Urticaria other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]


Urticaria activity score (UAS7) is a questionnaire-based scoring system which inquires about pruritus and wheals experienced by the patients. It is helpful to determine the spontaneous urticaria severity. Moreover, there is another diagnostic test, named ice cube test which is used to diagnose cold-induced urticaria. The aforementioned test is a practical method to observe wheals appearance after cold exposure.

Other Diagnostic Studies

Urticaria Activity Score

Urticaria activity score (UAS7) is a scoring system, which is helpful for evaluation of spontaneous urticaria severity. It is a questionnaire-based scoring system which mainly inquires about pruritus and wheals experienced by the patients.[1][2][3][4]

Score Wheals Pruritus
0 No wheals have been appeared Patient didn't experience any pruritus
1 Appearance of less than 20 wheals within 24 hours Patient experienced pruritus, nevertheless it didn't annoy the patient
2 The appearance of 20 to 50 wheals within 24 hours Patient felt annoyed with pruritus, nevertheless it didn't interfere with him/her daily activities or sleep
3 The appearance of more than 50 wheals within 24 hours or involvement of a large surface of the body with confluent wheals The patient felt annoyed with pruritus and it interferes with him/her daily activities or sleep

  • Scores have a range of 0 to 6 for every 24 hours.
  • Scores should be measured for the whole week, which can have a total range of 0 to 42.

Ice Cube Test

  • Ice cube test is recommended as a diagnostic test in order to diagnose cold-induced urticaria. This test is performed by applying a plastic bag which contains melting ice cubes on the patient's forearm for 5 minutes.
  • Appearance of wheal within 10 minutes after removing of the plastic bag is considered a positive test.[5]


  1. Godse K, De A, Zawar V, Shah B, Girdhar M, Rajagopalan M; et al. (2018). "Consensus Statement for the Diagnosis and Treatment of Urticaria: A 2017 Update". Indian J Dermatol. 63 (1): 2–15. doi:10.4103/ijd.IJD_308_17. PMC 5838750. PMID 29527019.
  2. Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau A; et al. (2009). "EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria". Allergy. 64 (10): 1417–26. doi:10.1111/j.1398-9995.2009.02179.x. PMID 19772512.
  3. Hollis K, Proctor C, McBride D, Balp MM, McLeod L, Hunter S; et al. (2018). "Comparison of Urticaria Activity Score Over 7 Days (UAS7) Values Obtained from Once-Daily and Twice-Daily Versions: Results from the ASSURE-CSU Study". Am J Clin Dermatol. 19 (2): 267–274. doi:10.1007/s40257-017-0331-8. PMC 5978890. PMID 29368043.
  4. Maurer, M.; Weller, K.; Bindslev-Jensen, C.; Giménez-Arnau, A.; Bousquet, P. J.; Bousquet, J.; Canonica, G. W.; Church, M. K.; Godse, K. V.; Grattan, C. E. H.; Greaves, M. W.; Hide, M.; Kalogeromitros, D.; Kaplan, A. P.; Saini, S. S.; Zhu, X. J.; Zuberbier, T. (2011). "Unmet clinical needs in chronic spontaneous urticaria. A GA2LEN task force report1". Allergy. 66 (3): 317–330. doi:10.1111/j.1398-9995.2010.02496.x. ISSN 0105-4538.
  5. Stepaniuk P, Vostretsova K, Kanani A (2018). "Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice". Allergy Asthma Clin Immunol. 14: 85. doi:10.1186/s13223-018-0310-5. PMC 6299577. PMID 30574166.

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