Urticaria
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: L50.9 DESCRIPTION An itchy, inflammatory skin and mucosal condition recognised by wheal and flare reaction. May be acute or chronic, often due to irritants, insect bites or allergens. Secondary infective features include excoriation, vesicles and pigmentary changes. Chronic papular
General and supportive measures
ICD-10 code: L50.9
DESCRIPTION
An itchy, inflammatory skin and mucosal condition recognised by wheal and flare reaction. May be acute or chronic, often due to irritants, insect bites or allergens. Secondary infective features include excoriation, vesicles and pigmentary changes. Chronic papular eruptive urticaria is often seen in HIV-infected individuals.
DIAGNOSTIC CRITERIA
- History of a recent infection or parasitic infestation.
- History of allergen exposure.
- Wheal and flare reaction (‘hives’).
- Positive skin test if due to allergy.
GENERAL AND SUPPORTIVE MEASURES
- Limit exposure to precipitants, e.g. drugs, allergens and toxins.
- Limit exposure to insects by using topical insect repellent which contains more than 10% diethyltoluamide (DEET).
- Search for and treat an underlying infection or parasitic infestation.
- Wrap with dressings soaked in sodium chloride 0.9%.
MEDICINE TREATMENT
- Chlorphenamine, oral, 0.1 mg/kg/dose as a single dose at night.
AND
- Betamethasone 0.1%, topical, applied twice daily as required.
- Useful when applied immediately after an insect bite.
Severe chronic urticaria
For children 2 years and older:
- Cetirizine, oral, as a single dose.
- Children 2–6 years: 5 mg.
- Children 6–12 years: 10 mg.
REFERRAL
- Recurrent cases.
- Recalcitrant and chronic cases.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 5: Dermatology, 5.3 Macules And Papules, 5.3.7 Urticaria