Figure 2. Hives following MMR vaccine
Transient pruritic hives are a key characteristic of CSU and the majority of other forms of urticaria.
Painful or burning hives are associated with urticaria vasculitis, presenting a diagnostic challenge when evaluating patients with chronic urticaria. Patients with urticaria vasculitis have wheals that persist for > 24 hours and are typically more painful than itchy. The resolving wheals in urticaria vasculitis result in pigment changes or scaling.
Although patients with CSU may have angioedema, a positive history of transient pruritic hives is the main characteristic of this condition.
Crusted and painful lesions that follow a dermatome are associated with herpes zoster, not CSU.
Learn more about the clinical presentation of CSU.
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Cite this: William D. James. Fast Five Quiz: Chronic Spontaneous Urticaria - Medscape - Jun 15, 2020.
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