Don’t routinely do diagnostic testing in patients with chronic urticaria.
|Rationale and Comments:||In the overwhelming majority of patients with chronic urticaria, a definite etiology is not identified. Limited laboratory testing may be warranted to exclude underlying causes. Targeted laboratory testing based on clinical suspicion is appropriate. Routine extensive testing is neither cost-effective nor associated with improved clinical outcomes. Skin or serum-specific IgE testing for inhalants or foods is not indicated, unless there is a clear history implicating an allergen as a provoking or perpetuating factor for urticaria.|
|References:||• Wanderer AA, et al. The diagnosis and management of urticaria: a practice parameter. Ann Allergy Asthma Immunol. 2000;85:521-44.
• Tarbox JA, et al. Utility of routine laboratory testing in management of chronic urticaria/angioedema. Ann Allergy Asthma Immunol. 2011;107:239-43.
• Bernstein IL, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100(3 suppl 3):S1-148.
• Kozel MM, et al. Laboratory tests and identified diagnoses in patients with physical and chronic urticaria and angioedema: A systematic review. J Am Acad Dermatol. 2003;48(3):409-16.