Urticaria, also known as hives, is a skin rash ot raised, itchy bumps. Hives usually itch, but they may also burn or sting. They can show up anywhere on  body, including the face, lips, tongue, throat, and ears. Hives can change size rapidly and move around, disappearing in one place and reappearing in other places, often in a matter of hours. Hives can often appear and then clear up within a few hours. Some people have one flare- up and never get hives again. It’s also possible to have many flare-ups. They range in size from few millimeters to many centimeters.

Angioedema is different. The swelling happens under the skin, not on the surface. It’s markedby deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours. It’srare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.

Different types of urticaria include

1)Acute urticaria and/angioedema;  hives or swelling lasts less than 6 weeks. The most common causes are foods, medicines, latex, infections, Insect bites or a disease.

2)Chronic urticaria and/or angioedema: Hives or swelling that lasts more than 6 weeks. The causes can be similar to those of acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.

3)Physical urticaria: Hives caused by direct physical stimulation of the skin – for example, cold, heat, sunlight, vibration, pressure, sweating, and exercise. They usually happen right where the skin was affected and rarely appear anywhere else. Most appear within 1 hour after exposure.

4)Dermatograhism: Hives that form after firmly stroking or scratching the skin. You may also have other forms of hives. Hereditary angioedema: Painful swelling under the skin. It runs in families.

Urticaria is diagnosed with detailed history and physical examination. Sometimes some blood tests and skin prick testis needed.

The best treatment is to identify and remove the trigger. Antihistamines are given to easesymptoms or help prevent them. For chronic hives, antihistamines or a combination of medications: such as steroids or a biologic drug may be needed. For angioedema, one may need a shot of epinephrine or a steroid medication. Supportive treatment includesUse of lukewarm water, mild soap, cool compresses or wet cloths to the affected areas and fragrance-free moisturizer.

Referral to specialist is needed for detailed evaluation and management