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Bullous pemphigoid

Can begin with urticarial plaques (pre-bullous stage), but is distinguished by the eventual development of large, tense blisters.

Chronic urticaria

Defined as urticaria that recurs for more than 6 weeks; this is a temporal distinction rather than a morphological one.

Insect bite reaction

Presents as grouped, pruritic papules or wheals at the site of a bite, which may persist longer than typical urticarial lesions.

Pemphigoid gestationis

A pruritic, urticarial eruption specific to pregnancy that often starts around the umbilicus and can progress to blistering.

Polymorphic eruption of pregnancy

The most common dermatosis of pregnancy, presenting as intensely pruritic urticarial papules and plaques within striae on the abdomen.

Serum sickness

A systemic reaction to foreign proteins or drugs, causing fever, arthralgias, and an urticarial or morbilliform rash.

Still's disease

Presents with a characteristic evanescent, salmon-pink, non-pruritic rash that appears with fever spikes, not the classic itchy wheals of urticaria.

Sweet's syndrome

Presents with painful, edematous, erythematous plaques and is associated with fever and neutrophilia, not transient pruritic wheals.

Urticaria multiforme

A benign pediatric eruption with large, annular urticarial lesions that may have a dusky center, mimicking erythema multiforme but being transient.

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