Klinik für Dermatologie, Venerologie und Allergologie, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany.
Dtsch Arztebl Int. 2008 Jun;105(25):458-65; quiz 465-6. doi: 10.3238/arztebl.2008.0458. Epub 2008 Jun 20.
The term "urticaria" refers to any of a group of distinct skin conditions that are characterized by itchy, wheal-and-flare skin reactions (hives). In spontaneous urticaria, the most common type, the hives seem to arise without provocation.
Selective review of the literature, including current guidelines.
Spontaneous urticaria is divided into acute (lasting less than six weeks) and chronic types. The pathognomonic itching, hives, and angioedema arise by the same mechanism--cutaneous mast cell activation and release of histamine and other mediators of inflammation--in both acute and chronic urticaria, but these two disorders have different etiological profiles. The underlying cause of acute urticaria cannot be identified in about half of all cases. Chronic urticaria, which is much rarer, is usually caused by autoreactivity, chronic infection, or intolerance to food additives. If the condition persists after the underlying cause has been treated or eliminated, non-sedating antihistamines are the agents of first choice for symptomatic treatment.
Unlike acute urticaria, which is self-limited and should be treated symptomatically, chronic urticaria should be treated by the identification and elimination of underlying causes, which is usually curative.
“荨麻疹”一词是指一组不同的皮肤疾病，其特征为瘙痒、风团和红斑样皮肤反应（荨麻疹）。在自发性荨麻疹中，最常见的类型，荨麻疹似乎无缘无故地出现。
对文献进行选择性综述，包括当前的指南。
自发性荨麻疹分为急性（持续少于 6 周）和慢性两种类型。特发性瘙痒、荨麻疹和血管性水肿是通过相同的机制引起的——皮肤肥大细胞的激活和组胺和其他炎症介质的释放——在急性和慢性荨麻疹中，但这两种疾病有不同的病因谱。大约一半的急性荨麻疹病例无法确定其根本原因。慢性荨麻疹则更为罕见，通常由自身免疫、慢性感染或对食物添加剂不耐受引起。如果在治疗或消除潜在病因后病情仍持续存在，非镇静性抗组胺药是治疗症状的首选药物。
与具有自限性且应对症治疗的急性荨麻疹不同，慢性荨麻疹应通过识别和消除潜在病因进行治疗，通常是可以治愈的。
