A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria.

1. Discuss the likely cause of the patient’s urticaria.

2. Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.

3. Describe the relationship between the patient’s symptoms and the concept of inflammation.

4. What pharmacological and non-pharmacologic? Treatment options are available??

5. Discuss the complications of urticaria.

6. What teaching would be appropriate to provide the parent and child about urticaria?

7. Support your response with at least two current evidence-based resource peer reviewed articles, ideally from reputable medical journals such as NEJM, JAMA, or the Lancet. Maximum 5 years old.