Chronic Urticaria and Angioedema: Review Article

Background: Chronic urticaria (CU) and angioedema are common characterized by repeated wheals, pruritus, and recurrent deep tissue swelling lasting for more than six weeks. CU has an impact on patients with quality of life and is hard to diagnose and manage. The condition is usually classified as chronic spontaneous urticaria (CSU), for which there is no underlying cause, and chronic inducible urticaria, which occurs following exposure to specific stimuli such as pressure, cold, or heat. Angioedema may occur in isolation or with urticaria and commonly involves the face, lips, tongue, and airway and may prove fatal under rare conditions.
Objective: This article throws a deep overview on chronic urticaria and angioedema, their epidemiology, pathogenesis, clinical classification, diagnostic strategy, and current therapeutic strategies.
Methods: From 2005 to June 2025, a thorough search was carried out in PubMed, Google Scholar, and Science Direct using the following keywords: Angioedema, Chronic urticarial, Histamine, Mast cells, Omalizumab. Only the most recent or comprehensive study was considered. Oral presentations, dissertations, conference abstracts, and unpublished papers are a few examples of works that weren't considered important scientific study.  Documents published in languages other than English were ignored as a result of lack of translation resources.
Conclusion: Although the exact pathogenesis remains unclear, autoimmune features, mast cell activation, and histamine release are all crucial considerations. The diagnosis is clinical with support from detailed history, physical examination, and selective laboratory evaluation. Non-sedating H1-antihistamines form the first-line of treatment with dose escalation as needed. Refractory cases may require omalizumab, cyclosporine, or other immunomodulators. Effective management relies on correct diagnosis, identification of associated causes or comorbidities, and stepwise treatment in accordance with international guidelines. Unraveling of disease mechanisms and therapeutic approaches will increasingly develop through research.