“(Urticaria) is not an allergic condition, it's an autoimmune condition, one. Two, it's not dangerous, but it can last long. Three, we have very good strategies to control it.”                                                                                                                                                                                                                                                         - Dr. Moshe Ben-shoshanHives are probably one of the most misunderstood rashes by the general public. Hives are not life-threatening, but they're debilitating. They're not an allergy, but they're often blamed for being one. They're a marker of autoimmunity with little to do with one particular disease and their course and triggers in one particular person is at best challenging to predict.Dr. Moshe Ben-shoshan tackles the intriguing world of chronic urticaria; cutting through common misconceptions, and walking us through the latest in diagnostic strategies and management options for hives. From the targeted effectiveness of second-generation antihistamines to the advanced treatment possibilities offered by biologics like omalizumab, and even the role of immunosuppressants such as cyclosporine. Special attention is given to the nuances of chronic urticaria in children versus adults.Emphasizing the critical role of disease scoring systems, Dr. Ben-shoshan explains how these tools are vital for assessing severity and guiding treatment decisions. The conversation also sheds light on the diagnostic value of blood tests, showcasing the multifaceted approach required to effectively manage hives.Dr. Ben-shoshan tip-toes into the delicate territory of how to handle the increasing requests for testing and dietary modifications. We also take a quick glimpse into the future of urticaria management including targeted pediatric guidance and new biologics on the horizon. This episode offers an indispensable resource for allergists and healthcare professionals seeking to enhance their understanding of chronic urticaria. It’s packed with practical insights and a look towards promising advancements in the field.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions