Urticaria: Classification, Causes, Symptoms, Complications, Diagnosis, Treatment and Prevention

Hives, also known as urticaria, are allergic reaction to the skin that results in itching wheals (welts). A chronic hive is a wheal that lasts longer than six weeks and frequently recurs over the course of months or years. Chronic hives frequently have unknown causes.

The welts frequently begin as irritating areas before swelling up to develop into different-sized welts. As the reaction progresses, these welts develop and disappear frequently.

In addition to making daily tasks and sleep difficult, chronic hives can be exceedingly unpleasant. Antihistamines, which treat itching, are helpful for many people.

Read this blog further to get a quick overview of this important topic for DERMATOLOGY to ace your NEET PG exam preparation.

Classification Of Urticaria

Urticaria is classified into two types based on the duration.

• Acute urticaria 
• Chronic urticaria

Acute Urticaria	Chronic Urticaria
Duration is less than 6 weeks.	Duration is more than 6 weeks.
In all cases, all 5 I's are included. Infections (40%)- viral infections  Drugs (9%)- penicillin, sulfa Food items (1%)- additives Inhalation- pollen Idiopathic (50%)	It can be chronic spontaneous urticaria driven by an autoimmune system (65%) Or most of the physical urticarias (35%) Urticarial vasculitis (5%).

Symptoms of Urticaria

Chronic hives symptoms include:

• Clusters of welts (wheals) that can appear anywhere on the body Depending on your skin tone, these welts may be red, purple, or skin-colored.
• Size and shape are variable and are  repeatedly appearing and fading welds
• Itching, or pruritus, can be extremely severe.
• Angioedema is a painful swelling around the lips, cheeks, or eyes
• heat, exertion, or stress-related flares

Symptoms that last longer than six weeks, return frequently, and sometimes last for months or years.

Complications Of Urticaria

You are not suddenly in danger of a significant allergic reaction (anaphylaxis) if you have chronic hives. You should seek emergency attention if you do get severe allergic hives. Dizziness, difficulty breathing, and swelling of the tongue, lips, mouth, or throat are all signs of anaphylaxis.

Causes Of Urticaria

Histamine and other immune system chemicals are released into the bloodstream during hives, which causes welts. Both the reasons why acute hives may turn into chronic problems and the causes of chronic hives are commonly unknown.

The following things could result in the cutaneous reaction:

• Either warmth or cold conditions
• Vibrations in the sun, such as those caused by running or operating lawnmowers
• Illnesses including cancer, infection, allergies, and thyroid disease can all result in skin pressure, such as that brought on by a narrow waistline.

Prevention Of Urticaria

Take the following preventative measures to lessen your risk of developing hives or angioedema:

• Stay away from recognized triggers. Try to avoid the material if you are aware of what causes your hives.
• Take a shower and change into new clothes. Take a bath or wash and change into clean clothes if you have previously experienced hives after coming into contact with pollen or animals.

Diagnosis Of Urticaria

Your healthcare professional will probably ask you about your symptoms and examine your skin to determine whether you have chronic hives. The fact that the welts appear and disappear at random is one of the telltale signs of persistent hives. You might be requested to keep a diary to document:

• Your activities
• Any prescription drugs you use, herbal supplements
• What you consume and ingest
• Where hives occur, how long it takes for a welt to go away, and whether a bruise or other mark is left behind. No matter if your hives cause excruciating swelling

Blood tests can also be required to identify the source of your symptoms. Your treatment choices will be influenced by an appropriate diagnosis. Your doctor may use imaging tests if necessary to confirm the diagnosis.

Treatment Of Urticaria

Depending on the underlying reason and whether the problem is acute or chronic, the appropriate course of action will vary.

Acute urticaria

Home treatments typically work to relieve itching until the rash goes away or  when symptoms are minor and appear after exposure to an allergen or irritant.

Among the choices a physician might advise following the Trusted Sources like:

• Short-term application of topical steroids antiseptic creams to avoid a secondary infection non-sedating antihistamines such as cetirizine (Zyrtec) or fexofenadine (Allegra)
• Lotions that are calming to lessen itching
• The doctor may recommend an epinephrine auto-injector to carry for use in emergencies if there are symptoms of allergy and the patient has swelling in their lips, face, or tongue.

Chronic urticaria

Until their symptoms go away, a person with chronic urticaria may need to take antihistamines often.

An injectable medication called omalizumab (Xolair) inhibits immunoglobulin E, which is a factor in allergic reactions. It can ease the symptoms of persistent spontaneous urticaria, an unidentified cause of hives.

Severe discomfort, anguish, and possibly depression can result from persistent hives. Hives might sometimes become worse under stress, and having hives makes stress worse. Any person who believes that having hives is harming their quality of life or mental health should consult a physician.

The doctor will suggest therapy for any underlying diseases, such as lupus if testing shows them.

Prevention Of Urticaria

Some suggestions for preventing hives include:

• Using moderate or fragrance-free skin care products, soaps, and detergents, and buying over-the-counter allergy medications If pollen may be a trigger when the pollen level is high
• Keeping track of any potential triggers, such as by keeping a food journal
• Adopting meditation and other relaxation techniques to handle stress, discussing with a doctor whether medicines may be to blame

An allergic reaction can be brought on by almost any food. Typical causes include:

• Milk eggs nuts
• Soy wheat seafood sesame
• Knowing which foods are causing the reaction can be determined by keeping a log of meals and symptoms.

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