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This interdisciplinary paper summarizes the news in the diagnosis and treatment of chronic urticaria (CU), and provides concepts, definitions and evidence-based suggestions for its management. Urticaria occurs in at least 20% of the population at some point in their lives. Acute urticaria (less than 6 weeks' duration), differs from CU in its etiology, but the onset of this disease is always acute. CU may occur as spontaneous (SCU) or induced (ICU). The diagnosis is simple, although a careful evaluation is necessary for differential diagnosis. ICU's diagnosis is mainly clinical, even if provocation tests can be useful. Supplementary studies should be limited and based on the clinical suspicion. Treatment may be divided into three approaches: avoidance, elimination or treatment of the cause, and pharmacological treatment. Recently treatment has been modified with the use of second-generation antihistamines as first-line and increased doses of nonsedating H1 antihistamines, up to 4 times, as second line. Antihistamines are essential to treat CU; however, 40% of patients do not achieve good control despite increased doses and require additional treatment. The most recent evidence indicates a group of drugs to be used as third line in these cases, to improve quality of life and to limit toxicity from frequent or chronic use of systemic steroids. Only 3 drugs are recommended as third line: omalizumab, cyclosporin A or anti-leukotrienes.

Cold urticaria is one of the five most common causes of chronic urticaria and is grouped as a physical urticaria. It can occur after exposure to cold, either through solid objects, air or liquids. Patients may have symptoms of urticaria, angioedema, respiratory distress and even anaphylaxis when the skin is exposed to a cold environment, such as handling refrigerated objects, swimming in cold water or entering an air-conditioned room. Five cases of cold urticaria are presented, followed by a brief literature review.

The skin is the largest body's organ, with a well defined functional lymphoid tissue. This organ can be the target of several hypersensitivity-mediated diseases, that are both, genetically determined and influenced by environmental factors. In this paper the main clinical features and the current treatment modalities for the most frequent allergic cutaneous diseases are reviewed.

This paper describes a 36 year-old white woman with six month history of epigastric abdominal pain, reactive arthritis and painful dermographism. Serum antibodies to Helicobacter pylori were identified. All symptoms subsided when she received eradication treatment.

Aims: The chronic urticaria and the angioedema affect to the population's wide sectors and up to now their cause is ignored., Material and Method: They were studied during one year 50 mature patients with chronic urticaria coming from the ambulatory consultation of the service of alergología of the Hospital CQ Hermanos Ameijeiras. The diagnosis of chronic urticaria settled down clinically for observation of the lesions and for the time of its evolution that should exceed six weeks. It was included as group witness to 26 healthy individuals., Results: They were high levels for the IgE seric in the patients' 70%; you even normal of IgA, IgG and IgM in the great majority of the cases. The determination of circulating immunocomplexs gave negative in 88% of the sick and only positive in 12%. The tests for cutirreacción with extracts alergénicos micóticos, in reading at the 48 hours, were not negative in a significant way, among the group of sick and in the group witness.

Substance P is a decapeptide which forms part of the group known as neuropeptides, that is, peptides released by some neurones such as the slow-conducting C fibres and the rapid-conducting A-delta fibres. These neurones belong to the category of non-adrenergic non-cholinergic nerves (NANC), which perform their action through a mechanism known as "axonic reflex". This mechanism is an antidromic stimulation which produces a secretion of neuropeptides, especially substance P. It is known that substance P, once released, is able to exert a number of actions including among others inflammatory and bronchospastic activities and a stimulation of the immunologic system. Other effects attributed to this substance are an increase in capillary permeability and oedema and the perpetuation of certain conditions such as asthma, rhinitis and chronic urticaria or hives. The production, metabolism and actions of this neuropeptide are described.