Abstract
Urticaria is a distressing dermatologic condition for many. Although the wheals of
urticaria are characteristically evanescent, lasting less than 24 hours, patients
tend to have recurrent episodes. Hives that last less than 6 weeks are considered
acute urticaria. Acute urticaria does not routinely require supplementary work-up
because the history often identifies a convincing, inciting allergen. Chronic urticaria
is defined as episodes that occur for longer than 6 weeks, and there is often not
an easily identifiable trigger. For both acute and chronic urticaria, patients frequently
report food as a precipitating cause. For acute urticaria, the foods that are associated
with true allergies, such as nuts and shellfish, are the most frequent offenders.
The relationship between diet and chronic urticaria is not as firmly defined. Many
patients unnecessarily restrict their diets, so it becomes the role of dermatologists
to help patients identify if there is a reproducible link between their symptoms and
their dietary exposures. The literature suggests that diets free from pseudoallergens
and histamine-releasing foods may attenuate urticaria. Supplements such as fats, vitamin
D, iron, and flavonoids have also been studied and may diminish symptoms.
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Published online: October 26, 2021
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