[Chronic urticaria as an atypical reaction after a vespid bite].

Background: Hymenoptera stings can produce IgE-mediated reactions, toxic reactions, or atypical reactions, which are rare. Cold urticaria has been described among the cutaneous manifestations in the atypical ones, but there is only one case of chronic urticaria.

Case report: A 56-year-old female patient experienced palmoplantar pruritus and generalized urticaria 60 minutes after two vespid stings, requiring medical assistance and several cycles of home treatment with oral antihistamines and corticosteroids for resolution in 12 weeks. Allergological studies showed normal tryptase and primary sensitization to Polistes dominula venom. Given the patient's profession, venom immunotherapy was started with Polistes dominula 100% without recurrence of urticaria after its administration.

Conclusions: We present a case of IgE-mediated systemic reaction followed by self-limited chronic urticaria, related chronologically to the same vespid sting trigger.