Suspected food allergies can be confirmed or disproved with the use of food diaries. A food or symptom diary for a fixed duration (eg, 2-4 weeks) may be helpful. Note all activities in which the patient was involved for 6-8 hours before the onset of urticaria. Cases have been reported in which a food or activity (eg, jogging) by itself results in no symptoms but when combined (eg, eating a shrimp cocktail and then jogging) may result in urticaria with or without progression to anaphylaxis. Excessive or prolonged use of a food or symptom diary is unlikely to be of benefit.
Removing offending ectoparasites can prevent papular urticaria, and insect repellent may lessen the chance of bites or stings from offending insects. Desensitization strategies are not recommended, except for stinging insect venoms.
Although the need for cold cardiopulmonary bypass surgery in patients with cold-induced urticaria is uncommon, one study reported success using an anti-inflammatory regimen before surgery and during recovery to prevent a systemic reaction of urticaria.
Patients with acute urticaria should avoid any medication, food, or other allergen that has precipitated urticaria or other serious allergic reaction previously. Chronic urticaria is seldom related to food allergens, and complicated elimination diets are seldom of benefit.
For more on the nonpharmacologic treatment of urticaria, read here.
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Cite this: William James. Fast Five Quiz: Refresh Your Knowledge on Key Aspects of Acute Urticaria - Medscape - Mar 27, 2018.