Chronic urticaria: should an allergy always be investigated?

Urticaria or deeper swelling with difficulty breathing or swallowing, or feeling faint, is a reason to call 15 or 112 in France without delay. Do not attribute these signs to previously known chronic urticaria: urgent care takes priority over a prevention discussion.

Assurance Maladie defines chronic urticaria as episodes occurring daily or every two to three days for at least six weeks. This describes the course for the doctor; do not wait six weeks to seek advice about a new, troublesome or worrying rash.

Urticaria involves mast cells, which release substances including histamine and cause the wheals. In chronic urticaria, their sensitivity to non-allergic stimuli explains why routinely looking for a food allergy does not address every situation.

Describe how long the wheals last, how they change location and how often they recur. Mention medicines taken and associated circumstances such as cold, pressure or exercise. The examination and this history guide the doctor; do not recreate an exposure yourself to try to prove the cause.

Allergy assessment is considered when the clinical history makes the doctor suspect an allergic cause. Further investigations are not routine at the first appointment. Ask which possibility an investigation is meant to check rather than assuming an allergy panel is essential.

Follow-up aims to control itching and wheals, which can disrupt everyday life. Follow the prescription and discuss its effectiveness with the doctor. Report drowsiness or another adverse effect; the doctor adjusts care without you changing doses on your own.