MANAGEMENT OF CHRONIC URTICARIA

Analysis of 50 cases of chronic urticaria revealed a large variety of foods, drugs, infections, inhalants, and other items as possible causes of the disorder. The patients ranged in age from 8 to 73 years, and some had been afflicted as long as 22 years. There was much overlapping of etiological diagnoses. Emotional difficulties appeared to be significant in 32 patients, but among these there were only 6 in whom no other factors were clearly operative. Patients were encouraged to discuss domestic and occupational situations that might be emotionally charged. When the cause eludes recognition or cannot be obviated, symptomatic treatment is necessary. In this series it usually consisted of hydroxyzine hydrochloride, given orally in doses of 10 to 25 mg. three or four times a day, with antihistamines. Ephedrine hydrochloride was occasionally given by mouth and seldom by injection. Injection of epinephrine may be required in an occasional patient in whom angioneurotic edema threatens life by involving the pharyngolaryngeal areas.