Excellence in Dermatology™
Excellence in Dermatologic Surgery™
Excellence in Medical Dermatology™
Excellence in Dermatopathology™



A 32-year-old woman has had hives for 8 weeks. She has not started any new medications. Her hives are not painful and do not leave behind any pigmentation or other marks when individual resolve (within 24 hours). She has not had respiratory symptoms or lip or tongue swelling. She is frustrated with the amount of pruritus, but does not want to take any medications that make her “sleepy.” Which of the following medications would you recommend?


A 27-year-old woman presents to clinic with one week of “hives” that have appeared on her neck, trunk, and proximal extremities (see photo). They are very pruritic, and each lesion resolves within about a day. What is the next best step in management?


A 25 year old woman notes a 2 month history of itchy, intermittent welts that appear all over her body, with individual lesions lasting about a day. She notes that topical hydrocortisone 1% cream does not offer much relief. What is the best first line therapy for her condition.

4.*Which of the following is the cardinal symptom of urticaria?

A 62 year old man has been struggling with urticaria for over 3 years. He has been tested several times for allergies, but all have been negative. What is the most common cause for chronic urticaria?


There are several medications used to treat urticaria, including antihistamines. Which of the following is considered the most potent treatment for urticaria?

7.*A 9 year old boy eats ice cream topped with peanuts and begins to develop erythematous wheals on the lips, face and trunk. He had slight wheezing during the episode, but was not taken to the hospital and felt better within an hour. The family presents for treatment options several weeks later. Which of the following is recommended?
8.*A 23 year old woman has had chronic urticaria for 2 years and is very frustrated. She has tried several second-generation antihistamines with only partial relief. She is concerned about sedation during the day. Which of the following would likely be helpful to add to her regimen?

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