Urticaria: Selected highlights and recent advances

Urticaria is a common and ancient malady. Early Chinese medical literature refers to this as "wind-rash-patch," or Fong-Tzen-Kwai [1]. This condition was also known to Western medicine by Pliny, Celsus, and Hippocrates [2]. More recently, in the eighteenth century, it was elegantly described by Heberden as, "The little elevations upon the skin in the 'nettle' rash often appear involuntarily, especially if the skin be rubbed, or scrubbed, and seldom stay many hours in the same place, and sometimes not many minutes. There is no body exempt from 'them' and by far the greatest number experience no other evil from it besides the intolerable anguish arising from the itching..." [3]. Comparing one recent review of urticaria [4] with another a half-century prior [5], the similarities are perhaps more remarkable than the differences in the present understanding of this challenging illness. Rather than presenting a comprehensive overview, this article instead highlights selected topics, controversies, and recent advances in the diagnosis, evaluation, and management of this fascinating condition.