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Hives

Answer

Urticaria, more commonly referred as to as hives, is estimated to affect 1 in 6 people at some point in their lives, compared with 1 in 1,000 people for chronic urticaria. Many people will experience urticarial in response to a food or drug reaction or insect sting, and some find emotional stress can be a trigger. However some people experience more prolonged or chronic bouts of the condition. In such cases an autoimmune reaction is thought to be associated with a high number of cases without an identifiable cause. A range of information for the public on the conditions is available via NHS Choices.

The care of people with skin problems is a core competence of general practitioner training and people with urticaria can usually be managed through routine access to primary or second care services. To support clinicians in the diagnosis, treatment, care and support of patients with chronic spontaneous urticaria, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either anti-histamines or steroids, but the guidance also makes clear that patients with chronic urticarial should be considered for a referral to a dermatologist. In addition, July 2015 NICE published the Technology Appraisal Omalizumab for previously treated chronic spontaneous urticarial, recommending the drug for patients in whom the conditions is identified as severe and standard treatments have not improved the symptoms. Both the NICE CKS and technology Appraisal can be found at the following links:

http://cks.nice.org.uk/urticaria

www.nice.org.uk/guidance/ta339/resources/omalizumab-for-previously-treated-chronic-spontaneous-urticaria-82602555773893

For those patients with the most serious forms of chronic spontaneous urticaria who cannot be managed through routine access treatments provided through primary or secondary care, a referral to a specialised dermatology service may be appropriate. NHS England commissions services for people with rare and complex skin conditions and has set out what providers must have in place in order to offer specialist dermatology care. These services may provide more intensive therapies with a involvement of a range of health and care professionals, subject to that patient’s needs. More information can be found at the following link:

www.england.nhs.uk/wp-content/uploads/2013/06/a12-spec-dermatology.pdf

Secondary information

Type

Written question

Reference

14697

Session

2015-16

Grouped for answer

Yes

Subjects

Diagnosis Hives

Link

View this Written question on www.parliament.uk