Hives and angioedema


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Tests and diagnosis

By Mayo Clinic staff

Your doctor will examine your welts or areas of swelling if they are still present and take a careful medical history to identify possible causes. Your doctor's questions may focus on recognized factors linked to urticaria and angioedema, such as certain foods, physical triggers and medications. It's important to tell your doctor about all medications you take, including over-the-counter (nonprescription) drugs and supplements, even if you don't take them every day. To help pinpoint the cause of your symptoms, your doctor may recommend that you keep a detailed diary of exposure to possible irritants.

If the cause of your hives or angioedema isn't apparent from your medical history or if your symptoms persist or recur often, your doctor may recommend an allergy skin test.

  • Puncture, prick or scratch (percutaneous) test. This is the type of skin test that's usually performed first. Tiny drops of purified allergen extracts are pricked or scratched into your skin's surface. This test is usually performed to identify allergies to pollen, animal dander, foods, insect venom and penicillin.
  • Intradermal (intracutaneous) test. Purified allergen extracts are injected into the skin of your arm. Doctors may perform this test if they strongly suspect you're allergic to an irritant even though your puncture test is negative — especially to an irritant to which a future reaction could be life-threatening, such as insect venom or penicillin.

If your doctor suspects hereditary angioedema, he or she may order blood tests to check for levels and function of specific blood proteins.

Treatments and drugs Preparing for your appointment
References
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  2. MacNeal RJ. Urticaria. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec10/ch109/ch109e.html?qt=urticaria&alt=sh#sec10-ch109-ch109e-101c. Accessed Sept. 14, 2010.
  3. Bingham CO. New onset urticaria: Diagnosis and Treatment. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  4. Atkinson JP. Diagnosis of hereditary angioedema. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  5. Bingham CO. New onset urticaria: Epidemiology, clinical manifestations and etiology. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  6. Urticaria and angioedema. In: Wolff K, et al. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 6th ed. New York, N.Y. The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=5187962. Accessed Sept. 14, 2010.
  7. Initial evaluation of all patients with urticaria. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, Scotland. Mosby/Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7234-3541-9..00015-8--s0180&isbn=978-0-7234-3541-9&type=bookPage&sectionEid=4-u1.0-B978-0-7234-3541-9..00015-8--s0180&uniqId=220753099-3#4-u1.0-B978-0-7234-3541-9..00015-8--s0180. Accessed Oct. 1, 2010.
  8. Treatment of urticaria. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, Scotland. Mosby/Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7234-3541-9..00015-8--s0290&isbn=978-0-7234-3541-9&type=bookPage&sectionEid=4-u1.0-B978-0-7234-3541-9..00015-8--s0290&uniqId=220753099-3#4-u1.0-B978-0-7234-3541-9..00015-8--s0290. Accessed Sept. 13, 2010.
  9. Acute urticaria: Evaluation and management. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, Scotland. Mosby/Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7234-3541-9..00015-8--s0185&isbn=978-0-7234-3541-9&type=bookPage&sectionEid=4-u1.0-B978-0-7234-3541-9..00015-8--s0185&uniqId=220753099-3#4-u1.0-B978-0-7234-3541-9..00015-8--s0185. Accessed Oct. 1, 2010.
  10. Bingham CO. An overview of angioedema: Clinical features, diagnosis and management. http://www.uptodate.com/index/home.html. Accessed Oct. 1, 2010.
  11. Delves PJ. Angioedema. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec13/ch165/ch165b.html. Accessed Oct. 1, 2010.
  12. FDA licenses for marketing new drug for rare genetic disease. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm161477.htm. Accessed Oct. 1, 2010.
  13. Cinryze. Food and Drug Administration. http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/LicensedProductsBLAs/FractionatedPlasmaProducts/ucm150480.htm. Accessed Oct. 6, 2010.
  14. Nolte H, et al. Overview of skin testing for allergic disease. http://www.uptodate.com/index/home.html. Accessed Oct. 2, 2010.
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  16. Kalbitor. Drugs @FDA. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm. Accessed Oct. 15, 2010.
  17. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 13, 2010.
DS00313 Dec. 21, 2010

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