Urticaria Cronica

Urticaria cronica is a form of urticaria in which signs and symptoms are recurrent on all days of the week lasting up to 6 weeks ¶

Hives, wheal, or urticaria is very common condition. Urticarial lesions are extremely itchy, red, and swollen areas. Urticaria can be associated with angioedema, which causes swelling in the skin.

An alleged trigger, like food intake, a medication, or insect sting infection, can be identified in people suffering from new-onset urticaria. However, there is no cause-specific in a majority of cases, especially when the symptoms persist for months or weeks.

Types of Urticaria

Urticaria is usually classified according to its severity:

• Urticaria that is acute Urticaria is considered to be acute if it’s been present for less than six months.
• Chronic urticaria Urticaria is considered to be chronic when it’s recurrent with signs and symptoms appearing on all days of the week, lasting up to six weeks.

The time period of six weeks is not a lot of fun and indicates a period in which the majority of cases of urticaria disappear. Nearly two-thirds of urticaria that are new appear to be self-limiting (acute) the lesions that are the result of chronic and acute urticaria appear similar in appearance, and so when the issue first appears it’s difficult to distinguish the two types of urticaria.

Clinical Presentation

                                                                                        

Urticarial lesions are defined with raised, erythematous plaques that are often characterized by a central pallor. The lesions can be oval, round, or serpiginous in form and range in dimensions ranging from less than one centimeter up to several centimeters in size.

They can be extremely itchy. The itching may interfere with school or work schedules, as well as sleeping. The symptoms are usually most intense during the night.
Individual lesions are temporary they usually appear and grow in the span of a few minutes or hours, disappearing after 24 hours.

 

 

Urticarial lesions typically aren’t painful and heal without leaving Ecchymotic marks that remain on the skin, unless there is trauma caused by scratching
Every part of the body could be affected, but those areas where clothing presses against the skin (eg under waistbands) or the skin rubs together (axillae) are often more severely affected.

Typically, areas that are compressed become more prone to being damaged after the clothing restricting it is taken off.

Causes

The causes that could trigger new-onset urticaria can be numerous but no specific cause can be determined in all patients.
Urticaria that is acute tends to have a distinct cause compared to chronic Urticaria. The various causes of mast cells by a variety of mechanisms.

Common causes

The main causes of new-onset urticaria are the presence of infections; allergic reactions to foods, medications or insect stings or bites. Other causes include reactions to medicines that trigger nonallergic mast cell activation (eg the narcotics, for instance) as well as the consumption of nonsteroidal anti-inflammatory medications

• Viral
• Parasitic
• Bacterial

IgE-mediated allergic manifestations

• Medications
• Insects
• The sound of stinging (yellow jackets, bees wasps, hornets Ants)
  Biting (Triatoma [kissing bugs])
• Foods
• Lood-based products (urticarial transfusion reactions)
• Latex (contact or inhaled)
• Allergic contact (animal saliva and raw food)
• Aeroallergens (rare)
• Food ingredients
• Narcotics/opiates
• Relaxants for muscles (eg succinylcholine)
• Radiocontrast agents
• Vancomycin

Physical stimuli

• Dermatographism
• Pessures delayed
• Cold
• Cholinergic
• Vibratory
• Aquagenic
• Solar
• Exertion/exercise

Miscellaneous mechanisms

• Nonsteroidal anti-inflammatory medicines
• Serum sickness
• Reactions of transfusion (distinct by IgE-mediated reaction)
• Hormone-associated (progesterone)
• Stinging Nettle

Tests for allergens

The possibility of an allergic reaction is raised in the event that the medical history indicates the presence of a trigger that the patient was subjected shortly prior to the first symptoms began to manifest (usually within a period of one to one hour). If the medical history suggests an allergy, then serum tests for specific allergen-specific immunoglobulin E (IgE) antigens can be performed, if they are commercially available.

For instance in the event that a patient is not a fan of seafood, but did at an event or occasion, experiences hives within 10 minutes after eating the crabcake, it might be sensible to get an anti-crab IgE test, especially when there were no fresh foods consumed, and the patient has been advised to avoid seafood to avoid an occurrence of the same reaction.

However, the analysis of allergy tests could require some experience. Positive results are indicative but not a definitive indication of an allergy, while a negative test does not rule out the possibility of having an allergy. Because of this, we suggest that patients suspected of having an allergy be referred to an allergist/immunologist for further evaluation when possible. Tests on the skin using fresh foods, which should be administered by an allergy expert, is most likely to be the most efficient affordable, cost-effective, and sensitive method of detecting food hypersensitivity.

Treatment

The first treatment for new-onset urticaria (with or without angioedema) should be focused on the temporary relief of urticaria and angioedema if it is present. Around two-thirds of cases of urticaria with a new onset will resolve themselves and be self-limited. quickly.

Antihistamines

The use of non-drowsy antihistamine tablets daily assists in blocking the symptom-producing production of the hormone histamine. They can cause a few adverse effects. Examples include:

• Loratadine
• Fexofenadine
• Cetirizine
• Desloratadine

If the antihistamines that aren’t drowsy don’ assist you, your doctor could increase the dose or recommend the one that can make people sleepy and should be used at nighttime. Examples include the hydroxyzine pamoate (Vistaril) and the doxepin (Zonalon).

Consult your physician before using any of these drugs in case you are pregnant, nursing, have an ongoing medical condition or you are taking any other medication.

Other medicines

If antihistamines aren’t enough to relieve your symptoms, then other medications might be able to help.

• Histamine (H-2) blockers. These medicines often referred to as antagonists of the H-2 receptor, can be given orally. Examples include cimetidine (Tagamet Hb) and Famotidine (Pepcid),  ranitidine.
• Anti-inflammation medications. Oral corticosteroids, like prednisone, can reduce swelling as well as redness and itching. They are usually used intended for the short-term treatment of severe angioedema or hives because they may cause severe side effects if used for long periods of a period of time.
• Antidepressants. The tricyclic antidepressant, doxepin (Zonalon) which is used in the form of cream, can assist in relieving itching. This medication can cause dizziness and drowsiness.
  Asthma medications that contain antihistamines. Medicines that block the effects of leukotriene-modifying agents can be beneficial when used in conjunction alongside antihistamines. Examples include montelukast (Singulair) and Zafirlukast (Accolate).
• Monoclonal antibodies. Omalizumab (Xolair) is extremely effective against the type of chronic hives that’s difficult to treat. It’s an injectable medication which is usually administered once per month.
  Immune-suppressing drugs. The options include cyclosporine (Gengraf, Neoral, others) and tacrolimus (Astagraft XL, Prograf, Protopic).¶

Usual Treatment

• For patients who have mild signs of urticaria with a new-onset Treatment with a nonsedating antihistamine H1.
  For patients who are at a lower risk of complications from adverse effects of anticholinergic medications (ie healthy adults), it is recommended to use an antihistamine with sedation before bed and a nonsedating H1 anthelminthine in the daytime is a viable alternative.
• If you have patients who suffer from moderate to severe new-onset urticaria, take H2 antihistamine
• In patients suffering from chronic symptoms even after taking an H1 or H2 antihistamine, or who have obvious angioedema, consider short courses of oral glucocorticoids

Home Remedies

• If you’re waiting for swelling and hives to diminish Here are some suggestions:
• Apply cool compresses or moist cloths on the affected areas.
• Make sure you work and sleep in a cool place.
• Wear loose, light-weight clothing.

Seek doctor help

If you experience hives that have any of the following symptoms, you should contact your physician immediately

• Dizziness
• Wheezing
• Breathing difficulties
• The chest is tight
• Tissue swelling in the tongue lips, tongue, or facial