Urticaria: The Daily PANCE Blueprint

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Urticaria: The Daily PANCE Blueprint

A 20-year-old male is brought to the ER due to an itchy rash that occurred after he wore latex gloves. He is breathing fine and vitals are stable. On physical exam, you note raised, erythematous plaques with a few excoriations. Which of the following is the most appropriate next step in the management of this patient?

A. High dose IV systemic corticosteroids
B. Oral famotidine
C. Oral cetirizine
D. Topical steroid cream only
E. Oral corticosteroids

Answer and topic summary

The answer is C. Oral cetirizine

Urticaria (aka hives) is a dermatologic disease defined by raised, pruritic, erythematous plaques. In most cases, it is caused by the release of histamine, bradykinin, and other vasoactive substances from basophils/mast cells in the superficial dermis. Etiologies include infections, medications (e.g., penicillins, NSAIDs, sulfa drugs), biting/stinging insects, latex, foods, allergens, etc. Diagnosis is usually clinical. 1st line is H1 antihistamines (e.g., cetirizine, diphenhydramine, loratadine). Systemic steroids can be given if symptoms persist for more than a few days.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Dermatology ⇒ Other Dermatological Disorders ⇒ Urticaria

Also covered as part of the Emergency Medicine EOR, General Surgery EOR, Family Medicine EOR, and Pediatric EOR topic lists

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