The Australasian College of Dermatologists

Recommendations from the Australasian College of Dermatologists on leg cellulitis, epidermal cysts, urticaria, distorted toenails & acne. The Australasian College of Dermatologists was established in 1966 as the medical college responsible for the training and professional development of medical practitioners in the speciality of dermatology.


Acute urticaria (i.e. of less than 6 weeks duration) does not routinely require investigation for an underlying cause. Where clinical history and examination suggest the possibility of a bacterial infection or food as a likely trigger, further testing may be warranted. If individual lesions (weals) persist for longer than 24 hours an alternative diagnosis may need to be considered.

Date reviewed: 1 August 2016

The individual weals of acute urticaria and angioedema can be widespread and variable in appearance, resolving in 24 hours leaving normal skin. In children, upper respiratory tract and viral infections are the most common cause of acute urticaria. Foods and medications such as antibiotics and nonsteroidal anti-inflammatory drugs are possible triggers in all age groups. Thus the cause of acute urticaria is usually suggested by a patient’s history without the need for routine blood investigations.

Supporting evidence
  • Frigas E, Park MA. Acute urticaria and angioedema: diagnostic and treatment considerations. Am J Clin Dermatol 2009;10(4):239-50.
  • Schaefer P. Urticaria: evaluation and treatment. Am Fam Physician 2011;83(9):1078-84.
  • Grattan CEH, Humphreys F. and on behalf of the British Association of Dermatologists Therapy Guidelines and Audit Subcommittee. Guidelines for evaluation and management of urticaria in adults and children. British Journal of Dermatology 2007;157(6):1116-23.
How this list was made How this list was made

A long-standing College Fellow, in consultation with the Honorary Secretary has prepared 5 recommendations. All ACD members were invited to choose three out of the five recommendations. Following an NPS Representatives meeting, it was noted that five recommendations are needed. Therefore the remaining two recommendations were selected.

Download ACD Recommendations