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2.1
Urticaria
Hives

Images

WIKIDATA, CC BY-SA 3.0
WIKIDATA, CC BY-SA 3.0
WIKIDATA, CC BY-SA 4.0
WIKIDATA, CC BY-SA 4.0

Presentation

CASE PRESENTATION: We present a 16-year-old female patient diagnosed with anorexia nervosa binge/purge type, who presented with urticaria and angioedema shortly after binge/purge episodes that subsided when these behaviors ceased. [ncbi.nlm.nih.gov]

AOSD patients may initially complain of a sore throat. 31-39 Most patients present with an evanescent rash, but some may present with a refractory cutaneous lesion, similar to that seen in CU. [emjreviews.com]

Clinical Practice Guideline: Initial Evaluation and Management of Patients Presenting with Acute Urticaria or Angioedema Links: aetiology mechanisms clinical features differential diagnosis investigations management urticaria activity score [gpnotebook.co.uk]

Respiratoric

  • Hoarseness

    […] breath, cough, chest tightness, or trouble breathing low blood pressure, dizziness, fainting, rapid or weak heartbeat, anxiety, or feeling of "impending doom" flushing, itching, hives, or feeling warm swelling of the throat or tongue, throat tightness, hoarse [xolair.com]

    Hoarse voice, wheezing or persistent coughing. Loss of consciousness and/or collapse. Infants and young children appearing pale and floppy. Mild to moderate systemic allergic reaction: Swelling of lips, face or eyes. Hives or welts. [rch.org.au]

    […] with and without the wheals of simple urticaria and presents clinically as subcutaneous swelling that is generally non-pitting and non-pruritic; it can affect the mouth as well as the mucosal surfaces of the respiratory and GI tracts, manifesting as hoarseness [lecturio.com]

    They may include the following (either alone or in combination): Hives Itchiness Flushing Swelling in areas away from the sting Dizziness or a sharp drop in blood pressure A hoarse voice, coughing, swelling of the tongue or difficulty swallowing Hives [acaai.org]

Cardiovascular

  • Hypotension

    This case report is the first to demonstrate severe intraoperative hypotension and urticaria from dermographism. [ncbi.nlm.nih.gov]

    ‘This usually manifests as flushing, breathlessness, rash, urticaria, and hypotension.’ ‘Other symptoms include fever, joint and muscle pain, malaise, urticaria, and pharyngitis.’ [en.oxforddictionaries.com]

    Anaphylaxis can be graded according to chart 10.41 Depending on the response to epinephrine, the following measures may be necessary:40 Raising lower limbs, which prevents orthostatic hypotension and helps deviating the blood circulation from the periphery [scielo.br]

    Exercise-induced anaphylaxis was first described in a series of patients in whom combinations of pruritus, urticaria, angioedema, wheezing, and hypotension occurred as a result of exercise. [worldallergy.org]

Jaw & Teeth

  • Lip Swelling

    Hives can be associated with lip swelling and throat itchiness and shortness of breath, which is a medical emergency called angioedema. Call for immediate medical help for any swelling of the airway. [firstderm.com]

Skin

  • Urticaria

    About Urticaria Urticaria, commonly known as hives, is actually the name for a diverse group of diseases with many subtypes. [thermofisher.com]

    Chronic urticaria comprises both chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU) that includes physical and non-physical urticarias. [ncbi.nlm.nih.gov]

    Sabroe, Cholinergic Urticaria and Exercise-Induced Anaphylaxis, Urticaria and Angioedema, 10.1007/978-3-540-79048-8_10, (81-89), (2010). [doi.org]

  • Pruritus

    Pruritus is a common symptom of primary skin diseases including allergic contact dermatitis. Less commonly it reflects a systemic reaction to drugs (e.g., NSAIDs, penicillin, and opioids) and other allergens. [dentalcare.com]

    Two trials demonstrated significant elimination of pruritus with second- or third-generation antihistamine treatment vs placebo (OR, 10.44; 95% CI, 4.39 to 24.84). [ncbi.nlm.nih.gov]

    Additional therapy aimed at pruritogenic mediators other than histamine would be expected to improve urticarial pruritus. © 1992 S. [karger.com]

    ‘Antihistamines may be beneficial in the treatment of urticaria and other allergic causes of pruritus.’ [en.oxforddictionaries.com]

  • Flushing

    Sometimes flushing (redness) and small wheals (welts) may also occur. In minor cases, hives may not be visible during the reaction, and the individual may only experience minor flushing, along with the stinging and itching sensation. [cholinergicurticaria.net]

    Symptoms of UP may include: pruritus (itching that varies in severity and intensity) flushing (redness of the skin) hyperpigmentation of lesions (very dark coloring of lesions) Adults or adolescents are more likely to have uncommon symptoms. [healthline.com]

    ‘This usually manifests as flushing, breathlessness, rash, urticaria, and hypotension.’ ‘Other symptoms include fever, joint and muscle pain, malaise, urticaria, and pharyngitis.’ [en.oxforddictionaries.com]

  • Eczema

    Atopy, past history of asthma, allergic rhinitis, and eczema (either atopic, allergic or irritant) are relevant risk factors for work-related eczema and urticaria in young farmers, along with family history of any skin disease. [ncbi.nlm.nih.gov]

    ‘Many sufferers of allergic rhinitis have other allergies such as eczema, urticaria, or asthma.’ ‘Rashes and urticaria may be present as part of a hypersensitivity reaction.’ [en.oxforddictionaries.com]

    Only a small percentage of eczema and urticaria cases he finds based on idiosyncrasy or specific sensitization. He is particularly impressed by the importance of changes in the blood chemistry in the eczema group. He [jamanetwork.com]

    […] hypersensitivity Board Certifications Internal Medicine, American Board of Internal Medicine Allergy & Immunology, American Board of Allergy and Immunology Locations Boston: Allergy Associates Conroy, Michelle E., MD Clinical Interests Food allergy Eczema [massgeneral.org]

  • Skin Rash

    From Wikidata Jump to navigation Jump to search skin disease characterized by skin rash notable for pale red, raised and itchy bumps, located in the upper dermis edit English urticaria skin disease characterized by skin rash notable for pale red, raised [wikidata.org]

    skin disease characterized by skin rash notable for pale red, raised and itchy bumps, located in the upper dermis [commons.wikimedia.org]

    People with urticaria describe itch and red, itchy lumps on their skin or swelling. What is urticaria? Urticaria is an itchy skin rash. It often looks like hives or itchy bites, similar to mosquito bites. [jodouglass.com]

    Cholinergic urticaria is a type of skin rash commonly called hives that occurs in some people when their body gets too warm and sweats. The rash usually develops very quickly after a person gets too hot. [medicalnewstoday.com]

Face, Head & Neck

  • Facial Edema

    Angioedema may be hereditary, but its nonhereditary causes can be similar to those of urticaria.3 For example, a patient could be severely allergic to cat dander and, when exposed to this allergic trigger, develop swelling of the lips, facial edema, and [mdedge.com]

    Puig, Cold Urticaria Associated with Intraoperative Hypotension and Facial Edema, Anesthesiology, 90, 3, (907), (1999). M.C. [doi.org]

Neurologic

  • Headache

    Side effects include a headache, stomach upset, and blurred vision. [verywellhealth.com]

    Side effects of H2 antihistamines are uncommon, but include: headache diarrhoea dizziness Don't drive or use tools or machinery if you feel dizzy after taking a H2 antihistamine. [nhsinform.scot]

    ‘The most common adverse effects of omeprazole are diarrhoea, headache, and rashes, of which urticaria and toxic erythema are the most common.’ ‘Patients who have seasonal allergic rhinitis and urticaria often use higher doses.’ [en.oxforddictionaries.com]

    In addition to hives, people with vibratory urticaria also sometimes experience headaches, fatigue, blurry vision, flushing, and a metallic taste in their mouths, the researchers say. [medicaldaily.com]

    The CNS changes include chronic aseptic meningitis, papilloedema, headaches, vomiting, static diplegia, and impaired cognitive function. [emjreviews.com]

Workup

(there is limited experimental evidence to recommend this, however); hepatitis B and C workup; chest radiograph and/or other imaging studies; ANA panel; rheumatoid factor; cryoglobulin levels; skin biopsy; and urinalysis. 7 Local urticaria can occur [mdedge.com]

Evaluation The initial workup for urticaria and angioedema is a history and physical examination to determine a possible etiology ( Table 3 ). [aafp.org]

Although only a weak association with urticaria of unclear pathogenesis exists, clinicians should consider these bacterial agents in the workup of the patients with urticaria. [ncbi.nlm.nih.gov]

Serum

  • Neutrophilia

    Neutropenia may suggest an autoimmune or viral cause, while neutrophilia may be caused by a bacterial infection. Acute viral infections, e.g. Epstein-Barr virus, or autoimmune thyroiditis may cause a high lymphocyte count. [bpac.org.nz]

Treatment

The time from initial treatment to control CIU according to initial treatment modalities is shown in Table S3. [doi.org]

OBJECTIVE: To perform a systematic review of the literature to determine the efficacy of second- and third-generation antihistamines in the treatment of ACU. [ncbi.nlm.nih.gov]

Prognosis

Finding autoantibodies in children does not impact a disease prognosis, unlike in adult patients, where the presence of autoantibodies is associated with a more prolonged run of the disease, a more severe prognosis and more intensive treatment methods [doi.org]

Prognosis of Hives (Urticaria) Urticaria causes significant distress in terms of the symptoms produced, however prognosis is excellent as it is not life-threatening. Acute urticaria is usually self-limited with resolution occurring within 24 hours. [healthengine.com.au]

Prevention, and Complications Prognosis most resolve spontaneously Prevention avoid known triggers take second generation anti-histamine daily Complications life-threatening angioedema neutrophilic vasculitis associated with arthritis, renal disease [step2.medbullets.com]

Prognosis of Urticaria Prognosis depends upon the cause of urticaria. Idiopathic chronic urticarias and physical urticarias tend to undergo remission after a variable period ranging from a few months to 6-9 years. [lecturio.com]

Etiology

Etiology of Urticaria Etiology of acute and chronic urticaria is different. [lecturio.com]

Urticaria has many etiologies and different pathophysiologies, having acute and chronic forms. The chronic form is by far the more difficult clinical problem, and is the subject of most of the following. [allergyweb.com]

The etiology of different forms of urticaria in childhood. Pediatr Dermatol. 2004;21(2):102–108. 9. [aafp.org]

The etiology could be established by the physical tests in only 37% patients. Most patients with physical urticarias were younger (24.5±8.8 years). [ijdvl.com]

Epidemiology

This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. [ncbi.nlm.nih.gov]

Ferrer M (2009) Epidemiology, healthcare, resources, use and clinical features of different types of urticaria. J Investig Allergol Clin Immunol 2:21–26 Google Scholar 9. Gaig P, Olona M, Muñoz LD et al (2004) Epidemiology of urticaria in Spain. [doi.org]

Aguilera, Solar Urticaria: Epidemiology and Clinical Phenotypes in a Spanish Series of 224 Patients, Actas Dermo-Sifiliográficas (English Edition), 2017, 108, 2, 132 CrossRef 19 Takaaki Hiragun, Makiko Hiragun, Kaori Ishii, Takanobu Kan, Michihiro Hide [onlinelibrary.wiley.com]

As of now, the epidemiology, duration, course, response to treatment and underlying causes of chronic urticaria are still ill defined. While a registry would be an appropriate tool to assess these features, this was, until recently, not available. [urticaria-registry.com]

[…] suppresses prostaglandins]), hereditary angioedema (deficiency of C1 esterase inhibitor causes uncontrolled complement component activation), infections, heat, cold, pressure, vibration Angioedema: like urticaria, but in deep dermis / subcutaneous fat Epidemiology [pathologyoutlines.com]

Pathophysiology

While clinical symptoms are due to the release of histamine by cutaneous mast cells, the underlying pathophysiology is still unknown. However, previous studies indicate that basophils might be of relevance. [ncbi.nlm.nih.gov]

PATHOPHYSIOLOGY Hives most commonly arise from an immunologic reaction in the superficial skin layers that results in the release of histamine, which causes swelling, itching, and erythema. [mdedge.com]

Prevention

A doctor will likely prescribe antihistamines to help prevent allergic reactions. These medications will help prevent a person's body overreacting to triggers. [medicalnewstoday.com]

Can exercise-induced urticaria be prevented or avoided? You cannot avoid exercise-induced urticaria. However, you can help prevent flare-ups. Avoid food, products, or types of exercise that trigger hives and other symptoms. [familydoctor.org]

Diagnosis is clinical, and management focuses on prevention, avoiding triggers, and treating the itching and inflammation that accompany these conditions. [ncbi.nlm.nih.gov]

There is no sure way to prevent UP. The inherited form is very rare, and even when the child has the abnormal gene, they may not ever develop UP. However, you can prevent the disorder from getting worse. [healthline.com]

"Acquired cold urticaria symptoms can be safely prevented by ebastine". Allergy. 62 (12): 1465–8. doi:10.1111/j.1398-9995.2007.01500.x. PMID 17900265. [en.wikipedia.org]

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