Urticaria and Angioedema

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Chronic recurrent whealing of the skin, with or without angioedema. Associated with atopy. 

Clinical presentation 

  • Wheals which disappear within 24 hours
  • With or without Swelling of tongue or lips
  • Maybe precipitated by spices, food, food colourants, drugs.

Investigations 

  • FBP and ESR
  • Stool for ova and parasite
  • Autoantibodies-ANA

Non-pharmacological Treatment 

  • Avoid precipitating factors e.g. NSAIDs, food, spices
  • Treat any infection appropriately fungal, viral if suspect H pylori investigate and treat as per gastrointestinal section.
  • Deworm

Pharmacological Treatment   

Antihistamine can be increased to maximum dose for not less than 12weeks 

A: cetirizine 10mg 12hourly 4weeks can be increased up to 4 folds 

OR 

C: loratadine 10mg 24 hourly dose can be increased up to 4 folds 

OR 

S: desloratadine 5mg 24 hourly for not less than 16weeks 

AND 

D: montelukast 10mg 24hourly for not less than 16weeks