• Patients , who believe they have hives or swelling, can complete the workbook section. This is shared with the health care professional, who can use the information to consider diagnostic possibilities, laboratory considerations and treatment recommendations.
• Health care professionals (HCPs) who can advise their patients to complete  the workbook section. Based upon the workbook information, the HCPs can utilize a numeric algorithm to guide them to discussion(s) of possible diagnostic possibilities, laboratory test considerations and treatment recommendations.

• Health care professionals (HCPs) who can advise their patients to complete a workbook section. Based upon the workbook information, the HCPs can utilize a numeric algorithm to guide them to discussion(s) of possible diagnostic possibilities, laboratory test considerations and treatment recommendations.
  
• Patients, who believe they have hives or swelling, can complete the workbook section. This is shared with the health care professional, who can use the information to consider diagnostic possibilities, laboratory considerations and treatment recommendations.

Use of this book will save valuable time and provide efficient and focused interaction between patients and health care professionals. Improved collaboration increases the chances of achieving diagnostic and treatment success. It can be a vehicle for improved exchange of information between patients and health care professionals and as an information resource to assist health care professionals in the diagnosis and treatment of these conditions. The use of the book should improve diagnostic and treatment success for patients and increase the professional satisfaction of health care professionals.

HOW TO USE THIS BOOK:

The book is divided into three sections:

Section 1: For patients and optional for health care professionals

• The Introduction discusses background information on hives and swelling.
• Chapter 1 answers common questions that are asked by patients regarding hives and swelling.
  • What are hives and swelling?
  • Why is it difficult to find the cause of hives and/or swelling?
  • Is there a common mechanism that causes hives and/or swelling?
  • Why do hives and/or swelling remain only for a short time in some individuals, while other patients experience symptoms for longer periods, sometimes months or years?
  • Can the duration of symptoms be predicted for chronic hives and/or swelling?
  • Why aren’t antihistamines completely effective in treating hives and/or swelling?
  • How can you determine whether a food, food additives, dyes, preservatives, or undetected allergens are causing hives and/or swelling?
  • Do psychological factors play a role in causing hives and/or swelling?
• Chapter 2 provides the clinical criteria for patients to establish with reasonable certainty that they are experiencing hives and/or swelling.

• Chapters 3 and 4 provide workbook exercises for patients.
  • The first exercise is to photograph the hives and/or swelling. This is important because skin symptoms change in appearance and may not be present during scheduled office visits.
  • The second exercise is to determine whether skin symptoms disappear within a defined time period. Hives (urticaria) characteristically disappear within 24 to 36 hours, and swelling (angioedema) almost always resolves within 72 hours.
  • The third exercise is to complete a detailed history questionnaire that may provide information pertinent to uncovering the cause of the hives and/or swelling.

• Chapter 5 provides diagnostic recommendations based on integration of information from the patient’s workbook section and the physical examination.
  • The HCP reviews the patient’s workbook exercises #1 and#2 (chapter 3).
    • Exercise 1:
      The photographs are reviewed to assess the severity of symptoms and confirm that the skin lesions are compatible with hives and/or swelling.
    • Exercise 2:
      (1) The photographs are reviewed to determine whether skin lesions disappeared over a 24- to 36-hour interval. Hives should have completely disappeared within that time frame. If they have not disappeared within this time, there is a possibility that the skin lesions are not urticaria. An appendix lists alternative conditions that can masquerade as hives.
      (2) The photographs are reviewed to determine whether swelling has disappeared within a 24- to 72-hour interval. Swelling associated with angioedema usually resolves within that time interval. An appendix lists alternative conditions that can masquerade as swelling (angioedema).
  • The HCP reviews the completed history questionnaire. The book utilizes a numeric algorithm as a guide to discussions of possible diagnostic considerations and laboratory recommendations based on the answers to the questionnaire. Each symptom or item that has been identified by the patient in the questionnaire (chapter 4) is followed by a number in bold, for example, (#54). The HCP refers to the same numbers in chapter 5 for a discussion of diagnostic possibilities for these symptoms or conditions and recommendations for the laboratory workup.
• Chapter 6 discusses treatment strategies for hives and/or swelling.
• Chapter 7 provides suggestions for the evaluation and treatment of difficult-to-diagnose hives and/or swelling.
• Appendix I list conditions that masquerade as hives and swelling.
• Appendix II is a sample diary that can be used by patients to determine if factors, such as diet, activities, medications etc., are causally related to hives/swelling.
• Appendix III is a sample table for recording and summarizing results of patients with these conditions.