Urticaria – causes, symptoms, diagnosis, treatment

Urticaria is a condition caused by allergies, although non-allergic hives also occur. This group of urticaria includes, for example, aspirin urticaria and some physical urticaria where the causative agents are sun, water, cold, pressure, etc. Allergic urticaria is usually caused by a food allergy or an allergy resulting from hidden infection foci.

What is hives?

Urticaria is a condition resulting from an allergy to a given factor, but there are also non-allergic hives (resulting from the effects of the sun or cold water). In the course of the disease, blisters appear on the skin around which redness is visible. These blisters resemble changes that appear after nettle burn, hence the name of the ailment.

In a large number of patients, urticaria is associated with angioedema, which is limited to the subcutaneous tissues such as the feet or eyelids. In addition, you can observe dermatographism, which is characterized by red discoloration on the skin.

Causes and types of urticaria

Urticaria can be divided into:

1. Acute – the most common cause is medication, and skin lesions appear and disappear within six weeks.

2. Chronic – unfortunately, in most cases it is not possible to identify the causative agent of the allergy (in this variant, skin lesions persist for more than six weeks).

In addition, hives can be:

1. allergic – then it appears as an allergy to food or cat allergens; urticaria is caused by the IgE-mediated reaction and the secretion of histamine from the cells, which is the main cause of swelling, redness and itching of the skin;
2. non-allergic – appears as a reaction to certain medications or physical factors, e.g. cold, water, sun.

Some causes of urticaria are presented below.

1. INHALATION AND CONTACT ALLERGENS / PLANT POLLEN – eg animal hair, dust, clothing, latex.

2. FOOD – chicken eggs, peanuts, cow’s milk, seafood, strawberries, spinach, soybeans, cheese, various dyes added to food, as well as monosodium glutamate and benzoate.

3. DRUGS – antibiotics (eg tetracycline and penicillin); aspirin, naproxen, ketoprofen, ibuprofen, codeine, morphine.

4. INSECT venom – bee, hornet or wasp venom.

5. PHYSICAL FACTORS – influence of water, sun, pressure, heat, cold, effort.

Symptoms of hives

The course of urticaria can be acute or chronic. Skin lesions are hives of various sizes (similar to those that appear on the skin after contact with nettle), which are very itchy. If the patient does not scratch the lesions, the individual lesions will disappear fairly quickly, but the disease itself may persist for a long time.

Urticaria may be accompanied by the so-called Quincke’s angioedema. It is a rapidly increasing pasty swelling, usually located on the eyelids, around the mouth, in the throat and larynx, and on the genitals.

Swelling in the larynx can even lead to life-threatening problems with the patency of the airways, therefore a patient with acute urticaria should seek medical help.

It is imperative to check if the urticaria is not accompanied by symptoms such as:

1. nausea,
2. vomiting
3. dizziness
4. palpitations
5. shortness of breath
6. low blood pressure
7. general weakness.

Urticaria – diagnosis

Urticaria diagnosis is not difficult because the appearance of the blisters is very characteristic. However, they may differ depending on the cause of the symptoms.

1. sunbathing – there is light urticaria,
2. effort – bubbles are huge and can even cause anaphylactic shock,
3. pressure – blisters may appear, e.g. on the feet, as a result of a long walk,
4. cholinergic urticaria – the blisters are tiny.

For the doctor, the location of the lesions / urticaria on the body and the time in which they disappear is of great importance. In general, patients have no idea where the urticaria is coming from, especially if it is chronic. Therefore, appropriate diagnostics should be based on a medical history, which includes the preparations taken by the patient previously, recent infections, consumed foods and physical factors causing urticaria.

In addition, it is important to exclude other ailments with similar symptoms, so urticaria should be differentiated from:

1. pemphigus (a skin disease characterized by blistering)
2. viral infection,
3. other immune diseases,
4. atopic and contact dermatitis.

In the initial diagnosis of urticaria, in addition to the medical interview, an ESR or CRP test is performed – revealing any inflammation in the body. In addition, the doctor orders the following:

1. liver tests
2. blood count with smear,
3. urine test,
4. assessment of thyroid function.

In patients with acute or chronic nettle, skin or contact tests and the level of IgE in the blood are performed. Based on the patient’s interview and the presence of other symptoms, a specialist may decide to extend the diagnosis to include other less frequent tests, e.g.

1. tests for the presence of autoimmune diseases,
2. tests for the thyroid gland,
3. blood eosinophilia,
4. testing for viral liver infections,
5. drug or food provocation attempts,
6. sometimes a skin biopsy.

Skin test using the patient’s serum – it takes the patient’s own blood and separates the blood cells from the rest of the blood, leaving only the serum. Then the liquid is applied to the punctured skin on the forearm – if a bubble appears, it means that the patient’s blood contains antibodies that are important in the formation of urticaria.

Find out more: Skin changes – as evidenced by spots, blisters, pimples and discoloration on the body?

Urticaria – treatment

Treatment of urticaria should be carried out under the strict supervision of a physician, so you should refrain from implementing the therapy yourself. The basic preparations include antihistamines, which not only alleviate the unbearable itching, but also help to disappear lesions (nettle blisters). New generation antihistamines are currently used, e.g. loratadine, cetirizine, and desloratadine. In patients with very severe symptoms, the dose of the drug is increased.

In addition to antihistamines, oral glucocorticosteroids are used, which have a strong antiallergic effect. Unfortunately, they can cause side effects, so it should only be taken for a few days in severe urticaria accompanied by angioedema.

In patients resistant to the above-mentioned drugs, anti-leukotriene preparations are introduced, but their effect is weak. There are cases where it is necessary to give the patient an antidepressant because he has difficulty falling asleep due to itching.

The symptoms of acute urticaria disappear after about six weeks and the response to the medications is very good. Conversely, a certain percentage of patients with acute urticaria develops into chronic urticaria, which in some develops symptoms even after five years.

It is very important to properly care for skin with hives, so try Exema cannabis soothing cream with a low pH of 4,7, which soothes redness, itching and burning on sensitive skin with eczema or hives.

Can hives be prevented?

So far, it has not been established what actions help to avoid developing urticaria. While the drugs listed above are effective in preventing relapses, triggering the disease is also important.

1. What does itchy calves show?

Some patients experience deterioration of health after taking aspirin, as a result of poor diet or severe stress. Some of the foods we eat can also cause allergies, such as strawberries. While it has not been proven that changing your diet has a significant impact on avoiding disease, reducing alcohol, dyes, preservatives, raw fruit and vegetables improves the appearance of your skin.