Urticaria has been described only rarely in patients with hepatitis A virus infection, although its association with acute hepatitis B virus infection is well recognized. A young male homosexual presented with hepatitis and urticaria, which proved to be an acute hepatitis A virus infection. In one study of a foodborne outbreak of hepatitis A virus, 2/130 patients developed hives. A few other isolated cases of presumed hepatitis A virus infection and urticaria have been reported, but this is the first detailed description of a serologically proven hepatitis A virus infection associated with the development of urticaria, in which no other risk factor could be implicated.