How are wheals characterized in chronic urticaria?

Updated: Jul 31, 2018
  • Author: Marla N Diakow, MD; Chief Editor: William D James, MD  more...
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An important historical characteristic of urticarial lesions is their transient nature. An individual wheal typically lasts for less than 24 hours. Pruritus is the most common associated symptom. If lesions last longer and are associated with pigmentary changes or symptoms (eg, pain or burning), consider performing a biopsy to exclude urticarial vasculitis.

In persons with physical urticaria, individual wheals last less than 1 hour. The exception to this rule is delayed pressure urticaria, in which individual wheals last at least 8-48 hours, especially on the palms and soles.

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