What are the different types of urticaria (hives)?

From the Guidelines

Urticaria can be classified into several types, including ordinary urticaria, physical urticarias, and other forms such as contact urticaria, urticarial vasculitis, and autoinflammatory syndromes. The classification of urticaria is based on the duration, triggers, and presentation of the condition, as outlined in the guidelines for evaluation and management of urticaria in adults and children 1.

Types of Urticaria

• Ordinary urticaria: can be acute (up to 6 weeks of continuous activity), chronic (6 weeks or more of continuous activity), or episodic (acute intermittent or recurrent activity) 1
• Physical urticarias: triggered reproducibly by one or more physical stimuli, such as mechanical (delayed pressure urticaria, symptomatic dermographism), thermal (cholinergic urticaria, cold contact urticaria, localized heat urticaria), or other stimuli (vibratory angio-oedema, aquagenic urticaria, solar urticaria) 1
• Other forms of urticaria: include contact urticaria (occurring only when the eliciting substance is absorbed percutaneously or through mucous membranes), urticarial vasculitis (presenting with urticaria clinically but small vessel vasculitis histologically), and autoinflammatory syndromes (presenting with urticaria, pyrexia, and malaise, with other features that define the disease phenotype) 1

Key Characteristics

• The duration of individual weals can be helpful in distinguishing between these clinical patterns, with weals typically lasting from 2 to 24 h in ordinary urticaria, up to 2 h in contact urticaria, and up to 48 h to fade in delayed pressure urticaria 1
• Angio-oedema without weals should be distinguished from angio-oedema occurring with weals, as it may be caused by angiotensin-converting enzyme (ACE) inhibitors or be a presentation of C1 esterase inhibitor (C1 inh) deficiency 1

From the Research

Types of Urticaria

• Acute urticaria: lasts for ≤6 weeks 2, 3, 4
• Chronic urticaria: lasts for >6 weeks 2, 3, 4

Subtypes of Chronic Urticaria

• Spontaneous chronic urticaria: no definite triggers 5, 2, 3, 4
• Inducible chronic urticaria: definite and subtype-specific triggers 5, 2, 3, 4

Characteristics of Urticaria

• Presents with pruritic wheals, angioedema, or both 2, 3, 4
• Can be associated with exacerbating factors such as infections, drugs, and food 3
• Can be classified based on duration and presence of triggers 2, 3, 4