**7. Associated diseases**

the lesions are usually painful rather than pruritic. Swellings of angioedema can be pink or skin-colored [9, 17, 18]. Involvement of the mucous membranes is a common feature. Stridor, abdominal pain, rarely intestinal obstruction may result from edema of respiratory or gastro-

Cases of acute urticaria have a benign course with most patients being managed with conven-

intestinal tract. Lesions may take up to 72 hours to resolve [9, 18].

14 A Comprehensive Review of Urticaria and Angioedema

**Figure 1.** Typical urticarial plaques are observed on the leg of the patient.

**6. Prognosis**

tional treatments [8].

**Figure 2.** Angioedema involving the lips.

An increased prevalence of concomitant allergic diseases including rhinitis, asthma and atopic dermatitis is observed in cases of acute urticaria [8].

Chronic autoimmune urticaria is associated with antithyroid antibodies namely anti-microsomal and anti-thyroglobulin antibodies, observed in 27% of cases [12]. In patients with chronic urticaria, other autoimmune conditions such as vitiligo, type I diabetes mellitus, systemic lupus erythematosus and rheumatoid arthritis are more prevalent than in general population [5, 16].

Patients with chronic spontaneous urticaria often have concomitant physical urticaria that present with wheals lasting 2 hours or less [6].

Role of *Helicobacter pylori* infection in etiology of chronic autoimmune urticaria is still controversial [5]. However, it has been shown that *H. pylori* infection may contribute to the exacerbation of urticaria and that 2 weeks long triple therapy for eradication of the bacteria led to improvement of symptoms. As most patients infected with *H. pylori* are asymptomatic, screening of chronic urticaria patients for the presence of *H. pylori* infection by a non-invasive test, such as urea breath test or fecal antigen test is recommended [20].
