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]

• Infectious Mononucleosis

  mononucleosis and hepatitis Pet dander Pollen Some plants Antihistamines – available either over the counter or by prescription – are a frequently recommended treatment for hives. [acaai.org]

  Chang, Idiopathic pure sudomotor failure and cholinergic urticaria in a patient after acute infectious mononucleosis infection, Clinical and Experimental Dermatology, 38, 2, (156-159), (2012). A. Sheraz and S. [doi.org]

  Viruses that cause infectious mononucleosis, hepatitis, and colds often cause hives. The first step in getting treatment is to figure out if you actually have hives. [healthline.com]

• Amyloidosis

  Inflammatory AA amyloidosis may be a serious complication. The disease follows a chronic course. Etiology Etiology remains unclear but the syndrome is probably an acquired auto-inflammatory disorder. [orpha.net]

  Other complications include severe inflammatory anaemia and amyloid A amyloidosis. 24-28 In the same way that SchS occurs through a distinct mechanism from that of AU or CU, it also requires a different treatment. [emjreviews.com]

  Urticaria is a feature of some autoinflammatory diseases, such as Muckle-Wells syndrome (characterized by amyloidosis, nerve deafness, and urticaria) and Schnitzler syndrome [21] (characterized by fever, joint or bone pain, monoclonal gammopathy, and [emedicine.medscape.com]

  […] that Omalizumab (Xolair) may be an effective and safe treatment to cold urticaria for patient who do not sufficiently respond to standard treatments.[25] Ebastine has been proposed as an approach to prevent acquired cold urticaria.[26] See also[edit] Amyloidosis [en.wikipedia.org]

  Hypo – or hyperthyroidism Malignancies, lymphoma Amyloidosis Mastocytosis, urticaria pigmentosa (cutaneous mastocytosis) Idiopathic – also called chronic spontaneous urticaria (CSU) Note: In more than half of chronic urticaria, the exact etiology cannot [lecturio.com]

• Lymphedema

  140 Livedo reticularis 457 141 Livedoid vasculopathy 460 142 Lyme borreliosis 464 143 Lymphangioma circumscriptum 467 144 Lymphedema 470 145 Lymphocytoma cutis 472 146 Lymphogranuloma venereum 475 147 Lymphomatoid papulosis 477 148 Malignant atrophic [books.google.ro]

  Initial use cases include lymphedema, lipoedema, and cancer. In the future, other use cases will be implemented. [bihealth.org]

• Constitutional Symptom

  Mild constitutional symptoms such as fever,malais,myalgia and arthralgia may precede the appearance of the eruption.The disease is self-limiting. Fig.224f. Erythema nodosum (Erythema nodosum was discussed in the previous chapters). [drmhijazy.com]

• 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]

• 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]

• 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]

  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]

  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]

• Myalgia

  […] generated by local pressure, would reduce the pH of the skin on that site leading to increased activity of kinins. 2 It is speculated that interleukin 1 (IL-1) is released on the skin exposed to pressure, and it would be responsible for fever, malaise, myalgia [scielo.br]

  Important red flags that may hint at an inflammatory syndrome include inflammation of the anterior eye, uveitis, periorbital oedema, serositis, stomatitis, ulcers, meningeal inflammation leading to headaches, abdominal complaints, arthralgia, myalgia, [emjreviews.com]

  Cold exposure causes a burning rash, fever, chills, arthralgia, myalgia, headache, and leukocytosis. Hereditary vibratory angioedema This reaction consists of pruritus and swelling minutes after a vibratory stimulus. [theasthmacenter.org]

  Mild constitutional symptoms such as fever,malais,myalgia and arthralgia may precede the appearance of the eruption.The disease is self-limiting. Fig.224f. Erythema nodosum (Erythema nodosum was discussed in the previous chapters). [drmhijazy.com]

• Urticaria

  Solar urticaria Solar urticaria is a rare disorder in which brief exposure to light causes the development of urticaria within 1-3 minutes. [worldallergy.org]

  Symptomatic dermographism Cold urticaria Cholinergic urticaria Contact urticaria Delayed pressure urticaria Solar urticaria Heat urticaria Vibratory urticaria Aquagenic urticaria Chronic urticaria See more images of urticaria Who gets chronic urticaria [dermnetnz.org]

  Urticaria (also known as Physical Urticaria). [allergy-clinic.co.uk]

  Allergic urticaria Autoimmune urticaria Infections Hive-like rashes Non-allergic urticaria Mechanisms other than allergen-antibody interactions Emotionally induced urticaria. [coldallergy.org]

• Pruritus

  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]

  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]

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

• Papule

  EM is: Usually not itchy Does not move around - individual lesions perist for days Has target lesions with a central papuler, blister, purpura or ulcer. [rch.org.au]

  It is characterized by cutaneous wheals (erythematous, oedematous, pruritic papules) that blanch on pressure. Angio-oedema is a variant of urticaria that predominantly affects the mucous membranes. [apps.who.int]

  A raised, erythematous papule or cutaneous plaque, usually representing short-lived dermal edema A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. [icd9data.com]

  Urticaria, is characterized by transient, itchy, elevated edematous wheals or red papules. 5. [slideshare.net]

  Coalescing urticarial papules. Image used with permission from VisualDx. Figure 2. Coalescing urticarial papules. Image used with permission from VisualDx. Enlarge Print Figure 3. Serpiginous erythematous urticarial plaques. [aafp.org]

• Eczema

  […] 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]

  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]

• 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]

  ‘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]

  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]

  Illness begins within 30 minutes to an hour or two of consuming the fish, usually with a feeling of warmth and flushing. An impressive rash develops on the face, neck, chest, and upper back. Affected areas are bright red, hot and itchy. [web.archive.org]

• 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]

• 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]

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

  At the same time as the rash, other symptoms may occur: Burning feeling in the mouth Pounding headache Raising heart Dizziness Difficulty breathing Abdominal pain Nausea Diarrhoea Collapse due to low blood pressure Symptoms usually persist for about three [web.archive.org]

• Tremor

  Neurologic examination should note any tremor or hyperreflexia or hyporeflexia. Musculoskeletal examination should note the presence of any inflamed or deformed joints. [merckmanuals.com]

• Vertigo

  In addition, they may be used to treat insomnia, motion sickness, or vertigo caused by problems with the inner ear. H2-antihistamines bind to histamine H2 receptors in the upper gastrointestinal tract, primarily in the stomach. [en.wikipedia.org]

(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]

• 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]

What is the treatment for chronic urticaria? The main treatment for chronic urticaria in adults and in children is with an oral second-generation antihistamine chosen from the list below. [dermnetnz.org]

The use of a novel asthma drug, the anti-IgE monoclonal antibody Omalizumab (Xolair) may be necessary if no other treatment is effective. [allergy-clinic.co.uk]

Treatment Treatment of acute urticaria and angioedema Identification of causative allergens, from the clinical history and blood testing for specific IgE antibodies, will enable the individual with urticaria and angioedema to avoid pathogenic allergens [worldallergy.org]

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

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

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

The etiologies of both acute and chronic urticaria are numerous (see Causes in Presentation). The etiologic agent is more likely to be identified in acute urticaria (40-60%) than in chronic urticaria (10-20%). [emedicine.medscape.com]

The etiology of the disease varies as well as its clinical manifestations which extend from the presence of urticarial hives to the potentially mortal angioedema. [ncbi.nlm.nih.gov]

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]

[…] 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]

The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations [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]

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]

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

If the hives feel itchy, the doctor may recommend an antihistamine medicine to block the release of histamine in the bloodstream and prevent breakouts. [kidshealth.org]

"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]