A 22 year old woman complains of recent onset of severe itching and weals which followed a viral infection


#1

A 22 year old woman complains of recent onset of severe itching and weals which
followed a viral infection. On inspection, numerous weals of all sizes are noticed on his
skin. The weals tend to come and go within hours. What is the SINGLE most likely
diagnosis?
A. Primary sclerosing cholangitis
B. Urticaria
C. Psychogenic itching
D. Atopic eczema
E. Primary biliary cirrhosis
Urticaria
The typical lesion is a central itchy white papule or plaque due to swelling of the surface
of the skin (weals). This is surrounded by an erythematous flare. The lesions are
variable in size and shape and may be associated with swelling of the soft tissues of the
eyelids, lips and tongue

Individual lesions are typically transient. They come and go within a few minutes to
hours.

Management

  • Where possible, identify and treat the cause. Nonspecific aggravating factors
    should be minimised, such as overheating, stress, alcohol, and caffeine Antihistamines: Non-sedating H1 antihistamines are the mainstay of treatment.
    In pregnancy chlorphenamine is often the first choice of antihistamine