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Angioedema is more often spontaneous urticaria, but each has gone or has altered in shape within 24 hours. Visual analogue scales can be used to record and compare the degree of itch. The mediators activate sensory nerves and cause dilation of blood vessels and leakage of fluid into surrounding tissues. Several hypotheses have been proposed to explain urticaria.The immune, arachidonic acid and coagulation systems are involved, and Severe allergic urticaria may lead to anaphylactic shock (bronchospasm, collapse).The infant dose (mg/kg) can then be expressed as a percentage of the maternal dose (mg/kg).An arbitrary cut-off of 10% has been selected as a guide to the safe use of drugs during lactation.The infant almost invariably receives no benefit from this form of exposure and is considered to be an 'innocent bystander'.Drug transfer from maternal plasma to milk is, with rare exceptions, by passive diffusion across biological membranes.If treatment is required, loratidine and cetirizine are currently preferred.Conventional first-generation antihistamines such as promethazine or chlorpheniramine are no longer recommended for urticaria: Some patients with inducible urticaria benefit from daily induction of symptoms to induce tolerance.

Almost all drugs transfer into breast milk and this may carry a risk to a breastfed infant.Urticaria is characterised by weals (hives) or angioedema (swellings, in 10%) or both (in 40%). The name urticaria is derived from the common European stinging nettle 'Urtica dioica'.A may last a few minutes or several hours, and may change shape.Phototherapy may be helpful for symptomatic dermographism.If non-sedating antihistamines are not effective, a 4 to 5-day course of oral prednisone (prednisolone) may be warranted in severe corticosteroids are not recommended, as high doses are required to reduce symptoms of urticaria and they have inevitable adverse effects that can be serious.

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