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Urticaria - Symptoms and Treatment

Urticaria is defined as the appearance of wheals caused by a specific stimulus.Urticaria results from dilation of capillaries allowing fluid to leak out into the surrounding tissue, the epidermis. Urticaria generally occur in deeper tissues of the eyes, mouth, hands or genitals. They itch and each individual hive lasts a few hours before fading away, leaving no trace. Urticaria is an allergic skin rash also known as 'nettle rash' or hives. There are two distinct types: acute urticaria is often caused by an allergy and can last between several hours and six weeks; chronic urticaria persists beyond six weeks. The border of a hive is described as polycyclic, or made up of many circles, and changes as fluid leaks out and then is absorbed.

Symptoms of Urticaria

Chronic Urticaria is common and extremely difficult condition. Epidemiological data available is scare. The rash consists of a number of raised bumpy weals surrounded by red skin. The Symptoms of Urticaria are include :

  • The condition tends to settle and then suddenly relapse again with co-existent viral illnesses, stress and aspirin containing medication.
  • Urticaria is a common disorder, characterised by formation of weals on the skin.
  • They may reappear following infection, when under stress or for no particular reason
  • Mast cells are like "land-mines", and contain "bags" filled with irritant chemicals including histamine.
  • The first symptom of Papular Urticaria is usually itching (pruritus), followed by the appearance of small or large wheals.
  • Hives (large or small) 
  • Itching of the skin
  • Flushing (redness) of the skin
  • Difficulty breathing or a choking feeling
  • Stomach cramping
  • Headache
  • Swelling of the face, tongue or hands

Causes of Urticaria

The most likely to cause acute urticaria are allergy to pets, horses, latex or food such as shellfish, nuts, fruit and dairy.

  • Urticaria associated with the onset of autoimmune disorders or malignancy (eg, systemic lupus erythematosus, lymphoma) will become chronic.
  • Most cases of new-onset urticaria are idiopathic in nature.
  • Infection, including sinusitis, helicobacter (a cause of stomach ulcers), dental abscess and candida (thrush).
  • Serum sickness, due to blood transfusion, viral infection or medicines (e.g. CeclorT); urticaria is accompanied by fever, swollen lymph glands, painful joints and nausea.
  • Non-allergic reactions to medicines (especially morphine, codeine, quinine, aspirin and other non-steroidal anti-inflammatory drugs).
  • Non-allergic recurrent angioedema, also provoked by medicines (particularly ACE inhibitors such as captopril, quinapril, enalapril and others).
  • Non-allergic food reactions, from salicylates in fruit, azo dye food colouring agents, benzoate preservatives and other food additives , or from histamine due to bacterial decomposition e.g. scombroid fish poisoning .

Treatment of Urticaria

The Treatment of Urticaria are :

  • Oral steroids (prednisone) are useful for severe acute urticaria but unsuitable long term because of serious adverse effects.
  • Ultraviolet radiation treatment ( narrowband UVB or PUVA ).
  • Antibiotics and antifungal agents , used to clear an assumed underlying infection or for non-specific anti-inflammatory action.
  • Immunosuppressive medications ( ciclosporin , plasmapheresis).
  • Antifibrinolytic agents (tranexamic acid, androgenetic steroids such as danazol).
  • Tricyclic medications such as amitriptyline , nortriptyline and doxepin (which have antihistaminic and neuropathic properties).
  • Avoid aspirin and codeine. It is usually safe to take paracetamol and the newer Cox-II inhibitor anti-inflammatories.

Prevention tips

  • Try not to overheat.
  • Cool the affected area with a fan, cold flannel, ice pack or soothing moisturising lotion.
  • Avoid aspirin and codeine.
  • Do not take the medications your doctor has told you to avoid.


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