therapies have been proven successful using acute and preventive approaches for management of hereditary angioedema. […] Further developments, including novel biologics, novel oral therapies, and gene therapy approaches, may hopefully continue to broaden therapeutic options to ensure optimal individual management of patients with hereditary angioedema.

• #15 Urticaria & Angioedema | Mount Sinai – New York

  https://www.mountsinai.org/care/allergy-immunology/services/urticaria-angioedema

  Urticaria, known as hives, is a common allergic reaction. Hives are the raised, itchy reddish areas on the skin. […] There isn’t a cure for hives, but medications can help alleviate them. The best treatment for the initial onset of hives are antihistamines. Non-sedating antihistamines will help control the itching with fewer side effects. […] In chronic urticarial, about 50 percent of people will respond to antihistamine as treatment. For the others who don’t respond to antihistamine, Xolair is an option. Xolair is an injectable medication given once a month to people with chronic urticaria.

• #16 Urticaria and angioedema – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/urticaria-and-angioedema/

  Urticaria may present with weals alone, angio-oedema or both together. […] If angio-oedema occurs without weals it may be an inherited illness called hereditary angio-oedema. This is a different problem to urticaria. It can be diagnosed with blood tests and needs different treatment. […] The aim of treatment is to suppress the symptoms of the condition until it becomes better naturally rather than cure it. […] Antihistamine tablets block the effect of histamine by reducing itch and the rash in most people but may not relieve urticaria completely. […] If antihistamine tablets are not helpful, your doctor may recommend other medicines, including montelukast, that is usually used as an add-on treatment of asthma. […] Oral steroids can occasionally be given as rescue treatment for severe flares of acute and chronic urticaria but are generally not necessary; their potential side effects usually outweigh the benefits in this condition.

• #17 Angioedema | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/angioedema/

  Drug-induced angioedema can usually be treated by using an alternative medication to the one causing your symptoms. […] If you also had symptoms of anaphylaxis during an episode of angioedema, you will probably be given an adrenaline auto-injector pen in case your symptoms return. […] Hereditary angioedema cannot be cured and does not respond to adrenaline, antihistamines or steroids, so a preventative approach is taken. A number of different medications are used to stabilise the protein levels in your blood to help prevent symptoms developing. […] Antihistamines work by blocking the effects of a protein called histamine, which is one of the chemicals responsible for causing your skin to swell. […] Corticosteroids (steroids) work by blocking many of your immune systems actions. […] The medication used to treat hereditary angioedema falls into 1 of 2 categories: medication used to prevent angioedema and medication used to relieve symptoms.

• #17 Angioedema | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/angioedema/

  Danazol is a synthetic hormone that is effective in preventing the symptoms of angioedema because it helps boost levels of the C1-inh protein. […] Tranexamic acid is also an alternative medication to danazol. […] Icatibant is a relatively new medication used to treat acute (short-lasting) episodes of swelling. […] Purified C1-inhibitor concentrate is widely used to replace the missing protein in the blood.

• #18 Urticaria and angioedema | Allergy, Asthma & Clinical Immunology | Full Text

  https://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-7-S1-S9

  Second-generation, non-sedating, H1-receptor antihistamines (e.g., fexofenadine, desloratadine, loratadine, cetirizine) are the mainstay of therapy for urticaria. […] For some patients with severe urticaria who are inadequately responsive to antihistamines, a brief course of oral corticosteroids (e.g., prednisone, up to 40 mg/day for 7 days) is warranted. […] Various immunosuppressive or immunomodulatory therapies may provide some benefit for patients with severe, chronic urticaria. […] Prophylactic therapy should be considered in patients who experience more than one severe attack per month, or if treatment for acute episodes is not sufficiently effective or is not available. […] First-line therapies for the treatment of severe acute attacks of HAE and AAE include: C1 inhibitor replacement therapy, ecallantide and icatibant.

• #19 Angioedema Treatment & Management: Approach Considerations, Histaminergic Angioedema (IH-AAE), Nonhistaminergic Angioedema (InH-AAE)

  https://emedicine.medscape.com/article/135208-treatment

  For laryngeal swelling and airway obstruction, close monitoring of the airway is mandatory. Epinephrine (1:1000) should be administered IM at a dose of 0.01 mg/kg or 0.3 mg, repeated every 10-15 minutes if necessary. […] Antifibrinolytic agents (eg, aminocaproic acid or tranexamic acid) may be helpful in treating HAE, C1-INH-AAE, and certain cases of InH-IAE. […] Acute HAE attacks can be treated with infusion of C1-INH 20 U/kg. […] Administration of nanofiltered C1-INH concentrate can shorten the duration of acute HAE attacks. […] In 2009, ecallantide, a potent, selective, reversible inhibitor of plasma kallikrein that suppresses bradykinin generation, was approved by the FDA for treatment of acute HAE attacks. […] In 2011, icatibant, a bradykinin B2 receptor antagonist, was approved by the FDA for the treatment of acute HAE attacks.

• #19 Angioedema Treatment & Management: Approach Considerations, Histaminergic Angioedema (IH-AAE), Nonhistaminergic Angioedema (InH-AAE)

  https://emedicine.medscape.com/article/135208-treatment

  The FDA has approved various agents including C1-INHs, the kallikrein inhibitor ecallantide, lanadelumab, a monoclonal antibody that targets kallikrein, and the bradykinin-receptor antagonist icatibant for use in patients with HAE, either as prophylaxis or to treat acute attacks. […] The Hereditary Angioedema International Working Group guidelines consider long-term prophylaxis to be appropriate for C1-INH-HAE patients in whom on-demand acute treatment is inadequate to minimize disease. […] For patients with an established food allergy or food additive hypersensitivity, avoidance of the identified allergen is indicated.

• #20 Urticaria & Angioedema | AMBOSS Rotation Prep

  https://resident360.amboss.com/adult-medicine/allergy-immunology/urticaria-angioedema/urticaria-angioedema.html

  HAE treatment options for acute attacks include the following: plasma C1-inhibitor concentrate (available in intravenous and subcutaneous preparations for treatment of acute attacks and preventative therapy), kallikrein inhibitors (subcutaneous ecallantide), bradykinin receptor B2 antagonists (subcutaneous icatibant), anabolic steroids (e.g., danazol or stanozolol) have slower onset of action and are associated with an increased risk of adverse effects; used less often now that more-specific, targeted treatments are available, fresh frozen plasma carries a risk of worsening angioedema; used less often now that more-specific, targeted treatments are available. […] HAE prophylaxis options include the following: purified C1-inhibitor concentrate, subcutaneous lanadelumab (human monoclonal antibody targeting plasma kallikrein), attenuated androgens (adverse effects limit use; contraindicated in growing children and pregnant/lactating women), antifibrinolytics (generally less effective), oral berotralstat (plasma kallikrein inhibitor) was approved by the FDA in December 2020.

• #21 Clinical Practice Guideline: Initial Evaluation and Management of Patients Presenting with Acute Urticaria or Angioedema – AAEM

  https://www.aaem.org/statements/clinical-practice-guideline-initial-evaluation-and-management-of-patients-presenting-with-acute-urticaria-or-angioedema/

  Corticosteroids are indicated for patients with anaphylaxis, laryngeal edema, and severe symptoms unresponsive to antihistamines. […] Administer an H1 antagonist to patients with acute urticaria and angioedema. […] For patients whose symptoms are not controlled with an H1 antagonist, add an H2 antagonist to the treatment regimen. […] Patients with severe symptoms, laryngeal edema, or anaphylaxis should receive corticosteroids. […] Regardless of whether an etiology is discovered, patients should avoid drugs that exacerbate urticaria or angioedema. Aspirin, NSAIDs, and opiates should be discontinued, as these medications can worsen urticaria. […] ACE inhibitors must be stopped in anyone presenting with isolated angioedema. […] Acute episodes of HAE typically do not respond to antihistamines, corticosteroids, or epinephrine. […] For patients with severe attacks, the treatment of choice is C1INH concentrate. However, C1INH concentrate is not available in the United States. […] Obtain a C4 level in patients with suspected HAE. […] Consider FFP for acute, severe episodes of HAE.

• #22 Urticaria and Angioedema | Treatment & Management | Dublin, Ireland

  https://www.allergy-ireland.ie/allergy/urticaria-angioedema

  Avoid Aspirin, NSAID’s and opiates. ACE inhibitors need to be avoided for life if angioedema was present. […] Minimise pseudoallergen junk foods which contain additives such as preservatives, artificial colours and flavours. […] Foods which are rich in histamine should be restricted during exacerbations of urticaria. e.g. tomato, strawberry. […] Smoking and alcohol should be avoided. […] Limit any obvious physical aggravating factors. e.g. heat, cold, pressure, sunlight. […] Second generation oral anti-histamines are the mainstay of treatment in Chronic Urticaria. These include cetirizine, levocetirizine, loratadine, desloratadine, fexofenadine and bilastine. […] All cases which have persisted beyond 4 weeks despite treatment with a second generation anti-histamine should be referred for treatment by an allergy specialist, immunologist or dermatologist.

• #23 Hives: Causes, Symptoms, Diagnosis, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/8630-hives

  Hives, a skin rash thats often very itchy, often results from an allergic reaction to food or something youve touched. Treatments may include antihistamines or steroids. […] Your healthcare provider can diagnose hives and angioedema by looking at your skin. Allergy tests can help identify whats triggering a reaction, but this is true primarily for acute hives. […] Most of the time, hives go away without treatment. Your healthcare provider might recommend medications and at-home care to help you feel better and lower your chances of having hives again. Treatments include: Allergy medications: Medicines called antihistamines block histamines effects. […] For hard-to-treat chronic hives, your healthcare provider may discuss monthly injections of drugs that block allergic reactions. […] To relieve hives, you can take a cool bath or shower, wear loose-fitting clothing and apply cold compresses. An over-the-counter (OTC) hydrocortisone or antihistamine cream can relieve itching and swelling.

• #24 What is Angioedema – Asthma & Allergy Clinic | Boise, Nampa, Eagle, Meridian, Caldwell

  https://theallergygroup.com/what-is-angioedema/

  In some cases, the cause of angioedema is not identified. This is referred to as idiopathic angioedema. In these instances, an oral antihistamine at higher doses might be prescribed. Omalizumab is once a month subcutaneous injection for idiopathic angioedema and very helpful in patients with recurrent symptoms. […] It is important that you avoid your triggers. When itching occurs, talk to your doctor about using a non-prescription oral antihistamine to help alleviate this discomfort. Wearing clothing that is cotton and loose can help to decrease your risk of skin irritation. Cool compresses or a cool bath might also be beneficial for calming irritation and itching.

• #25 Effective ways to get rid of hives

  https://www.medicalnewstoday.com/articles/320268

  Home remedies and medications can help treat hives quickly and effectively. Examples include cold compresses, aloe vera, antihistamines, and more. […] In more severe cases of hives, medical treatment may be preferable. Some over-the-counter options include: antihistamines to reduce itchiness, steroid tablets, such as prednisone, calamine lotion, diphenhydramine, such as Benadryl. […] Angioedema is a buildup of fluid in layers of the skin that causes swelling and can affect the eyes, lips, hands, feet, and genitals. Doctors can prescribe medication to manage and reduce swelling. […] A person should seek medical advice if symptoms are severe, ongoing, or affect their quality of life.

• #26 Hives: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/hives-treatment

  When treating hives, the goals are to: Control the itch, Prevent new hives (existing hives go away on their own), Avoid what’s causing the hives (when known). […] When antihistamines fail to work, your dermatologist may prescribe this medication. It works throughout the body to calm your immune system, which can prevent your body from overreacting and producing hives. […] If your hives are caused by something physical like cold, heat, or pressure on your skin, your dermatologist may recommend this treatment. It involves exposing you to what is causing your hives, so that you no longer have flare-ups every time you encounter the cause. […] A treatment plan often works best when you follow these dermatologists at-home tips.

• #26 Hives: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/hives-treatment

  Hives can require emergency care. Go to urgent care or the nearest emergency room if you have any of the following: Swelling on your face, inside your mouth, or in your throat […] For many people, hives are mild. If you have a mild case, it will likely go away in a few days. To get relief until then, dermatologists recommend that you take an antihistamine (non-drowsy, 24-hour relief) and use these home remedies. […] Your treatment plan will be tailored to your needs and may include one or more of the following: Soothing anti-itch lotion or cream […] Antihistamine. This medication can help control the itch and swelling. Some antihistamines may also flatten hives, shorten how long you have hives, or reduce the number of hives you get. […] If the first antihistamine you take fails to work, your dermatologist may increase the dose or add another antihistamine to your treatment plan.

• #27 Angioedema: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000846.htm

  Angioedema may be caused by an allergic reaction. Angioedema typically is not itchy while hives are very itchy. […] Hives and angioedema may also occur after infections. Angioedema may occur alone or with other illnesses (including autoimmune disorders such as lupus, leukemia, and lymphoma). […] Mild symptoms may not need treatment. Moderate to severe symptoms may need to be treated. Breathing difficulty is an emergency condition. […] People with angioedema should: Avoid any known allergen or trigger that causes their symptoms. Avoid any medicines, herbs, or supplements that are not prescribed by a provider. […] Medicines used to treat angioedema include: Antihistamines, Anti-inflammatory medicines (corticosteroids), Epinephrine injectors (people with a history of severe symptoms may need to carry these with them in case of a severe reaction), Inhaler medicines that help open up the airways. […] If the person has trouble breathing, seek medical help right away. A severe, life-threatening airway blockage may occur if the throat swells.

• #28 Angioedema: Causes, Symptoms, Types & Treatments

  https://my.clevelandclinic.org/health/diseases/22632-angioedema

  Angioedema is a reaction to a trigger that causes swelling in the tissue below the inner layer of your skin called the dermis or the layer below a mucous membrane. Angioedema often happens at the same time as hives (urticaria) and for similar reasons. Both angioedema and hives happen when liquid from small blood vessels escapes and fills up tissues, causing swelling. […] Treating angioedema depends on what kind of angioedema you have. For severe allergic reactions, you’ll often have injectable epinephrine to carry. You should administer this while calling 911. […] For allergic angioedema, your provider may suggest antihistamines or steroids. You may get them either in oral (pill or liquid) or intravenous (in the vein) form. […] If you have hereditary, idiopathic or acquired C1 inhibitor deficiency angioedema, you’ll probably be referred to a specialist. Some medications that treat or prevent heredity angioedema include: C1 esterase inhibitor (recombinant) (Ruconest), C1 inhibitor (human) (Berinert, Cinryze, Haegarda), Ecallantide (Kalbitor), Icatibant (Firazyr), Lanadelumab (Takhzyro), Berotralstat (Orladeyo).

• #29 Angioedema – UF Health

  https://ufhealth.org/conditions-and-treatments/angioedema

  Medicines used to treat angioedema include: Antihistamines, Anti-inflammatory medicines (corticosteroids), Epinephrine shots (people with a history of severe symptoms can carry these with them), Inhaler medicines that help open up the airways. […] If the person has trouble breathing, seek medical help right away. A severe, life-threatening airway blockage may occur if the throat swells.

• #30 Urticaria and Angioedema: A Practical Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0301/p1123.html

  Patients with a history of urticaria and angioedema or isolated angioedema episodes should be prescribed epinephrine in an auto-injectable instrument (EpiPen) in a dosage of 0.3 mg given intra-muscularly in the thigh and be instructed in its proper use for laryngeal edema, bronchospasm, and hypotension. […] Patients with unresponsive urticaria or angioedema should be referred to an allergist or dermatologist and may require a short-term course of oral glucocorticoids (e.g., oral prednisone, 10 to 20 mg daily). […] Investigative treatment using immunomodulatory therapies such as cyclosporine, plasmapheresis, and intravenous immunoglobulin have been shown to be beneficial in autoimmune chronic urticaria.

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