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?


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