Fever in Urticaria
Fever can occur in specific subtypes of urticaria, particularly autoinflammatory syndromes presenting with urticarial lesions, but is not a feature of ordinary urticaria. 1
Key Clinical Distinctions
Autoinflammatory syndromes presenting with urticaria typically develop spontaneous wheals, pyrexia (fever), and malaise, distinguishing them from ordinary urticaria. 1 These include:
- Hereditary syndromes: Cryopyrin-associated periodic syndromes (CAPS) such as Muckle-Wells syndrome 1
- Acquired syndromes: Schnitzler syndrome 1
When to Suspect Fever-Associated Urticarial Conditions
The presence of recurrent unexplained fever alongside urticarial lesions should prompt consideration of autoinflammatory disease rather than chronic spontaneous urticaria. 1
In patients presenting with persistent urticarial plaques associated with fevers and elevated inflammatory markers (CRP, leukocytosis), autoinflammatory disorders should be considered. 2
One-third of CSU patients may report systemic symptoms including recurrent fever (5.3%), though this may indicate comorbid conditions or mimickers requiring exclusion. 3