Chronic urticaria is a condition in which various factors cause temporary inflammatory congestion and tissue edema in the skin, mucous membranes, and blood vessels for more than 6 weeks. The cause is often uncertain. The clinical manifestations of urticaria are the erratic occurrence of wind and plaques on the trunk, face or extremities. The episodes vary from several times a day to once every few days. In fact, there are different clinical types of chronic urticaria, and their clinical manifestations are not uniform. The common types and manifestations are: 1. Chronic spontaneous urticaria: can develop at any age. Varying sizes and numbers of bumps (commonly known as wind bumps) can occur naturally in any part of the body and can subside within 24 hours. The bumps can occur at any time of the day, but are commonly seen at night and in the early morning. Regardless of the etiology or course, most spontaneous urticaria has a similar clinical pathogenesis pattern. Chronic spontaneous urticaria was previously thought to be “idiopathic”, but in recent years numerous studies have confirmed the involvement of autoimmune factors in the development of the disease. At the same time, chronic spontaneous urticaria with a positive autologous serum skin test (ASST) is more severe in terms of pruritus, frequency, duration, and number of attacks of urticaria than in patients with a negative ASST. A small number of patients may have systemic symptoms including fever and joints along with the appearance of spontaneous wind clusters. Diagnostic care should be taken to differentiate from urticarial vasculitis or other types of urticaria-like syndromes (e.g., Schnitzler’s syndrome, Still’s disease, auto-inflammatory response syndrome, etc.). 2, skin scratching: including rapid-onset skin scratching and delayed-onset skin scratching. Rapid-onset cutaneous scarring is the most common type of induced urticaria, which is manifested by scratching or rubbing followed by the appearance of the current wind masses. Some patients have pruritus prior to the appearance of the wind masses. Symptoms are more severe at night and the damage usually disappears within 1 hour. The duration of the disease is often unpredictable, but there is usually a tendency for gradual remission. Late-onset skin scratching usually develops 30 minutes after rubbing. 3, cold urticaria: the onset of the wind mass often appears on exposure to cold and includes several different types. Primary cold urticaria is the most common, often idiopathic, occurring within minutes of rewarming after exposure to cold, and the disease can occur at any age, but is more common in young and middle-aged populations. Secondary cold urticaria is clinically similar to primary urticaria, but the clusters last longer and care should be taken to rule out various secondary factors (e.g., cryoglobulinemia and cold agglutininemia and infectious diseases including hepatitis B and infectious mononucleosis). Hereditary cold urticaria is an autosomal dominant disorder that usually has a family history and begins at an early age and is poorly treated with antihistamines. 4, delayed pressure urticaria: manifested as deep edema with surface erythema at the site of skin pressure, usually within 30 minutes to 24 hours after pressure, with self-induced pruritus or (and) pain, which can last for several days. The disease may present with systemic symptoms such as general malaise, flu-like symptoms and joint pain. The relationship between stress and the occurrence of this disease is often overlooked because patients often have a combination of spontaneous urticaria. 5, cholinergic urticaria: often occurs within 15 minutes after heat-producing stimuli (such as exercise, hot baths, emotional excitement), the rash is manifested as 1-3mm diameter papules and rashes, often surrounded by a red halo, often symmetrically involved in the upper part of the trunk. Some patients may have systemic symptoms such as angioedema, syncope, headache, palpitations, and abdominal pain. There are also some patients whose rash does not appear as a typical wind cluster and manifests as cholinergic pruritus, cholinergic erythema and cholinergic cutaneous scratchiness. 6, contact urticaria: generally occurs after skin or mucous membrane contact allergenic substances, in the local appearance of erythema or wind masses. The disease occurs in the atopic regime (Atopy) population. In terms of pathogenesis, this type of urticaria can be classified as immune or non-immune. Immunity is usually caused by allergen-specific IgE-mediated activation of mast cells, which often occurs after a few minutes of exposure and responds well to antihistamine treatment; non-immunity can be caused by the direct action of substances on blood vessels, which may be mediated by prostaglandin D2 (PGD2), which often occurs after half an hour of exposure and can be inhibited by NSAIDs. 7, other types: solar urticaria mostly occurs when the patient is exposed to visible light within a few minutes of itching and wind clumps, severe cases can be accompanied by headache and syncope. Waterborne urticaria occurs after the patient is exposed to water of any temperature, with lesions occurring on the upper part of the trunk, and should be distinguished from waterborne pruritus. Shock urticaria/angioedema presents as localized edema and erythema of the skin after shock, is less common in clinical practice, and is often present in combination with other types of induced urticaria (e.g., skin scratching).