Urticaria is one of the most complex in terms of diagnosis and treatment of disease that can come on reception to the doctor-allergist immunologist. Rashes on the skin type of urticaria can have many causes, which requires a thorough examination of the patient and balanced approach to its treatment. The proposed article is devoted to modern views on the cause of this pathology and discusses existing standards for diagnosis and treatment of urticaria.
Urticaria is a term that encompasses a whole group of diseases of different nature, but with similar clinical symptom: skin elements in the type of blisters, resembling burns from the nettle.
Urticaria is quite a common disease. Accurate statistics on its occurrence there, but a number of national studies have shown that at least once in life it occurs in 31% of the population. A particular challenge for patients are chronic forms of the disease (hives lasting longer than 6 weeks).
The first detailed description of the symptoms of urticaria in 1882, although similar symptoms described in the works of Hippocrates.
Causes of hives
Urticaria is a classic polyetiological disease. This means that causes the same symptoms can be many.
One of the most frequent types of diseases, allergic urticaria, which is based on the hypersensitivity of the immediate type. This mechanism is the basis of many allergic reactions. It is characterized by the rapid development of symptoms after exposure to the allergen. This type of Allergy is characteristic of hives after insect bites or associated with the consumption of food.
Immunocomplex mechanism of urticaria. Here, the basis of the pathological process is excessive formation of antigen-antibody. (An antigen is a substance that causes an immune response and antibody – a protein produced by the human immune system to fight against extracellular antigens. Read more about this in the article devoted to immunity). This mechanism is often observed in reactions to drugs, such as the introduction of sera.
Also in the basis of skin problems can be the development of anaphylactoid reactions. Their distinctive feature is the increased ability of fat cells (a special type of cells, located, usually under the skin and mucous membranes, and bearing a large number of biologically active substances) to release the backlog of active enzymes and proteins. Moreover, this process occurs without involvement in the response of cells of the immune system.
Often urticaria is a consequence of autoimmune inflammation. The condition when the immune system begins to respond to its own tissue as foreign.
These are just a few of the most common mechanisms of urticaria. This problem has been extensively studied, and every year new aspects of it.
Direct provocateur or stimulator of acute urticaria can be use of drugs, food, insect bites. Chronic urticaria is most often based on some chronic pathological process. In the manual they wrote that rashes on the skin are a reflection of internal pathology.
The Diseases associated with chronic urticaria, that is able to run the above mechanisms, causing skin symptoms:
1) gastro-intestinal tract (gastritis, colitis, cholecystitis, intestinal dysbiosis, fermentopathy).
2) Infection: bacterial (Helicobacter pylori, chronic foci of infection in the oropharynx or the urinary tract, gynecological infections), viral (Herpes simplex, etc.), fungal (Candida, Trichophyton, etc.), parasitic infestations (worms).
3) Endocrine diseases (autoimmune thyroiditis, diabetes mellitus, hyperthyroidism, hypothyroidism, dysfunctional disorders of the ovaries, etc.).
4) Systemic diseases of connective tissue (rheumatoid arthrit, etc.)
5) Lymphoproliferative disorders (myeloma, chronic lymphocytic leukemia, waldenstrom of Valderrama, etc.).
6) Tumors (carcinoma of the colon, rectum, liver, lung and ovary, etc.).
7) Other diseases (sarcoidosis, amyloidosis).
Video: Hives – treatment, causes, symptoms
Symptoms of urticaria with photo
The main symptom of urticaria is the appearance on the skin blisters. Externally, the blister is a raised area of skin, like trace of an insect bite or a burn left by the nettles. Skin element is accompanied by itching. The skin around the blister may be red. Elements may merge, gaining giant size. Most often the lesions are symmetrical in nature.
A characteristic feature of urticaria is the complete reversibility of the elements. That is, after the relief of an attack of the disease the skin returns to its original state. No white spots, hyperpigmentation, scarring remains. Elements can appear on any part of the skin may migrate. For example, today, tomorrow on the stomach…
Urticaria in children
In children is dominated by the acute form of urticaria. Urticaria rarely occurs in children younger than 6 months. Most commonly observed forms of allergic urticaria.
For children with urticaria, is characterized by the severity of exudation: elements edematous, sharply raised above the skin. Itching, usually more than adults. May increase body temperature, pain in joints…
Urticaria in pregnancy
During pregnancy induces the production of increased amount of estrogen (female sex hormones), which is a risk factor for urticaria. Often the occurrence of urticaria is a symptom of developing preeclampsia pregnant. Characteristic features of urticaria in pregnancy are pronounced itching, insomnia, irritability, scratching of the skin.
What tests have to take in urticaria
When the hives should go to the doctor or dermatologist or an allergist.
As we said: this symptom as urticaria can be caused by any number of reasons. In this regard, the patient with urticaria always offer to take a sufficiently large number of tests. This, of course, can be startling, but there is no other way! If not to determine the exact cause of the treatment may be ineffective.
Treatment of urticaria
Mandatory component of treatment of urticaria is a diet, a special lifestyle (more details in diet and lifestyle with urticaria). Note that in urticaria banned a number of medications that can be prescribed to treat comorbidities of the patient with urticaria. Those drugs include: Aspirin and its derivatives, codeine, ACE inhibitors (Enap, Enam, Capoten, etc.). If you suffer or have suffered from hives, you should be sure to inform your physician, so he didn’t prescribe you drugs that can cause worsening.
Traditionally, treatment of hives to start with antihistamines. Preferably, the use of drugs of the 3rd generation: Telfast, Zyrtec, Aerius etc. Sometimes (chronic urticaria) is required for a long period, up to three months or more medications.
Treatment of urticaria folk remedies.
Funds from the Arsenal of traditional medicine that could be recommended to the patients with urticaria not. In addition, many recommended ways treat hives can cause exacerbation of the disease. Talk about the fact that some recipes has helped someone, most often based on the self.
Diet and lifestyle with urticaria.
In all forms of urticaria are contraindicated stress, alcohol, Smoking. Not recommended for long periods in the sun, especially for patients with solar urticaria. It is not recommended to overheating. Absolutely can not sunbathe.
It is necessary to avoid pressure on the skin. For this we need to abandon tight clothing, belts, suspenders. Not recommended work associated with heavy physical exertion.
Perhaps the purpose of local protective measures. For example, when solar urticaria is necessary active use creams from the sun with an SPF of at least 40, at cold urticaria – protective creams from low temperature, for example, baby cream Jack frost or cream Mustella with mink oil.
Against the backdrop of worsening is necessary to observe a hypoallergenic diet.
Possible complications of urticaria and forecast
The prognosis generally is favorable. Perhaps the development of angioedema occurring with development of edema of the upper respiratory tract. This condition is a threat to life.
In addition, the rash may be a manifestation of internal pathology, including cancer, which, of course, aggravates the prognosis for the patient. In 30% of cases occur chronic form of the disease.
Prevention of urticaria
Measures aimed at preventing the development of urticaria has not been developed. It is necessary to following a healthy lifestyle, early detection and treatment of comorbidities. If there is a frequent infectious diseases – sanitation of all possible foci of infection.