Comment implications for clinical practice

Generally the available therapeutic evidence for acute urticaria is quantitatively and qualitatively weak. RCTs of the therapeutic efficacy of the second-generation antihistamines are lacking, although one would like to consider these the first choice of therapy based on the studies in chronic urticaria.3 There is some evidence that the combination of H1 and H2 antagonists has additional beneficial effects. A short-term intervention with corticosteroids seems to be superior to a treatment with antihistamines alone, but should be considered in the context of individual needs.

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