Ep. 76: Diagnosing Chronic Spontaneous Urticaria
How do you know if your hives are really chronic spontaneous urticaria?
Join Kortney and Dr. Payel Gupta in the second episode of this chronic spontaneous urticaria (CSU) series as they delve into the diagnostic journey of CSU.
Have you wondered if the path to a chronic spontaneous urticaria diagnosis is long? CSU can feel like a very complex disease to diagnose due to the lack of identifiable triggers, but this episode breaks down the steps healthcare professionals take to diagnose CSU.
Dr. G clarifies how allergists' and dermatologists' roles differ in diagnosing CSU. The episode emphasizes the importance of a detailed medical history and the tests involved in ruling out other conditions. It also describes the journey of determining CSU from other skin and allergic reactions through meticulous evaluation and specific testing methods.
What we cover in our episode about diagnosing chronic spontaneous urticaria:
Introduction to CSU Diagnosis: CSU has no identifiable triggers, making diagnosis a process of elimination.
Role of Specialists: Patients often start their diagnosis journey at urgent care, after which they consult allergists and dermatologists depending on the severity and symptoms of hives.
Detailed Medical History: Essential questions cover medications, infections, travel history, and other health changes to rule out underlying causes.
Physical Examination: Doctors check if hives are “blanchable” to differentiate from other conditions like vasculitis.
Ruling out other Conditions: This involves evaluating other conditions in which hives are a symptom, such as mast cell disease or various autoimmune diseases.
Necessary Tests: Doctor’s apprehension about doing a food allergy test unless necessary. Other tests include looking at blood count (CBC with differential) and inflammation (ESR or CRP).
More resources about spontaneous hives:
Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/
Other episodes about urticaria:
Diagnosing Chronic Spontaneous Urticaria Episode in a Nut Shell
Specialist Consultation: The choice between allergists and dermatologists in diagnosing spontaneous urticaria depends on the patient's symptoms and medical history.
Diagnostic Approach: Diagnosis relies on ruling out other causes through comprehensive history and physical exams.
Testing and Procedures: Routine biopsies are rare unless hives don’t fit the typical presentation. Allergy tests are approached cautiously to avoid false positives. Doctors may perform other blood tests if there are reasons to suspect other conditions that are causing the hives.
Common Misconceptions: Avoid over-testing and unnecessary dietary restrictions due to misdiagnosed food allergies.
We thank Novartis for sponsoring this podcast.
Timestamps
Diagnosing Chronic Spontaneous Urticaria
00:01:23 Differentiating hives from an allergic reaction versus Chronic Spontaneous Urticaria (CSU)
00:02:28 Choosing between an allergist or dermatologist for diagnosis of hives
00:06:03 Considering specialist consultation for Chronic Spontaneous Urticaria (CSU) diagnosis
00:07:46 Consulting a dermatologist for a skin biopsy in hives diagnosis
00:09:28 Diagnosing CSU: key questions and comprehensive review
00:12:13 Determining true hives: identifying a blanchable rash
00:14:48 Summary of blanchable rashes in hives diagnosis
00:15:38 The importance of hives coming and going without leaving marks and their relation to Vasculitis
00:17:53 Conditions associated with hives: Mast Cell Disease and autoimmune disorders
00:20:06 Autoimmune disorders commonly associated with Chronic Spontaneous Urticaria (CSU)
00:21:58 Tests conducted for CSU diagnosis, including physical tests for inducible urticaria
00:23:24 Overview of food allergy testing in hives diagnosis
00:25:38 Understanding false positives in food allergy testing in the context of hives
00:28:25 Environmental allergy testing in relation to hives diagnosis
00:29:38 Additional blood tests used in the diagnosis of hives
00:31:22 Ensuring the patient undergoes a general healthcare maintenance exam in hives diagnosis
00:32:38 The importance of not over-testing in hives diagnosis
00:33:38 Timeframe for reaching a diagnosis of Chronic Spontaneous Urticaria (CSU)
00:34:38 Consulting a specialist in hives diagnosis
