Summary about Disease
Urticaria, commonly known as hives, is a skin condition characterized by raised, itchy welts (wheals) that vary in size and appear on the skin. These welts can appear anywhere on the body and often come and go. Angioedema, which involves swelling in deeper layers of the skin, can sometimes accompany urticaria, particularly around the eyes, lips, and throat.
Symptoms
Itchy welts (wheals) on the skin
Welts that can be small, round spots or large, connected patches
Welts that can change shape, move around, and disappear within 24 hours
Angioedema (swelling, especially around the eyes, lips, tongue, genitals, hands, and feet)
Possible burning or stinging sensation
Causes
Urticaria can be triggered by a variety of factors, including:
Allergens: Foods (e.g., shellfish, nuts, eggs), medications (e.g., penicillin, aspirin, NSAIDs), insect stings.
Physical stimuli: Pressure, cold, heat, sunlight, vibration, exercise, water.
Infections: Viral infections (e.g., common cold, flu), bacterial infections, fungal infections.
Medical conditions: Autoimmune diseases (e.g., lupus, rheumatoid arthritis), thyroid disorders, celiac disease.
Other triggers: Stress, latex, certain plants, blood transfusions. In many cases, the cause of urticaria is unknown (idiopathic urticaria).
Medicine Used
Antihistamines: These are the primary treatment for urticaria, helping to relieve itching and reduce the size of the welts. Common antihistamines include cetirizine, loratadine, fexofenadine and diphenhydramine.
H2 Antihistamines cimetidine or ranitidine
Corticosteroids: In severe cases, oral corticosteroids (e.g., prednisone) may be prescribed for short-term relief.
Epinephrine: For severe allergic reactions with angioedema that affects breathing, an epinephrine auto-injector (EpiPen) may be needed.
Omalizumab: A monoclonal antibody injection used for chronic idiopathic urticaria that is not controlled by antihistamines.
Montelukast: A leukotriene receptor antagonist, which may be used in conjunction with antihistamines.
Is Communicable
Urticaria is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
Identify and avoid triggers: If you know what causes your hives, avoid those substances or situations.
Avoid scratching: Scratching can worsen the itching and inflammation.
Wear loose-fitting clothing: Avoid tight or restrictive clothing that can irritate the skin.
Use cool compresses or take cool baths: This can help relieve itching.
Avoid hot showers or baths: Heat can worsen hives.
Use mild, fragrance-free soaps and detergents: Avoid products that can irritate the skin.
Manage stress: Stress can trigger or worsen hives.
Keep a symptom diary: Recording when hives appear and what you were doing or eating can help identify triggers.
How long does an outbreak last?
Acute urticaria: Lasts less than six weeks.
Chronic urticaria: Lasts more than six weeks, with hives appearing frequently or recurring over months or years. Individual welts usually disappear within 24 hours.
How is it diagnosed?
Medical history and physical examination: The doctor will ask about your symptoms, potential triggers, and medical history. They will also examine your skin.
Allergy testing: Skin prick tests or blood tests may be performed to identify specific allergens that could be causing the hives.
Blood tests: To rule out underlying medical conditions, such as autoimmune diseases or infections.
Skin biopsy: In rare cases, a skin biopsy may be performed to rule out other skin conditions.
Physical urticaria testing: Applying pressure, cold, heat, or other stimuli to the skin to see if it triggers hives.
Timeline of Symptoms
The timeline of symptoms can vary depending on the type and cause of urticaria:
Acute urticaria:
Sudden onset of itchy welts.
Welts appear and disappear within hours, typically lasting less than 24 hours each.
The outbreak resolves within a few days to weeks.
Chronic urticaria:
Recurrent episodes of hives lasting for more than six weeks.
Welts appear and disappear unpredictably.
Symptoms can persist for months or years.
Angioedema:
Swelling develops rapidly, usually within minutes to hours.
Swelling typically resolves within 24-72 hours.
Important Considerations
Angioedema: If you experience swelling of the tongue, throat, or difficulty breathing, seek immediate medical attention. This could be a sign of anaphylaxis, a life-threatening allergic reaction.
Chronic Urticaria: Chronic urticaria can significantly impact quality of life due to persistent itching and discomfort. Finding and working with a doctor that understands your condition is key.
Triggers: Identifying and avoiding triggers is essential for managing urticaria, but it can sometimes be challenging, especially with chronic cases.
Medications: Always inform your doctor about any medications you are taking, as some medications can trigger or worsen hives.
Underlying conditions: If urticaria is suspected to be caused by an underlying medical condition, it's important to diagnose and treat that condition to control the hives.