Physical Examination Typical urticarial lesions are blanchable, wheal-like, erythematous, dermal swellings. Look for signs and symptoms of systemic disease such as fever, lymphadenopathy, organomegaly, and joint swelling. Laboratory Evaluation Extensive laboratory testing is rarely needed. Some cases require tests for sedimentation rate, antinuclear antibody, rheumatoid agglutinin, liver function, mononucleosis, or C1 esterase inhibitor level. Remove, eliminate, or treat the offending source when possible.
Antihistamines are the cornerstone of urticaria management.
Short-term glucocorticoid therapy may be prescribed in some cases of acute and chronic urticaria. Long-term therapy is not indicated. Patients at risk for exercise-induced anaphylaxis should carry injectable epinephrine with them at all times and only exercise with a partner knowledgeable in its administration.