ABSTRACT
The urticarias and angioedemas form a group of disorders characterized by transient cutaneous swellings that are frequently itchy. Urticarial lesions (wheals, hives) are superficial dermal swellings. In angioedema, the transient swellings are deeper in the dermis, subcutaneous, and submucosal tissue. In most types of urticaria, the wheals are pink or red with a pale center, and are often itchy, especially in the evenings and at night. They occur in varying shapes and sizes on any part of the skin and generally last less than 24 hours, resolving through a flat erythematous stage to normal-appearing skin. Angioedema frequently affects the lips and eyelids, and sometimes the hands, feet, and tongue. Occasionally it involves the submucosal tissue of the oropharynx, larynx, and gastrointestinal tract. Lesions of angioedema may be red or skin-colored, are sometimes itchy, and generally resolve within 48 hours. They are distressing and worrying for patients, who fear the possibility of choking and impending death. In 40% of patients, both urticaria and angioedema occur at some stage of their disease (1) and are generally considered to be part of the same process. Angioedema without urticaria occurs in 10% of patients, and is frequently intermittent.
