home Audience 5 Urticaria: forms of the disease, provoking factors, principles of therapy and prevention. Severe hives all over the body How does hives occur?

Urticaria: forms of the disease, provoking factors, principles of therapy and prevention. Severe hives all over the body How does hives occur?

Allergies are an extremely common problem. Such a pathology is known to be associated with an inadequate response of the immune system to a particular substance. Allergic pathologies are diverse, they are accompanied by different symptoms - some bring discomfort to a person’s life, while others can be deadly.

Urticaria is one of the most common allergic diseases, which is accompanied by the appearance of watery small blisters on the skin (like a nettle burn). Naturally, patients are interested in additional information. For example, what are the causes of the disease? How to recognize allergies yourself? How to get rid of hives and is it possible to be cured once and for all? The answers to these questions will be useful to many readers.

What is urticaria?

Today it is quite often diagnosed, for example. The symptoms and treatment of this disease, meanwhile, are quite ambiguous. The fact is that the term “urticaria” combines a whole group of diseases of allergic origin. They are accompanied by characteristic symptoms - watery blisters of various sizes suddenly appear on the skin, which, however, disappear after 1-2 days. Information about this disease was first recorded in the 4th century BC by Hippocrates.

The mechanism of development of this allergic reaction is as follows. When an allergen (a substance to which a person is hypersensitive) first enters the body, the immune system produces specific protein antibodies (usually IgM). They are accumulated by special cells, such as basophils and mast cells. Biologically active substances accumulate in these same structures - serotonin, histamine, heparin and some others. When an allergen re-enters the body, its molecules combine with antibodies, and subsequently with mast cells, which causes the release of histamine and other active substances directly into the blood and tissues.

Due to an increase in histamine levels, swelling of the skin tissue, dilation of small blood vessels, itching and other signs of allergy are observed. This is exactly how urticaria develops. Symptoms and treatment in adults (and in children too) directly depend on the mechanism of development and causes of allergies. That is why it is worth familiarizing yourself with the risk factors more carefully.

Causes of urticaria in adults and children

Of course, the most important issue for every patient is successful treatment of the disease. But in order to understand how to get rid of urticaria, you should first become familiar with the mechanism of occurrence of this pathology. Since this is an allergic reaction, its development is based on contact of the immune system with the allergen. The causes of urticaria in children, as well as in adults, can be very different. But all of them can be divided into several large groups:

First, it’s worth talking about the impact of the external environment. Cold, contact with water, exposure to ultraviolet rays, radiation - all this can cause an allergic reaction.
If you are interested in the most common causes of urticaria in children, then you should pay attention to food products, since in most cases they provoke an allergic reaction in childhood. The most active allergens include nuts, honey, cocoa and chocolate, cow's milk, seafood, eggs, as well as some fruits and vegetables (people especially often suffer from strawberries).
What causes hives? Quite often it is a side effect of taking medications, in particular antibiotics. Allergies develop especially often when consuming tetracyclines, rifampicin, and penicillins. Potentially dangerous drugs include non-steroidal anti-inflammatory drugs. By the way, the reaction can develop gradually - often the first signs of urticaria appear 14 days after starting antibiotics.
The causes of allergies in adults may include contact with various chemically aggressive substances, including latex, detergents and household cleaning products.
Insect bites (usually wasps, bees, and hornets) can also trigger the rash.

What symptoms accompany the disease?

Quite often people are faced with such an unpleasant problem as urticaria. Symptoms and treatment in adults are important points, so it’s worth going over them in more detail. So what are the signs that accompany the disease and can you notice it yourself?

In fact, urticaria is accompanied by characteristic skin changes. Blisters with watery contents begin to appear on the skin - they are somewhat reminiscent of burns from contact with nettles, which, in fact, gave rise to the name of the allergic reaction. The rash can be present on almost any part of the body.

Most often, urticaria appears on the arms, legs, and less often on the back and abdomen. The blisters are usually small, but can sometimes enlarge and reach 10 cm in diameter. By the way, more often they disappear within 24 hours after their appearance, leaving no traces on the skin (scars, age spots, vascular networks).

The second sign of urticaria is itching, which intensifies in the evening and at night. By the way, “clean” areas of the skin (there are no rashes on them) can also itch. There is no burning or pain associated with this pathology. Their appearance may indicate the development of Quincke's edema and other complications.

Classification: forms and types of urticaria

Today there are many ways to classify this disease. For example, allergies can be acute or chronic (in most cases, its causes cannot be determined). The location of the blisters on the skin also matters - urticaria is most common on the hands, but rashes can also appear on the skin of the legs, face, abdomen, back, etc.

Depending on the reasons, the following forms are distinguished:

Of course, when the first symptoms appear, it is better to consult a doctor. A specialist will be able to tell whether an allergic reaction is occurring. As a rule, examination of the skin and collection of anamnesis already give reason to suspect the presence of pathology. When performing a blood test, you can note an increase in ESR and leukocyte levels, as well as a decrease in the number of red blood cells - this indicates disorders of the immune system.

How to get rid of hives? Conservative treatment

It’s worth saying right away that therapy largely depends on the severity of the allergic reaction, as well as the nature of the allergen. Of course, first of all you need to eliminate contact with a potentially dangerous substance. After this, a treatment plan is drawn up. So how to get rid of hives?

As a rule, patients are prescribed antihistamines. There are two generations of these drugs. Most often today, second-generation drugs are used, since they do not cause addiction, drowsiness or other side effects. Relatively safe tablets include Loratadine, Desloratidine, Zyrtec, and Claritin. If these drugs do not have the desired effect, treatment is carried out using first-generation drugs. "Diphenhydramine", "Diazolin", "Tavegil", "Suprastin" for urticaria are used most often.

In addition, therapy may include the use of ointments. These medications may or may not contain hormones. Naturally, non-hormonal drugs are safer. Unfortunately, they are not always effective. The most popular ointments today include such ointments as Soventol and Fenistil-gel. They help relieve swelling and itching and improve the patient’s well-being.

In more severe cases, hormonal medications are used to eliminate skin manifestations of allergies. For example, it is used quite often for urticaria, judging by the reviews, it helps quite well. The list of drugs for external use includes Lokoid, Cloveit, Laticort, Dermovate.

First aid for an allergic reaction

Of course, first you need to make sure that there is no anaphylactic shock. Further actions depend on what exactly caused the allergic reaction. If there is reason to believe that urticaria is associated with medication, therapy should be discontinued. If blisters begin to appear upon contact with a cream, cleanser, or powder, then the skin should be immediately rinsed with warm water.

If you have a severe food allergy, you can take an enterosorbent to quickly remove the allergen from the digestive system. You can also try to rinse your stomach. Blisters that appear can be treated with a special product - ointment for allergic urticaria. Sometimes it is advisable to take an antihistamine (Loratidine, Tavegil).

Proper diet for urticaria

Naturally, if an allergic reaction is associated with the consumption of some food products, then the allergens must be immediately excluded from the diet. Sometimes a person can determine for himself what food he is allergic to; in some cases, special tests are carried out for this.

On the other hand, even if the occurrence of a skin reaction has nothing to do with the food, a proper diet will help improve the functioning of the digestive system, quickly eliminate external signs of allergies, and improve well-being. So what is possible for hives, and what is not?

The diet must necessarily include porridge, boiled meat, and light soups. Vegetables and fruits can be consumed, but it is advisable to first peel, boil or freeze them (such treatment destroys allergenic substances). Be sure to drink enough water (at least 2-3 liters per day).

But products that contain preservatives, dyes, emulsifiers and other additives should be avoided. The same goes for potentially dangerous fruits, vegetables, nuts, chocolate and milk. You need to give up tonic drinks (especially coffee) and alcohol for a while. This principle of nutrition helps the body recover faster.

Complications of urticaria: how dangerous can allergies be?

According to statistics, in approximately 40% of cases, urticaria is combined with other, more dangerous allergic diseases, including anaphylactic shock. Naturally, such reactions are accompanied by characteristic signs.

For example, early signs of severe allergies include a sharp decrease in blood pressure, sometimes even to the point of loss of consciousness. Acute abdominal pain may occur (especially often observed in reactions to food). Swelling of the neck, tongue, lips, breathing problems, hoarseness, hoarseness, lack of air - all these are good reasons to call an ambulance. This is especially true when urticaria develops in children. Symptoms (and treatment, accordingly, too) can be different, so diagnosis and first aid for young patients is the prerogative of the doctor. Self-medication in this case is unacceptable.

Are there preventive measures?

Sometimes it is much easier to prevent a problem from occurring than to then think about how to get rid of hives. Unfortunately, there are no medications or other specific preventive measures. But, knowing what the causes of urticaria in adults and children are, you can try to avoid dangerous situations.

Contact with potentially hazardous substances should be avoided. For example, it is recommended to follow the principles of a healthy diet and avoid eating highly allergenic foods (strawberries, chocolate, honey, nuts, coffee, etc.). Choose high-quality cleaning products and powders. If you have to work with chemicals, be sure to wear protective clothing, including gloves.

Doctors are advised to always carry antihistamines (for example, Suprastin, Loratadine) with them and take them before the rash appears. It is better to wear loose clothing made from natural fabrics that do not irritate the skin. In order to get rid of itching, you can take a cool shower or bath with the addition of a decoction of oatmeal.

How to cure hives? This question is becoming increasingly relevant. This is due to the growing trend of allergic diseases in both children and adults. Often, allergies begin to manifest themselves only in adulthood, despite the fact that the body is sensitized to the allergen throughout its life. This often happens with veterinarians who work with animals for many years or with workers in hazardous industries. Treatment of urticaria in adults takes place in several stages: identifying the causes, taking antihistamines, taking toxin-removing agents, treating the affected areas of the skin.

Antihistamine injections are used to treat urticaria.

What are the symptoms of this disease

Clinical symptoms of urticaria:

a characteristic sign is red rashes on the body, which can be in the form of blisters;
unbearable itching;
fever;
vomit;
headaches, difficulty breathing;
bronchospasm.

The symptoms of hives largely depend on its causes. The acute form is manifested by the sudden appearance of a rash over large areas of the body. This is a consequence of a new allergen entering the body, so it can go away in a couple of hours. If the cause of the rash is exposure to sunlight, then swelling and blisters appear, plus damage to the mucous membranes. In people with pathological liver disorders, the course of the disease causes the appearance of nodules on the bends of the limbs, which over time turn into papules. There is also increased sensitivity to sunlight. Possible anaphylactic shock.

Urticaria of gigantic proportions - this lesion of the skin is accompanied by fever, diarrhea, and fever. The risk of Quincke's edema is very high, since the lesion reaches the mucous membranes and causes their swelling. In the chronic form, the manifestations of urticaria are paroxysmal and have a certain periodicity. Occurs due to disturbances in the body's metabolic processes. How to treat urticaria in adults? The first priority is to find out the reasons. The appearance of urticaria is caused by much more serious processes in the body. A rash is already a consequence. By curing the cause, you can remove the effect, which is why treatment is mandatory in children and adults. Why does hives appear:

due to allergic reactions;
pathologies of the liver and kidneys also lead to such manifestations;
unstable functioning of the gastrointestinal tract, which can often provoke urticaria, a disease such as gastritis;
nervous shock or exhaustion of the body, overwork, lack of sleep;
temperature changes, environmental situation, hazardous work;
medicinal urticaria, provoked by taking medications;
insect bites can provoke not only hives, but swelling of the respiratory tract;
against the background of hormonal disorders or changes in the body (adolescence, pregnancy, menopause);
helminthiasis, HIV, syphilis, autoimmune diseases.

Long-term use of medications can cause hives

Treatment methods

How to quickly cure hives? It won't be possible to do this very quickly. It all depends on why the hives occur.

General therapy involves taking antihistamines. They are available in various forms: tablets, injections, inhalers.

List of some anti-allergy drugs: citrine, claritin, edem, diazolin, loratadine and its analogues, diphenhydramine.

In order for the body to cleanse itself of toxins, the use of enterosorbents is indicated. You will also need to take medications that improve intestinal function - these are:

pancreazyme;
mezim.

Often, urticaria appears during exacerbations of chronic gastritis, so you need mild remedies that help the stomach recover: almagel or gastrophyte.

In rare cases, when urticaria is caused by an overdose of medications, gastric lavage is performed. When the rash appears due to nervous disorders, it takes a very long time to treat urticaria.

With this course of the disease, sedatives, antidepressants, and vitamin complexes are indicated. Sedatives are prescribed to almost all patients with this disease, because the very manifestations of itching, headache, and nausea cause sleep disorders.

Pancreazym will improve bowel function

Anaphylaxis, laryngeal edema

This manifestation is very scary because swelling of the mucous membranes quickly occurs, blood pressure drops, and the heart begins to function poorly. Due to suffocation, consciousness leaves the patient. Even coma is possible. In this case, the person needs emergency help. At the first symptoms, you must call an ambulance. Lay the patient down with his legs slightly elevated. If possible, inject an adrenaline cube intramuscularly. Typically, such manifestations of urticaria occur in people who have suffered from allergies for a long time and also know about possible attacks. Therefore, they should have medications with them that will help provide assistance until the ambulance arrives.

Chronic relapsing disease

The causes of this form do not differ from the acute form. The blisters become infected. Symptoms of recurrent urticaria:

diarrhea;
joint pain;
temperature increase;
nervous system disorders.

When will the rash go away? A very large number of people experience unpleasant skin rashes of various types. Basically, it's hives. And everyone is wondering: how long will it continue to pour? Urticaria is one of the complex diseases, so it is unlikely that it will be possible to answer the question immediately. Acute urticaria, which appears for the first time, may go away within two hours after contact with the irritant. The chronic form implies a long course, often seasonal in nature.

The recurrent form can appear after four weeks of unsuccessful treatment for chronic urticaria, so it all depends on how carefully the patient monitors his regimen and follows the instructions.

One of the important stages of treatment is the treatment of directly affected areas of the skin. This should be done to prevent secondary infection. Sometimes the rash causes itching that is simply unbearable. Ointments are applied to the affected areas in a thin layer two to four times a day. They are divided into hormonal and non-hormonal.

The first ones are indicated for very strong manifestations. According to the principle of action, they are not particularly different, they have the same goal - to remove swelling and itching. Hormonal ointments: advantan, diprosalik, prednisolone, hydrocortisone, histan-N.

zinc ointment;
nezulin;
bepanthen;
psilo balm.

Psilo-Balm does not contain hormones

Contact view

One type of disease that I would like to focus on is contact urticaria. The title speaks very eloquently. Development occurs due to direct contact of the skin or mucous membranes with allergens. Contact urticaria causes:

latex (gloves, condoms);
various chemistry (detergents, bleach, caustic substances);
plants;
cosmetics;
animals;
Food.

This type manifests itself under the influence of immune or non-immune mechanisms. Contact urticaria and how to treat it: the allergen that causes the reaction should be eliminated. Absorption of a large volume of fluid is recommended, sometimes even a laxative and antihistamines are prescribed. Ointments and creams to relieve symptoms are also an important point. And don’t forget that you will need a hypoallergenic diet.

This type of urticaria in itself is not dangerous and can be treated very quickly. However, it can lead to swelling of the larynx and suffocation if the cause is not eliminated in time and sensitization to the allergen continues.

Latex gloves may cause harmless hives

Autoimmune form

What causes autoimmune urticaria? Cell degeneration occurs. The body ceases to recognize its native cells, and the work of the immune system is directed towards their destruction. In this way, infection occurs with various groups of viruses, because the body’s work is aimed at self-destruction. This type of urticaria is the most dangerous. Diseases of this form often go unnoticed in the initial stages. And when irreversible processes are reached, treatment is already useless.

Autoimmune urticaria symptoms and treatment: contribute to the appearance of this pathology:

infections of various types;
pathological changes in the endocrine system;
tumor;
taking nutritional supplements;
sarcoidosis, amyloidosis.

External symptoms are no different. The main difference is the reason. A characteristic feature is the seasonality of the rash.

An indispensable condition for treatment is a diet and a special lifestyle after the course of treatment, because this disease cannot be cured, because the treatment of concomitant diseases involves giving up a large number of medications.

Treatment for an attack of urticaria will take three months. Mostly third generation drugs are prescribed.

Dietary additives may cause autoimmune urticaria

Papular urticaria

A characteristic sign is the further transformation of blisters into papules. Causes: bites of certain insects, rarely liver pathologies.

Papular urticaria treatment:

eliminating the irritant;
taking antihistamines;
droppers for blood purification;
ointments and creams - a very effective remedy for insect bites, fenistil gel, cooling compresses.

The main danger of this type of manifestation is very severe itching, which is practically unbearable. By scratching the blisters, the patient runs the risk of additional infection. The constant appearance of more and more new papules leads to very long treatment, sometimes even up to several months.

Traditional medicine in the fight against disease

Although many people say that they didn’t have allergies before, there are still a lot of traditional medicine that are designed to help in the fight against this serious illness. It’s just that no one knew what it was called correctly before. Medicinal therapy with herbs and decoctions is indicated only for a certain circle of people, and only the attending physician can prescribe these drugs in combination with other medications.

Urticaria - treatment with traditional methods is effective and fast. One such method for cleansing the intestines is castor oil. It acts like a carrier.

Several times a day you can drink a decoction of celandine. This will help disinfect the stomach.
Salicylic acid or menthol solution perfectly relieves itching. It is recommended to soak the affected areas.
Nettle is used in the form of teas and decoctions. Take it orally and make lotions.
Baths with decoctions of oak or marjoram bark will help relieve inflammation and itching.
Soothing herbs such as mint, lemon balm, valerian, and echinacea will help not only restore the nervous system, but also gently relieve the symptoms of urticaria.

Echinacea soothes and strengthens the body

Can it be cured or is it for life?

To understand whether it can be cured, you need to clearly understand what urticaria is. On the one hand, everything seems clear and simple. This is a rash that appears as a result of exposure to an irritant from the inside or outside of the body. Yes, it’s very easy to remove the allergen and that’s it. But sometimes there are factors beyond the control of patients. Allergic reactions are divided into:

controlled - these are reactions to allergens that can be easily excluded from your environment;
uncontrollable, reaction to dust or animals: dust is everywhere and animals walk along the street, so this type of allergy is not subject to strict control.

Due to this turn of events, it is simply impossible to say how long urticaria will be treated in an adult.

You can stop the symptoms, but sooner or later the body will encounter the irritant again and the rash will begin to appear on the body again. Therefore, you should not believe that you can be cured in a matter of days by taking antihistamines.

If these are manifestations in connection with the pathology of the development of internal organs, then one should certainly not think that one can quickly get rid of the disease. If you ask the question correctly - how long can a rash last on the body, then it’s a completely different matter. This already depends on the degree of manifestation. On average from two hours to several months.

You can’t get rid of allergies to cats and other animals

Why does it appear in adults, what diseases accompany it?

There are urticaria not only of an allergic nature. There are many reasons and diseases that may be hidden behind it:

as a result of disorders of the digestive processes, gastric juice enters the intestines;
helminthiasis;
metabolic disorders;
complications after childbirth;
Bowen's disease;
impaired metabolism.

If an adult has urticaria, the following foods should be excluded from the diet: fish, honey, caviar, caffeine; fruits that cause allergies and sweets are not recommended.

What can be included in the diet:

green fruits;
some vegetables;
dairy products;
cereals: buckwheat, rice, oatmeal, pearl barley;
lean meat;
natural sugar.

Taking vitamin complexes is indicated. These complexes are also prescribed taking into account the characteristics of each individual patient. Basically, these are B vitamins, vitamin C, A, PP.

Green fruits can be included in your daily diet

Additional treatments

How else to treat urticaria in adults? Blood purification: plasmapheresis, ultraviolet irradiation, hemoxygenation, hemosorption, laser plasma purification. Blood purification using traditional methods and physiotherapeutic methods.

Plasma purification methods are a source of stumbling blocks for scientists, so the feasibility of these methods has not been proven. Side effects may occur, but what product does not have them? In emergency cases, such methods remain the only possible option to save the patient’s life.

Conclusions and preventive measures

One of the most common diseases is urticaria in adults: everyone should know the symptoms, treatment and prevention so as not to encounter problems

There are many reasons for this disease and they are not always allergic in nature. Appearing in the form of itchy blisters, localized anywhere on the human body, including the scalp. The most acceptable treatment method is to eliminate the irritant. However, it is not always possible to identify it, and sometimes it simply cannot be avoided.

Hence the conclusion is that you can stop the symptoms and undergo a course of treatment, but sooner or later the rash will reappear. If this is an allergic factor, you can undergo specific allergen immunotherapy, after which ten or even more years of remission are observed.

Prevention: There is no prevention as such, because urticaria appears abruptly and never announces when it might appear. There are some factors that can reduce the risks, but do not guarantee that manifestations will not occur.

Overheating and hypothermia must be avoided. It is better to gradually begin to harden the body. Thus, the immune system will become stronger, and the body will get used to changes and will not react to them. Only after consulting a doctor.
Clothing and shoes should not restrict movement, rub or press.
If you have solar urticaria, avoid being in direct sunlight.
If possible, avoid contact with the irritant, or limit these contacts as much as possible.
If you have come into contact with an allergen, avoid physical activity that day. Otherwise, you can provoke an attack of suffocation.
Dieting. Gradually, after an exacerbation, you can introduce other foods into the diet. However, it is still worth sticking to proper nutrition. Avoid eating fast food, mayonnaise and other similar products. There are a lot of delicious healthy dishes.

The most important thing to remember is that you cannot treat yourself. And no matter how much you want to cure hives quickly, you need to be patient. This rash can be a harbinger of such consequences as angioedema and anaphylaxis.

These consequences cause great harm to health, so you need to be treated on time.

There is a large group of diseases that have similar clinical symptoms - allergic urticaria.

A third of the world's population has experienced manifestations of this disease at least once.

What is this

With allergic urticaria, blisters appear on the skin that resemble a nettle burn, causing itching and burning.

A feature of the mechanism of development of the disease is immediate hypersensitivity.

Once an allergen enters the body, the reaction develops very quickly. The disease is not contagious.

Causes

The human body can react differently to certain substances.

Approximately 75% of patients suffering from this type of allergy develop an acute form of the disease.

Depending on what exactly stimulates the production of mast cells, immune and non-immune forms of nettle fever are distinguished.

In the acute form, the immunological mechanisms of the occurrence of the rash dominate, while in the chronic form, the mechanism of activation may be different.

Etiological factors that provoke urticaria are divided into:

to exogenous (physical) factors. These include mechanical, temperature, food, and medicinal provocateurs;
to endogenous factors. These are somatic diseases and pathological processes of internal organs. The cause of an allergic reaction in this case may be cholecystitis, pancreatitis, lupus erythematosus, gout, diabetes mellitus, tumors of various locations, and hormonal fluctuations.

Acute

In acute nettle fever, after contact with the allergen, a rash appears quickly. It looks like small or large blisters, red in color with a bright edging.

The rash may appear in small areas in the form of spots.

Most often they are localized on the skin, but sometimes they can also be observed on the mucous membranes.

The rash disappears within twelve hours.

From time to time it may appear in new areas of the skin. In general, the disease lasts up to six weeks.

Chronic

Chronic or recurrent urticaria. The illness lasts more than six weeks and can last for three to five years.

In half of the cases, the rashes reappear after a long remission.

More often women suffer from this disease.

There are chronic persistent urticaria, in which the rash is constantly renewed, and chronic recurrent urticaria, manifested in the form of exacerbations after certain periods of time.

Pseudo form

Pseudoallergic urticaria is not an independent disease, but a symptom indicating problems in the digestive organs.

It occurs when:

chronic gastritis;
hepatitis;
infectious diseases;
helminthiasis;
or is a consequence of poisoning.

It differs from the allergic form of the disease in that the immune system does not take part in the formation of mediators of its occurrence.

Types of hives allergies

There are the following types of urticaria:

acute;
chronic;
subacute;
chronic recurrent.

Acute

Acute urticaria develops as an allergic reaction to medications, foods, viruses or insect bites.

Most often it occurs on the skin of the extremities and torso and is accompanied by severe itching, which intensifies in warmth and hyperemia that occurs 15-20 minutes after contact with the allergen.

Acute urticaria begins suddenly, and the rash can disappear just as quickly, leaving virtually no traces.

Giant form or acute limited angioedema

Nettle fever or Quincke's edema is an allergic reaction of the body to any irritant.

It manifests itself in the form of blisters, which can reach large sizes.

Most often observed on the face in the area of the lips, eyes or mucous membranes. With sudden swelling of the skin, large nodes form.

Sometimes it can cause swelling of the arms, legs, or genitals.

Nettle fever can block the airways, causing asphyxia, in which case it poses a threat to human life. The swelling disappears within a day or several hours.

Persistent papular

Papular urticaria develops as a result of long-term treatment of any type of urticaria.

It is accompanied by the formation of papular blisters, due to the fact that a cellular infiltrate is added to the existing edema.

The blisters rise above the surface of the skin, and the tissue underneath them swells.

The disease can last for months and progress, accompanied by severe itching and hyperpigmentation, due to which some areas of the skin acquire a dark tint.

Chronic relapsing

This type of disease is characterized by a wave-like course.

The disease can last up to twenty years, with periods of stable remission occurring.

Urtricarial elements transform into papular elements quite rarely.

It is often accompanied by Quincke's edema.

This form of allergic reaction is characterized by particularly severe itching. Often, patients suffering from the disease scratch their skin until it bleeds.

The scratches may become infected and a secondary infection may occur.

Solar

The cause of the disease is ultraviolet radiation, but its occurrence is also associated with porphyria of various origins and chronic liver diseases.

It appears on exposed areas of the body, in the form of rashes and blisters that appear within ten minutes after exposure to the sun.

Video: More about the disease

Symptoms

There are characteristic signs that indicate nettle fever. Allergy symptoms of hives can vary in severity.

These include:

rash. For different forms of the disease, the rash may differ. It can be small or large and consist of scarlet blisters with a bright red or white border, which is characteristic of acute urticaria. Sometimes they merge, forming large spots. With giant nettle fever, the blisters can reach enormous sizes, and with papular fever they can be supplemented with papules;
itching Determines the severity of the disease. The most severe is painful itching, as a result of which insomnia and neurotic disorders develop;
swelling and redness of tissues;
temperature increase. Occurs if the rash occupies a large area;
joint pain;
convulsions, asphyxia, dizziness.

Diagnostics

Diagnosis of nettle fever occurs in several stages. A visual examination and history taking are performed.

If the cause of the disease is difficult to identify, diagnostic tests are prescribed:

to food allergens. In this case, a potato-rice diet is prescribed to exclude allergies to the most common foods.
physical provocative tests for heat, cold, tension, pressure.
atopy tests: house dust, plant pollen, animal hair.

The patient should keep a food diary in which he notes which foods and in what quantities he consumed.

In this case, an elimination diet is prescribed, and foods that can provoke the disease are excluded from the patient’s menu one by one, and a general assessment of the condition is carried out.

Treatment

In some cases, treatment for urticaria allergies may take a long period. For this, both medicines and traditional methods are used.

In order to get rid of this type of allergy, products are used for external and internal use.

Drugs

When treating endogenous urticaria, it is necessary to eliminate the underlying disease that provokes the symptom.

For this purpose, medications of different groups are prescribed:

for liver diseases, sorbents and hepaprotectors are prescribed;
if the symptom is a consequence of gout - drugs that remove urea and non-steroidal anti-inflammatory drugs;
for diabetes mellitus - antidiabetic drugs;
if the disease is provoked by worms or protozoan microorganisms, then antiprotozoal and anthelmintic drugs are prescribed.

For nettle fever, intravenous administration of Calcium Chloride or Sodium Thiosulfate is indicated, which helps remove the allergen from the body.

In severe forms of the disease, corticosteroid therapy is indicated. These drugs include Prednisolone or Dexamethasone.

Pathogenetic therapy is also carried out in parallel, antihistamines of the first second and third generation are prescribed:

Diazolin, Suprastin, Tavegil, Fenkarol, Diphenhydramine. They act for a short time and cause drowsiness.
Loratadine, Cetirizine, Fenistil. The action is longer, taken once a day, and does not cause drowsiness.
Astemizole, Erius, Telfast, Tigofast. They act for a long time and have a minimum of side effects.

For Quincke's edema accompanied by laryngeal edema, the following is prescribed:

subcutaneous Adrenaline;
intravenous Prednisolone;
intramuscular Tavegil or Suprastin.

Subsequently, the body is cleansed with the help of sorbents, calcium supplements and antihistamine therapy is carried out.

If necessary, intravenous drip administration of infusion solutions is indicated: Reamberin, Sodium chloride, Neohemodez. For chronic recurrent urticaria, the hormonal drug Prednisolone in tablets is prescribed for a course of up to one and a half months according to the scheme, in combination with antihistamines.

Traditional methods

To treat nettle fever, decoctions and infusions of herbs are used to help relieve itching and get rid of rashes.

Baths with string and chamomile are effective:

raw materials should be mixed in equal proportions;
Place a glass of herbal mixture in a gauze napkin;
tie and pour three liters of boiling water;
after it has infused for six hours, the infusion is poured into a bath one-third filled with water.

If the rash is localized, the squeezed raw materials can be used for compresses, which are applied for twenty minutes.

You can take a decoction of the herb orally, for this, add a tablespoon of herb, pour half a liter of hot water and boil for five minutes. After an hour, the infusion should be strained and drunk throughout the day.

How to relieve severe itching

In order to relieve severe itching, hormonal ointments are used for contact nettle fever:

Sinaflan;
Prednisolone;
Hydrocortisone.

They are used if the area of skin affected is small.

Non-hormonal ointments that relieve itching include:

Psilo-balm;
Fenistil;
It is possible to use herbal baths or cold compresses.
Talkers with the addition of menthol are effective.
Antihistamines are used orally.

In severe cases, hormonal medications are prescribed intravenously and infusions.

Prevention

To prevent nettle fever, it is necessary to avoid direct contact with the allergen.

People suffering from allergies need to adhere to a dietary diet, avoiding the consumption of synthetic dyes and preservatives.

It is necessary to use hypoallergenic household chemicals and cosmetics.

Allergens can accumulate in the body, their number expands, so in adults, symptoms of the disease appear more often.

People who are allergic to the sun should use sun protection and avoid direct sunlight on exposed skin.

In the complex treatment of the disease, a hypoallergenic diet is prescribed.

The following should be excluded from the menu:

foods that cause histamine liberation: cheese, chocolate, citrus fruits, nuts, strawberries;
products that promote the formation of histamine-like substances: sauerkraut;
foods that irritate the gastrointestinal tract: fried, fatty, spicy, smoked, salted;
alcohol, carbonated drinks;
If possible, stop taking medications.

A healthy diet and nutrition will help avoid relapses of the disease.

Periodically you need to arrange fasting days and drink enough liquid. Alkaline water is a natural antihistamine;
To prevent relapse of the disease, you need to monitor the condition of the liver and avoid stagnation of bile in the ducts and gallbladder. To do this, you need to take choleretic medications (if there are no stones in the gall bladder);
in childhood, the cause of urticaria can be dysbacteriosis, so if your child develops a skin rash, a coprogram is necessary.

How to assess severity?

The severity of the allergic reaction is assessed by the degree of damage to the skin. If more than 50% of the skin is covered with a rash and the disease progresses, it means it is severe.

The appearance of Quincke's edema is already a severe form of the disease and requires immediate treatment.

A severe degree is indicated by:

severe itching;
lowering blood pressure.

With moderate severity, the rash covers the skin by 30-50%.

Do I need to call an ambulance?

Quincke's edema can develop within a quarter of an hour and is accompanied by a drop in blood pressure, difficulty breathing and will end in death.

At the first signs of illness, you should immediately call an ambulance. This should also be done if a generalized rash occupies a large area and is accompanied by an increase in body temperature and convulsions.

If you experience any allergies, you should consult your doctor.

First aid

First of all, you need to stop the action of the allergen. In acute cases, you can do a cleansing enema or take a laxative.

It is imperative to take an antihistamine; if possible, it should be administered intramuscularly or intravenously with a solvent.

The disease is treated by an allergist or dermatologist. Various infectious diseases can manifest themselves under the guise of urticaria. Self-medication can be harmful to health.

What is urticaria, according to medical statistics, 20% of people had to learn from their own experience. This pathology is included in one group of allergic diseases along with agioedema and Quincke's edema. The manifestations of these three diagnoses are similar, but the development mechanisms are different.

Urticaria gets its name because of its symptoms. It is accompanied by pink inflammation similar to that characteristic of nettle burns. Blisters can be as small as 1 mm. up to several centimeters, they turn pale under pressure. The disease occurs with severe itching, high fever and headaches. In people predisposed to urticaria, specific areas of the skin or the entire body may be affected.

According to the course of the disease, an acute or chronic form is diagnosed. The latter is often associated with serious pathologies of the liver, digestive system, and kidneys. It can develop due to helminthic infestations, infections in the tonsils, gall bladder, during the disintegration of malignant tumors, toxicosis.

If the symptoms of urticaria occur immediately after exposure to allergens, the disease is identified as an acute form. Its characteristic features will be a rapid, intense course of symptoms. Acute urticaria appears suddenly and lasts several hours, sometimes a day. Without drug intervention, the malaise lasts about 10 days. The chronic version is characterized by the presence of a rash for several months.

Cholinergic urticaria occurs most often. Its course is accompanied by an unpleasant, obsessive itching, after which a rash appears in the form of blisters on the chest and in the neck area. This may be preceded by a hot shower, heavy physical activity, or strong emotions. Urticaria from exposure to cold water is called cold urticaria. Its course is characterized by the fact that the rash does not appear immediately after exposure to water, but later.

Urticaria pigmentosa is accompanied by spots on the skin with a red-brown tint, after scratching which many blisters appear. Quincke's edema is called giant urticaria and is characterized by deep damage to the skin. Its development is characterized by the formation of edema in areas with delicate skin - cheeks, eyelids, larynx, mucous membranes. The rash causes pain and an unpleasant burning sensation.

Giant urticaria in a mild form disappears without a trace in two to three hours, or a couple of days. The same cannot be said about moderate and severe manifestations; with such courses of the disease, patients are hospitalized. The main thing to be wary of is swelling of the neck, mouth and larynx. They can cause suffocation.

Hereditary manifestations of Quincke's edema threaten the digestive system. Accompanied by spasmodic pain in the stomach, nausea and colic in the intestines. The occurrence of edematous laryngitis is likely - inflammatory processes in the vocal cords and larynx. With angioedema, swelling of the tongue, lips, and eyes occurs; medical attention is required.

Causes of urticaria

Allergens that enter the body from food: fruits, seafood, nuts, eggs.
Medicines: antibiotics, hormonal drugs, sulfonamides.
Allergens contained in the air: particles of wool, dust, pollen.
Infectious diseases; hepatitis B, mononucleosis.
Physical factors: exposure to cold, ultraviolet radiation, pressure.

Factors in the development of the disease

Urticaria will cause less trouble if it is not treated, but prevented. If you have a high sensitivity to allergens, you should carefully select products and test medications before use. It is important to exclude food preservatives and additives: flavor enhancers, dyes, sodium gluconate, sulfites. Use peanuts, tree nuts, soy products, and milk with caution.

The list of medications that can provoke unpleasant symptoms of the disease includes: antibiotics, drugs of the sulfonamide group, analgesics. Also tranquilizers, drugs with codeine, insulin, some serums and vaccines. In the chronic form of the disease, aspirin increases rashes and itching, but does not independently cause symptoms of the disease.

Acute urticaria can occur during treatment with blood products or the administration of X-ray contrast agents. The impetus for the progression of angioedema and Quincke's edema can be drugs aimed at treating hypertension and heart failure. Among them: Prestarium, Kapoten, Enap. You can identify a medicine as an allergen by stopping taking it for a while.

People prone to allergies should beware of stings from bumblebees, wasps, bees, mosquitoes and ants. The danger of giardiasis, oscoridosis, and hepatitis with chronic urticaria increases. Its relapses are common in chronic gastritis and stomach ulcers. Alcohol, menstrual days, severe stress increase the symptoms of the disease.

Drug treatment

Treatment for urticaria includes antihistamines. You can treat it by taking: Lorotadine, Claritin, Telfast, Zyrtec. Combinations of these drugs and combinations with antidepressants are possible. The positive effect is complemented by cleansing enemas and the administration of activated carbon. Severe forms that are dangerous to health require hospital treatment. In clinical settings, oral corticosteroids are prescribed. When chronic urticaria worsens, it is effectively treated in centers with a narrow specialization. Where there is an opportunity to establish the source of pathology.

Therapy algorithm

Treatment of diseases begins with identifying the cause of the allergic reaction and eliminating it. It is not always possible to completely eliminate the substance that causes the pathology. In case of exacerbation of the chronic form, an elimination diet is prescribed to eliminate negative factors. Allergens that enter the body are removed with cleansing enemas over a three-day period.

The diet involves removing from the diet all foods that can provoke allergic reactions. These include: chicken, strawberries, all types of citrus fruits, chocolate and sweets with dyes. Also smoked products, marinades, carbonated drinks, canned food, spices.

Treatment is based on a course of taking antihistamines. It is important to identify concomitant pathologies of the body that increase the symptoms of urticaria. If it is impossible to completely eliminate the disease, it is necessary to relieve its exacerbation. The functioning of the digestive system is rehabilitated by prescribing vitamins: nicotinic and ascorbic acids, riboflavin, vitamin U, calcium pantothenate. Doses are selected according to the patient's age and weight.

To increase capillary tone and reduce vascular permeability, chloride is used
calcium in combination with iron-containing drugs. To treat severe forms of urticaria, anabolic steroids and glucocorticoids are used. External treatment is considered to be ineffective measures. Zinc pastes, preparations with naftalan oil, and ointments with glucocorticoid hormones are used. Physiotherapeutic methods are used.

If you are prone to allergies, chronic urticaria or recurrent angioedema, you must follow the following rules.

Use warm water for washing, do not visit a hot bath, sauna, avoid ice water, touching ice or cold metal.
Use mild soap, preferably without aromatic fragrances.
Apply moisturizers to your body.
Choose clothes made from natural fabrics: linen, cotton.
Avoid prolonged presence in stuffy rooms.
Replace aspirin with other antipyretics.
In emotional moments, take sedatives.

An effective method for preventing urticaria is a periodic diet that includes exclusively plant foods. Natural foods, eliminating fatty meats, spicy seasonings, smoked foods, canned food and alcohol from the diet will help cleanse the body. This will avoid exacerbations of the disease. Medicinal plants are also considered beneficial for itchy skin. Decoctions of celery root, common yarrow, infusions of dried duckweed, and nettle leaves are relevant.

Urticaria is a disease of heterogeneous causative factors, the main clinical manifestation of which is a skin rash in the form of widespread or limited blisters that disappear spontaneously or under the influence of appropriate treatment.

The pathology occurs on average in 20% of the population, in 25% of whom it is chronic. Among children, the disease is less common than in adults, and in women more often than in men. The maximum incidence of cases occurs between 20 and 40 years of age. What are the causes of hives?

Classification and etiopathogenesis

The mechanisms of development of various forms are very complex and are still insufficiently studied.

How long does the illness last? In most clinical classifications, according to the duration of the pathological process, the following types of urticaria are distinguished:

Acute, which can last from a few minutes to 6 weeks. It is much more common and is diagnosed on average in 75% of all cases of urticaria.
Chronic. Its duration is more than 6 weeks. The chronic form with relapses occurs in 25%. In its natural course, this form of the disease can last mainly up to 10 years (in 20% of patients).

Among children under 2 years of age, as a rule, only its acute form develops; after 2 years of age and up to 12 years of age, acute and chronic forms develop, but with a predominance of the first; after 12 years of age, urticaria with a chronic course is more common. Chronic urticaria is most common in people between 20 and 40 years of age.

A pattern has been noted - if a chronic process lasts for 3 months, then half of these people then suffer for at least 3 more years, and if the preliminary duration is already more than six months, 40% of patients suffer from its symptoms for the next 10 years.

Remission in chronic urticaria can occur spontaneously, regardless of how this pathology is treated. In half of the patients it occurs within the first six months from the onset of the disease, in 20% - within 3 years, in another 20% - 5 years, and in 2% - 25 years. In addition, at least 1 relapse develops in every 2nd patient suffering from a chronic course with spontaneous remission.

In addition, depending on the prevalence throughout the body, the disease is divided into options:

localized - on a certain limited area of the body;
(spread of rash elements throughout the body), which is a life-threatening condition, especially when localized in the area of organs of vital importance.

Based on the cause and mechanism of formation of the reaction, the following forms of urticaria are distinguished:

allergic, caused by various immunological (cytotoxic, reagin, immunocomplex) mechanisms of increased sensitivity (hypersensitivity);
non-allergic.

Causes

The causes of hives are numerous. The most common of them include:

The causes of acute and chronic forms of the disease are different:

Among all chronic forms of urticaria (with an unknown cause) it occurs on average in 75-80%, in 15% it is caused by a physical factor, in 5% it is caused by other factors, including allergic ones.

Development mechanisms

Under the influence of one or more causative factors, both immunological and non-immunological in nature, skin mast cells are activated with the destruction of their granules (degranulation), as a result of which mediators (biologically active substances) are released from them. They cause symptoms in the skin characteristic of acute local inflammatory processes.

In this case, the main biologically active substances are histamine and prostaglandins. Under the influence of histamine, local expansion of small skin vessels occurs with an increase in their permeability. This results in limited redness of the skin (erythematous patch) and swelling of the hypodermal or submucosal layer with the formation of a blister or papule. In addition to hyperemia and edema, these mediators cause itching, sometimes significant.

Prostaglandin D 2 and histamine are also activators of C-fibers that secrete neuropeptides. The latter cause additional vasodilation and degranulation processes in mast cells, which determines the duration (more than 12 hours) of the rash.

Most often, acute urticaria is associated with allergic, that is, with immunological reactions of activation of mast cells, on the surface of the membrane of which highly specific receptors for immunoglobulin “E” (IgE) antibodies are located, as well as receptors for cytokines, C3A, C5A receptors, etc.

Allergic reactions are mediated primarily by the participation of immunoglobulin “E”. Characteristics of urticaria, regardless of the cause, are increased permeability of microcirculatory vessels and the development of acute edema in the tissues located around these vessels, with various manifestations of an allergic reaction.

In cases of a chronic form of the disease, immunological mechanisms are not excluded, for example, in the presence of autoimmune pathology (systemic lupus erythematosus, rheumatism, etc.). At the same time, in a chronic process, activation of mast cells more often occurs through nonspecific (non-immunological) stimuli (emotional stress, the influence of alcoholic beverages, the premenstrual period, physical factors, etc.).

Rash due to hives

In the last 10 years, the concept of the autoimmune nature of the chronic course of the pathological process has prevailed, according to which autoimmune urticaria is caused by the presence of autoantibodies to IgE receptors with high affinity and antibodies directed against IgE. This mechanism occurs in 30-50% of patients suffering from chronic urticaria.

Autoantibodies bind to the IgE receptor, resulting in activation of basophils or mast cells, which leads to histamine-like reactions with corresponding symptoms. This principle formed the basis of a relatively new theory, according to which in some patients the chronic form is an autoimmune disease.

The participation of other mediators, such as bradykinin, prostaglandins, neuropeptides, leukotrienes, and platelet activating factor, is also possible in maintaining the chronic course. During remission, mast cells are restored to their normal state.

Is hives contagious and can you get rid of it?

Based on the description of the causes and mechanisms of development of the pathology, it becomes clear that it has nothing to do with infectious diseases.

What does urticaria look like and is it dangerous?

Clinical picture

The acute form is characterized by fairly typical manifestations. The onset of the disease is sudden. The main symptoms of urticaria are rashes accompanied by severe itching and a burning sensation, sometimes a feeling of “bloating.” In the chronic course of the disease, itching may occur at certain times of the day without the appearance of morphological elements.

As a rule, the morphological element is a round-shaped blister (less often a papule), protruding above the surface of the skin and having clearly demarcated contours. It resembles an insect bite or a nettle mark and is a limited swelling of the dermal papillary layer, several millimeters in diameter, but there can often be elements with a diameter of several centimeters. In the dermographic variant of the pathology, the blister takes the form of a traumatic physical object (tourniquet, spatula).

The elements have a pale pink or red color; in the peripheral parts the hyperemia is more pronounced. When pressed, they become pale in color; no traces of pressure remain.

A rash with urticaria can be localized on any part of the skin - on the scalp, on the body, on the arms and legs, including the areas of the palms and the plantar surface of the feet. The density of mast cells is very high in the face and neck, so the number of elements is usually higher here compared to other areas of the body. They often occur on the mucous membranes, especially on the lips, soft palate and larynx.

The duration of the episode is determined from the moment the first element appears and the last element disappears. In most cases, the duration of existence of blisters does not exceed 24 hours, during which they quickly appear, increase in size, and can merge with each other, acquiring a bizarre shape.

A small blister can thus turn into a giant element with an area of up to several tens of centimeters. Their merging with each other is accompanied by a deterioration in the general condition - general weakness, joint pain, headache, chills (“nettle fever”) appear, body temperature rises to 38 ° and above.

Symptoms of urticaria

Then, also, over the course of 1 day, the intensity of color and clarity of the boundaries of the rashes decreases, after which they disappear without a trace - without the formation of secondary elements (pigmentation and peeling).

Against the background of the listed symptoms, acute urticaria may be accompanied by cramping pain in the abdomen, intermittent pain in small joints, as well as in the elbow and knee joints (arthralgia), pinpoint hemorrhages and nosebleeds. Very rarely, and mainly in children, symptoms of meningism may develop.

Histologically, the classic wheal presents with swelling of the middle and upper dermis, as well as dilated venules and lymphatic vessels located in the upper dermis. In addition, an infiltrate around small vessels is detected in the skin, which consists of mast cells, blood cells (neutrophils and eosinophils) and T-lymphocytes.

If the edema spreads to the deep dermal layers, subcutaneous fat and mucous membranes with similar (described above) histological changes, the disease can occur in the form of “giant urticaria” or acute limited angioedema.

Angioedema

It accompanies 50% of cases of chronic urticaria and can occur independently or be combined with localized manifestations of the acute form.

Quincke's edema is characterized by an asymmetrical location of pronounced painless swelling on the face (in the area of the cheeks, lips, eyelids, auricle), which leads to its disfigurement, or on the external genitalia. The skin in the affected area becomes white or (less commonly) pinkish in color. Angioedema disappears after a few hours or, at most, after three days.

In clinical practice, hereditary angioedema is especially distinguished, caused by a quantitative or functional deficiency of the C1 inhibitor, which is a serum protein synthesized in the liver. With its deficiency, plasmin is activated, which is a trigger for the development of edema. The pathology is hereditary. Edema is localized, as a rule, in the mucous membrane of the larynx and is provoked by psycho-emotional stress or microtrauma. Men are most often affected. The principles of treatment for this condition differ from the treatment of other forms.

Quincke's edema

Why is urticaria dangerous?

The consequences of urticaria, as a rule, do not pose a threat to health or life. If minor limited swelling of the mucous membranes develops, swelling of the tongue, conjunctivitis and rhinitis, cough, difficulty swallowing, nausea and vomiting, diarrhea, and abdominal pain are possible. Swelling of the laryngeal mucosa, especially in children under 1.5–2 years of age, is dangerous due to the development of laryngeal stenosis and breathing problems in the form of suffocation.

At the same time, emergency care for urticaria and its nature are determined not by the reasons that caused the body’s reaction, although they must also be taken into account, but by the localization, severity and prevalence of edema and urticarial (blister) rashes.

25% of cases of Quincke's edema develop in the neck in the larynx area, which can result in sudden swelling of the subcutaneous fat, muscles and fascia of the neck. This is manifested by hoarseness of voice, difficulty in inhaling and shortness of breath, rapid intermittent breathing, barking cough, cyanosis of the face against the background of its pallor, and an anxious and excited state of the patient.

If the degree of damage is mild to moderate, this condition (without medical assistance) can last from 1 hour to a day. But, at the same time, after the severity of the symptoms has decreased, soreness in the throat, hoarseness and coughing, difficulty breathing, especially during physical exertion (even minor), persist for some time, and scattered dry rales can be heard on auscultation over the lungs. If the edema spreads to the trachea and bronchial tree, bronchospastic syndrome may develop with a fatal outcome.

When the edema is localized in the area of the mucous membranes of the digestive tract, nausea, vomiting, and possible abdominal pain, which is initially local and then widespread. Against this background, false symptoms of intestinal obstruction or peritonitis may develop, while elements of the rash are present in only 30% of patients. This causes significant difficulties in diagnosis and, in some cases, is a reason for useless surgical intervention.

The development of Quincke's edema in the head area may cause involvement of the meninges in the process, especially in children, with the development of convulsive syndrome and meningeal symptoms.

Less commonly, the morphological elements can be papules or a urticarial rash (papular urticaria) can transform into them. Papules usually occur in women and children with a persistent chronic course and can persist for months. They are localized mainly on the limbs in places of bend, have sizes up to 6 mm and are richly red in color with a brownish tint.

Papular elements rise above the skin surface and have a dome-shaped or flat shape. They are characterized by greater density and durability compared to blisters, as well as a lack of tendency to group and merge. The rash is accompanied by severe, sometimes unbearable itching. After the elements resolve, pigmentation and peeling often remain, and sometimes scars formed as a result of a purulent infection caused by scratching.

Diagnosis of the disease

Diagnostics consists of several conditionally sequential stages.

Stage I

It consists of carefully collecting an anamnesis of the disease and determining whether the patient has concomitant somatic pathology. Maximum attention is paid to questions about the presence of a tendency to allergic reactions.

At the same time, the duration of the disease itself, the nature of the elements, their localization and prevalence, the frequency of appearance and duration of evolution, the dependence of the appearance on the season and time of day, the appearance of angioedema and subjective sensations in the area of the rash must be clarified. It is very important to establish the presence of a predisposition to allergies in family members and a possible connection with a specific causative factor.

Stage II

Includes an external examination of the patient, which determines the nature of the rash and/or angioedema, localization, presence of pigmentation or peeling in the area of the rash. It is necessary to assess the general condition of the patient and conduct a preliminary diagnosis of possible somatic diseases (in the absence of anamnesis data on their presence), which may be the cause of urticaria or its provoking factors. In addition, at this stage the nature of skin dermographism is also determined, but after a 2-day break in taking antihistamines or a week (at least) of immunosuppressants.

Stage III

Assessment of the clinical activity of the disease in accordance with a specially developed 3-level scoring scale, which takes into account the number of blisters and the degree of intensity of itching.

Stage IV

Carrying out a scream test with non-infectious allergens (skin pricking at the sites of application of various pollen, food, epidermal, household and contact allergens) and intradermal tests with infectious (mycotic and bacterial) allergens. Tests are also performed to diagnose other forms of the disease:

Duncan test (cold using ice cubes);
skin thermal - through a water compress at a temperature of 25 °;
tourniquet test;
mechanical or line test with a spatula;
testing with hanging or applying a load;
bicycle ergometer test - to determine the reaction to general physical activity;
photo testing.

Stage V

Includes laboratory diagnostic and instrumental studies. A detailed examination is determined by the need to identify diseases that provoke urticaria, especially chronic, or pathologies in which it is a symptom, for example, diseases of the digestive system, helminthiasis, hepatitis, malignant neoplasms, lymphoma, systemic autoimmune pathology of connective tissue, etc.

Therefore, the main laboratory and instrumental studies are clinical and biochemical (glucose, total protein, cholesterol, creatinine, urea, liver tests) blood tests, clinical urine analysis, RW, examination for the presence of hepatitis “B”, “C” and for HIV infection, determination of total IgE in blood serum by enzyme immunoassay, ultrasound of the abdominal organs, ECG, esophagogastroduodenoscopy, chest fluorography and, if indicated, radiography of the paranasal sinuses.

Further examination is carried out depending on the results of the preliminary examination. For example, consultations with specialists of a narrow profile (otolaryngologist, gastroenterologist, etc.) are prescribed; if there is an assumption of the presence of an autoimmune form of urticaria - intradermal tests using autologous serum; if the presence of thyroiditis is suspected - determination of the level of antibodies to thyroid tissue in the blood, etc. d.

Treatment of urticaria and prevention of relapses

Treatment of patients with an acute course or relapse of the disease is aimed at the fastest possible complete relief of all clinical manifestations, especially in cases of development of symptoms that threaten the patient’s life. In addition, the goal of treatment is to achieve a state of clinical remission as long as possible in the chronic form.

Treating urticaria at home and diet

Possible in cases of mild disease. In the absence of the effect of outpatient treatment, in moderate and severe cases, as well as in angioedema in the area of vital areas (tongue, larynx), intestines, in abdominal syndrome, dehydration, in combination with anaphylactic reactions and in any life-threatening conditions The patient is treated in a hospital, preferably an allergy department, and sometimes even in an intensive care unit. The average duration of treatment in the allergy department is about 20 days.

Non-drug therapy involves frequent wet cleaning and ventilation of the living space, avoiding contact (if possible) with known or suspected causal and provoking factors, which are often detergents and other household chemicals, the epidermis and hair of pets, and food.

What can you eat?

The diet should exclude foods that contain histamine or promote its release in the body (citrus fruits, nuts, alcoholic drinks, extractives, etc.). In some cases, a 2-3 day fast is necessary with a further gradual transition to a hypoallergenic diet. The diet for urticaria is, as a rule, table No. 7.

At the same time, it is recommended to use so-called elimination therapy (to remove allergens from the body, etc.), which, in addition to nutrition, includes the use of diuretics, laxatives, and enterosorbents (Polysorb). On an outpatient basis, dysbacteriosis is also treated, chronic sources of infection in the body are rehabilitated, and, if indicated, specific immunotherapy is performed.

Drug therapy

The choice of the volume of specific drug therapy is determined by the severity of the patient’s condition. In all cases, the basic drugs for urticaria are first and second generation antihistamines. The first generation (classical) drugs include mainly Clemastine, or Tavegil, and Chloropyramine, or Suprastin in tablets for oral administration or in solution for intramuscular and intravenous, often drip, administration.

However, classical first-generation antihistamines have a number of side effects such as drowsiness, slowing of the reflex reaction, general depression of the function of the central nervous system, dizziness, loss of coordination, blurred vision and double vision, dry mucous membranes and many others.

In this regard, the drugs of choice are second-generation antihistamines. Most of them do not have many side effects and can be used in high dosages. These include Loratadine, Fexofenadine, Cetirizine and Levocetirizine, Desloratadine, Ebastine.