Frigas Evangelo, Park Miguel A
Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Am J Clin Dermatol. 2009;10(4):239-50. doi: 10.2165/00128071-200910040-00004.
Urticaria is defined as wheals consisting of three features: (i) central swelling of various sizes, with or without surrounding erythema; (ii) pruritus or occasional burning sensations; and (iii) the skin returning to normal appearance, usually within 1-24 hours. Angioedema is defined as: (i) abrupt swelling of the lower dermis and subcutis; (ii) occasional pain instead of pruritus; (iii) commonly involving the mucous membranes; and (iv) skin returning to normal appearance, usually within 72 hours. Acute urticaria and angioedema is defined by its duration (<6 weeks) compared with chronic urticaria and angioedema. The most common causes are infections, medications, and foods. The best tools in the evaluation of these patients are a comprehensive history and physical examination. There are a variety of skin conditions that may mimic acute urticaria and angioedema and the various reaction patterns associated with different drugs. Oral antihistamines are first-line treatment. In the event of a life-threatening reaction involving urticaria with angioedema, epinephrine may be needed to stabilize the patient. This review focuses on the value of a comprehensive clinical evaluation at the onset of symptoms. It underscores the importance of coordination of care among physicians, and the development of an action plan for evidence-based investigations, diagnosis, and therapy.
荨麻疹的定义为风团，其具有三个特征：(i) 大小各异的中央肿胀，伴有或不伴有周围红斑；(ii) 瘙痒或偶尔的灼痛；(iii) 皮肤通常在1 - 24小时内恢复正常外观。血管性水肿的定义为：(i) 真皮下部和皮下组织突然肿胀；(ii) 偶尔疼痛而非瘙痒；(iii) 通常累及黏膜；(iv) 皮肤通常在72小时内恢复正常外观。急性荨麻疹和血管性水肿是根据其持续时间（<6周）来定义的，与之相对的是慢性荨麻疹和血管性水肿。最常见的病因是感染、药物和食物。评估这些患者的最佳手段是全面的病史采集和体格检查。有多种皮肤疾病可能会模仿急性荨麻疹和血管性水肿以及与不同药物相关的各种反应模式。口服抗组胺药是一线治疗方法。如果出现危及生命的伴有血管性水肿的荨麻疹反应，可能需要使用肾上腺素来稳定患者病情。本综述重点关注症状发作时全面临床评估的价值。它强调了医生之间协调护理的重要性，以及制定基于证据的调查、诊断和治疗行动计划的重要性。
