Urticaria and angioedema represent the same pathophysiologic process occurring at different levels of the skin.

Urticaria involves dilation of vascular structures in the superficial dermis.

Angioedema originates from the deeper dermis and subcutaneous tissues.

Urticaria can occur on any area of the body as well-circumscribed wheals with erythematous raised serpiginous borders and blanched centers that may coalesce to become giant wheals.


  1. Drug Reactions
  2. Allopathic drug: Antibiotic, NSAIDS,Pain killer Ibuprofen, Naproxen, Diclofenac, IV Contrast, Angiotensin converting Enzyme (ACE) Inhibitors, Penicillin, Cephalosporins, Macrolides (Erythromycin), Aminoglycosides, Tetracycline, Sulphonamides, Vancomycin, Fluoroquinolones, Anticonvulsants, Oral Antifungal Agents: Fluconazole, Ketoconazole, Betadine (Povidone-Iodine), IV Contrast, Angiotensin converting Enzyme (ACE) Inhibitors, Insulin, Corticotrophin, Vasopressin, Aspirin, Vaccines
  3. Foods: Shell Fish, Prawn, Crab, Dry Fish, Milk ,Egg, Almond, Cashew Nut, Artificial Sweetener
  4. Inhalation or contact with environmental allergens ,pollens
  5. Transfusion reactions
  6. Insects bites,wollen caterpillar
  7. Infections—viral, bacterial, parasitic
  8. Alcohol
  10. Smoking
  11. Tobacco chewing
  12. Mosquito repellent, coils
  13. Fast food
  14. Junk food
  15. Artificial Coloring agent in food
  16. Vibration, cold, pressure,
  17. Water (aqua genic)
  18. Sun (solar)
  19. Reactions to blood products
  20. Autoimmune


Urticarial eruptions are distinctly pruritic, may involve any area of the body from the scalp to the soles of the feet, and appear in crops of 12- to 36-h duration, with old lesions fading as new ones appear.

The most common sites for angioedema are often periorbital and perioral.

Angioedema of the upper respiratory tract may be life-threatening due to transient laryngeal obstruction

Angioedema of the gastrointestinal involvement may present with abdominal colic, with or without nausea and vomiting


IgE binds to the surface of mast cells and basophils through a high-affinity receptor. Cross-linking of this IgE by antigen causes cellular activation with subsequent release of histamine, prostaglandins, leukotrienes ,acid hydrolases, neutral proteases, proteoglycans, and cytokines. These mediators have been associated with immediate-type hypersensitivity, such as vasodilatation, increased vasopermeability, smooth muscle contraction, and chemotaxis of neutrophils and other inflammatory cells.


  • Avoid chemical pesticides, chemical fertilizer for farming
  • Avoid herbicides
  • Avoid weedicides
  • Avoid rodenticide
  • Eat organic fruits, vegetable
  • Regular exercise
  • Avoid smoking
  • Eating foods high in fiber
  • Drinking an adequate amount of fluids
  • Avoid alcohol
  • Avoid tobacco
  • Avoid allopathic drugs that causing urticaria
  • Avoid antibiotics
  • Avoid pain killers
  • Avoid Mosquito repellent, coils
  • Avoid junk food
  • Avoid Artificial Coloring agent in food


History, of exposures to allergen or ingestion of drug, environmental or food allergen


C1 inhibitor (C1INH) testing for deficiency of C1INH antigen (type 1) if history suggests hereditary angioedema





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