What assessment do I need to make for recurrent or persistent urticaria?
• Admit a person with urticaria and angio-oedema involving the airway and/or anaphylaxis. Start initial treatment with intramuscular adrenaline, if available. • Refer to an immunologist or dermatologist when there is: • Urticaria with angio-oedema not involving the airway. • Acute urticaria which is severe and thought to be due to a food or latex allergy. • Chronic persistent urticaria (usually lasting beyond 6 weeks) which is troublesome despite the use of antihistamines and avoidance of known trigger factors. • Vasculitic urticaria: suspect if lesions are painful and persistent.
