GuidelinesEML (Adult Hospital STG)
Urticaria
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
L50.0-6/L50.8-9
DESCRIPTION
- A transient itchy inflammatory skin and mucosal condition recognised by a wheal and flare reaction.
- There are many causes, and in most chronic cases, the precipitant for the urticaria is never found.
- Lesions due to insect bites are often grouped, show a central bite mark, are on exposed areas of the body, and are often associated with excoriation, vesicles, pigmentary changes, and secondary infection.
GENERAL MEASURES
- Limit exposure to triggers such as non-immune mast cell degranulators which aggravate and prolong urticaria, e.g. opioids (such as codeine), NSAIDs, salicylates, alcohol, etc.
- Avoid oral corticosteroids.
MEDICINE TREATMENT
Antihistamines
Regular use is recommended until the urticaria is quiescent.
For chronic urticaria, less sedating antihistamines are preferable:
- Cetirizine, oral, 10 mg daily.
REFERRAL
All patients with urticaria that have individual lesions for longer than 48 hours should be referred to a specialist to exclude urticarial vasculitis.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_07 November 2024
Chapter 4 Dermatology_4.9 Urticaria