Urticaria is a skin disease, which manifests itself in the occurrence of raised red itchy welts. These lesions may have different shapes and may be clustered and may be found in any part of the body including face, arm, leg, and trunk. Even though these welts tend to go away automatically within a few hours or days, on some occasions they may come back resulting in severe impact to the welfare and quality of life of the sufferers.
Urticaria is a wide-ranging and oftentimes troubling dermal response which shows itself in the form of the emerging of welts or lumps on the skin. These lesions may vary in size, being small spots or large plaques, they tend to be raised, red or skin-colored, and usually intensely itchy. Yet, though heart-stopping, in most cases, urticaria turns out to be a superficial and temporary condition.
Urticaria is a condition in which some of the body cells know as mast cells releases a chemical called histamine and other chemical mediators into the blood. This liberation causes the tiny blood channels of the skin (capillaries) to overflow fluid and the swollen (edematous) welts arise.
These are the key symptoms of urticaria:
Hives: Swelling, well-marked lesions that can be pale inside and red on the edge.
Pruritus: An itch which may at times be very severe.
Evanescent Character: The individual welts tend to fade (in most cases within 24hrs) without a trace but other sites on the body can form new ones.
Urticaria can sometimes be combined with angioedema, the swelling of the deeper skin. Angioedema may involve the eyelids, lips, hands, feet or genitals and may produce a tightness or pain. When the throat or the tongue is involved with angioedema it can cause difficulties in breathing and is consequently a medical emergency.
Kinds of Urticaria
Primarily, the severity of urticaria is divided into two categories:
Acute Urticaria: It is the most prevalent one. Outbreaks take less than six weeks to complete and the cause is usually determined.
Chronic Urticaria: It occurs when the outbreaks last longer than six weeks. Chronic urticaria is also difficult to diagnose towards determining the cause and this is termed chronic spontaneous (or idiopathic) urticaria.
Moreover, the hives may be of inducible or physical type where this physical stimulus activates the hives, including:
Dermographism: Occurrence of hives as the result of scratching or rubbing the skin.
Cold Urticaria: It is caused by cold.
Sustained pressure on the skin (e.g. by tight clothing) causes Pressure Urticaria.
Solar Urticaria: Caused by sun.
Cholinergic Urticaria: Linked with warming of the body like exercise or after a hot bath.
Some Common Causes of Urticaria
The causes of acute urticaria are broad:
Allergies: To food (e.g., shellfish, nuts, eggs, milk), to drugs (medications, antibiotics, pain reliever like aspirin or ibuprofen) insect stings, or latex.
Infections: Viral (common cold or hepatitis), and bacterial (strep throat).
Physical Factors: These include as noted above in inducible urticaria.
Emotional Stress: It is not directly causative, but can increase outbreaks in susceptible people.
In chronic urticaria there is frequently no external causative agent. In a large proportion of these, autoimmune pathology is suspected i.e. the auto immune components of the immune system of the body target the mast cells.
Diagnosis and Treatment
Urticaria is mostly diagnosed through physical examination and medical history of the patient. The physician will attempt to determine the length of outbreaks and potential triggers.
The treatment is focused on mitigating the symptoms, and, where feasible, preventing their triggering factors:
Antihistamines: They are the treatment of choice. They inhibit the effect of histamine to prevent the occurrence of itching and hives. They include both non-prescription and prescription anti-histamines.
Corticosteroids: In the most severe or chronic cases oral corticosteroids can be prescribed in the short-term to relieve inflammation.
Avoid Triggers: In case a certain trigger has been confirmed, like food or medication, then the most crucial step is avoiding trigger.
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