Hives may appear afterwards. Symptoms and treatment of urticaria, photo of the disease. Various forms of this disease
is an allergic disease that is manifested by the formation of blisters on the surface of the skin and mucous membranes. Urticarial rash is itchy, raised above the surface of the skin, and sometimes painful. The diagnosis of urticaria is established on the basis of typical manifestations of the disease and anamnestic data, and allergy skin tests. Treatment should include elimination of the allergen, taking antihistamines, enterosorbents, and in severe cases, corticosteroids.
General information
Urticaria (from the Latin "urtica" - nettle) is a dermatosis that occurs with the formation of blisters or angioedema. 25% of the population have experienced symptoms of urticaria at least once in their lives, and the majority of them are women. The onset of incidence occurs before the age of 40 years, 2-7% of patients are children. If contact with the allergen is constant, then urticaria becomes chronic. In 40% of cases, urticaria is accompanied by Quincke's edema.
Causes of urticaria
Pathogenesis
The main mechanism for the formation of blisters on the skin is the release into the blood of a large amount of histamine, which is formed upon contact with an allergen. Depending on how quickly the body's sensitization develops, urticaria may occur upon initial exposure or after repeated exposure to the allergen, and when the concentration of antibodies in the blood is high enough, urticaria symptoms occur. Under the influence of active substances, the walls of capillaries increase their permeability, fluid from the vessels sweats into the dermis and a blister appears, which is why urticaria is considered a disease of an allergic nature.
Symptoms of urticaria
Acute and chronic urticaria
Numerous bright pink blisters suddenly appear on the skin and mucous membranes. With urticaria, the main part of the rash appears within an hour, when the concentration of histamine in the blood is still quite high, but a little later a few more blisters may appear, while the main part of skin diseases begins gradually with several elements. After a few hours, the blisters either disappear without a trace, or a second wave of hives occurs with the formation of new blisters. Chronic urticaria lasts for months and sometimes years.
The blisters are itchy and painful to the touch, and the skin around them is swollen and hyperemic. Depending on the size of the lesion in urticaria, the general condition may not change, or there may be a rise in temperature, malaise and headache.
Chronic forms of urticaria are associated with autointoxication and occur in diseases of the digestive organs and liver. Foci of chronic infection in the tonsils and gall bladder, caries and various helminthic infestations can also sensitize the body and cause chronic urticaria. When urticaria recurs, patients may experience headache, nervousness, nausea and vomiting, sleep disturbances, and in some cases, urticaria may be complicated by swelling of the membranes of the brain.
Pediatric urticaria
The resulting blisters quickly transform into pink-brown nodules up to 3 mm in diameter with a small bubble at the top. Since urticaria causes blisters to itch, the affected skin quickly macerates, scratching, erosions and bloody crusts appear. Urticaria affects large folds of the body, the upper limbs and sometimes the elements spread throughout the body. In young children, especially under the age of three, dyspeptic disorders are observed: vomiting, diarrhea, or, conversely, constipation. If urticaria takes on a chronic, sluggish nature, then children become lethargic, capricious, and there is loss of appetite and sleep disturbances. Due to maceration, urticaria elements become infected with pyococcal flora. Urticaria in children must be differentiated from scabies due to similar clinical manifestations. After seven years, in almost all children, urticaria goes away without a trace.
Giant hives
Treatment of urticaria
The most effective way to treat hives is to identify and eliminate the allergen. But if it is not possible to identify the allergen or the urticaria is episodic, then local therapy and antihistamines help to quickly eliminate the symptoms. During the treatment period, it is important to follow a hypoallergenic diet, not use perfumes and come into contact with aggressive substances, so as not to provoke a new attack of urticaria.
Treatment of urticaria is carried out by a dermatologist and an allergist-immunologist. Gel-like preparations that have antipruritic, cooling, decongestant and soothing effects are prescribed locally. The drug dimethindene is effective for all forms of urticaria, its effect begins immediately after applying the drug to the skin.
Taking antihistamines internally is indicated. Fexofenadine and loratadine do not cause side effects such as drowsiness and attention problems, and therefore do not interfere with patients’ ability to lead a normal lifestyle. Calcium glucanate and calcium chloride, like all calcium preparations, reduce the manifestations of allergies. But you need to be careful, since many patients with recurrent urticaria experience hypersensitivity to intravenous administration of calcium chloride and sodium thiosulfate, although these drugs help remove allergens from the body. In the event that antihistamines are ineffective and in severe forms of urticaria, corticosteroid therapy is used. Low-percentage hormone-containing ointments are also indicated locally.
For food urticaria, it is necessary to take adsorbents, mild laxatives and drink large amounts of liquid to force the removal of the allergen from the body. Since urticaria is more common in people with disorders of the autonomic nervous system (vegetative-vascular dystonia), taking sedative drugs in the form of courses can completely eliminate urticaria. Autolymphocytotherapy is the latest method in the treatment of urticaria; statistical data indicate the high effectiveness of the technique. Elements of the cellular immune system are isolated from the blood of patients and injected subcutaneously after the relapse of urticaria is stopped.
Prevention
People prone to hives should avoid contact with possible allergens. Patients who have an allergic predisposition and who have previously been diagnosed with urticaria should use antihistamines before local anesthesia procedures and before vaccination. A complete allergy examination is necessary to identify the range of allergens that may cause unwanted reactions.
Urticaria is a polyetiological disease (dermatosis), the main clinical manifestation of which is transient urticarial rashes, that is, blisters (elevations above the skin) and angioedema.
This is the 3rd most common allergic manifestation after bronchial asthma and drug allergies. Manifestations of urticaria are rashes that resemble nettle burns, accompanied by such severe itching that it sometimes leads to nervous disorders in patients.
In clinical practice, urticaria is relatively common. Over the course of a lifetime, 20% of people in the population experience this disease (Matews K.P., 1983). Moreover, acute reactions are much more common (60-75%) than chronic ones (25-30%). In this article we will look at the types, symptoms and treatment of urticaria with folk remedies and medications.
Causes of urticaria
Urticaria can be acute or chronic. The duration of the chronic form is on average 3-5 years (can stretch up to 20 years). The acute form is an immediate allergic reaction that lasts up to 6 weeks.
The cause of the acute form of urticaria in children and adults is various allergens: food, pollen, animal dander, medicines, etc. Cases of such a reaction are also often recorded after exposure to vibration, pressure, ultraviolet radiation, low air temperatures, increased physical activity , thermal effects on the skin. Chronic reactions are most often caused by internal causes.
The main factors that provoke the occurrence of urticaria in children and adults are:
- external causes - physical, chemical, mechanical
- internal - diseases of internal organs, nervous system
According to the results of research in 2011, the provoking factors are:
- Idiopathic urticaria (a chronic disease with unclear causes) - 40-90%
- Autoimmune processes in 40-60%
- Sun, cold, pressure (physical reasons) -20-30%
- Infectious diseases 10-20%
- Intolerance to certain foods (food allergies) -10%
- Hormonal disorders, inflammatory processes - 10%
Symptoms of urticaria in children and adults
The blisters resemble traces of mosquito bites or nettle stings. At first they are red or pink, varying in size from 0.5 to 15 cm. Over time, exudate accumulates and the skin capillaries are compressed, and the elements of the rash become light. The rash can be isolated on the face, hands, and as it progresses, it can spread to free areas of the body, becoming generalized, and the rash is accompanied by itching and burning.
If a generalized urticarial rash appears in children in the first years of life, this may indicate its hereditary nature. Urticaria in adults, the symptoms of which are similar to hereditary ones, is almost always acquired.
Like any other chronic disease, it occurs with periods of remissions and exacerbations. When a relapse occurs, the patient also experiences headache, weakness, fever, vomiting, anxiety, and sleep disturbance due to severe pain.
Clinical manifestations of urticaria are associated with an immediate-delayed hypersensitivity reaction. A common link in the pathogenesis of any clinical form of the disease is swelling of the papillary layer of the skin, which develops as a result of increased permeability of the capillary wall of the microvasculature. These changes are associated with the action of histamine, which is released by mast cells. Their activation (degranulation) can occur for various reasons. In this regard, there is a classification of urticaria according to the etiopathogenetic principle:
Physical urticaria
- Mechanical (dermatographic) urticaria. In this form, itching often precedes the appearance of rashes. The rash consists of linear blisters that appear as you scratch. Linear elevations of the skin occur after mechanical irritation - pressure from belts, applying pressing movements to the skin. Urticarial dermographism without itching can be observed as a short-term phenomenon with the disappearance of blisters within 30 minutes. It occurs in 3-5% of the population and does not require treatment.
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- Delayed urticaria from pressure. The provoking factor is prolonged local exposure to vertical pressure. They usually manifest as hyperemic, sometimes painful lesions with deeper spreading edema. Typical locations: on the hands, feet, buttocks and back of the thighs.
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- Vibrating. Blisters appear on the skin in areas exposed to vibrating surfaces or parts of objects. Similar symptoms of urticaria in children may be a diagnostic sign of hereditary vibrational angioedema.
- Heat contact urticaria. Occurs when local heat is applied to the skin. A hereditary form of this disease has been described, in which blisters appear 4-6 hours after heat contact.
- Cold urticaria(see details). Characterized by the appearance of blisters after local exposure to cold. The reaction to cold exposure is manifested by a rash, but not on the cooled skin, but around it. Areas of skin that were in direct contact with the cold are not affected. In some patients, in response to exposure to cold, the release of neurotransmitters is recorded, in others - the synthesis of anaphylatoxins through the complement system. Considering the mechanism of development, some authors classify the cold variant of urticaria as spontaneous rather than physical.
special shapes
Spontaneous urticaria
In acute urticaria, symptoms and rashes resolve on their own as a result of treatment or withdrawal of the causative factor. The following forms of spontaneous urticaria are distinguished:
Diagnostics
The diagnosis is made visually and is based on the presence of the primary element characteristic of urticaria - a blister. Bright urticarial dermographism in the affected areas is a confirmatory criterion. The diagnostic program is always formed individually based on the anamnesis and clinical picture. Thus, if allergic urticaria is suspected, the “gold standard” is to conduct skin tests with specific allergens. If contact, cold, aquagenic and thermal urticaria is suspected, diagnostic tests are performed with suspected provoking factors.
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Treatment
It is advisable to begin treatment for urticaria only after the cause of its occurrence has been established. As a rule, treatment is carried out in two directions: elimination (elimination) of the etiological factor and the prescription of pharmacotherapy.
The first direction includes:
- Prescribing a hypoallergenic diet for nutritional urticaria;
- Drink plenty of fluids to quickly remove allergens from the body;
- Elimination or reduction of external influences that provoke the appearance of blisters in contact, cold, thermal, aquagenic and vibration urticaria;
- Maintaining optimal temperature conditions, eliminating stressful situations and limiting physical activity for cholinergic and adrenergic urticaria;
- Limiting medications for drug-induced urticaria.
In most cases, the causative factor cannot be identified, so drug therapy is prescribed, which is based on the use of antihistamines.
Antihistamines and other drugs:
Antihistamines are especially effective in cases where the manifestations are associated with changes in vascular permeability and other consequences of the local action of histamine, for example, irritation of the nerve fibers responsible for the presence of itching (see review of all).
Drowsiness as a consequence of the anticholinergic and antiserotonergic effects of these drugs, realized in the central nervous system, is the most significant adverse side effect of traditional antihistamines. This explains the popularity of non-sedating antihistamines, which penetrate the blood-brain barrier poorly and have weak or no anticholinergic and antiserotonergic effects.
2nd generation drugs, such as Zyrtec, Zodac, Erius, Claritin, do not have a sedative effect and are currently the most preferred for the treatment of urticaria in children and adults, both acute and chronic.
If antihistamines are ineffective, short-course glucocorticoid drugs (Dispropane, Prednisolone, Celeston) or hormonal ointments are prescribed (see the list of all hormonal creams and ointments in the article). If the allergic reaction becomes generalized and is complicated by life-threatening conditions such as anaphylaxis or Stevens-Johnson syndrome, it is advisable to prescribe epinephrine.
In addition to antihistamines and corticosteroids, the following is indicated for the treatment of allergic urticaria:
- , diuretics as prescribed by a doctor
- enterosorbents - Enerosgel, activated carbon, Polyphepan,
Traditional methods of treating urticaria
Folk remedies for the treatment of urticaria have been successfully used since ancient times, among them we present the most effective and time-tested. However, persons with allergic reactions to certain types of medicinal plants should use the proposed methods with caution, or abandon them if there is individual intolerance:
- Dill juice - fresh juice is extracted from pre-washed dill and applied to the rash areas using a clean napkin for 30 minutes. This folk method relieves unbearable itching of the skin due to hives.
- Similar applications can be made from red clover flowers and grass. To obtain clover juice, first the raw material is passed through a meat grinder, then squeezed and applied to the rash for half an hour.
- If you are not allergic to nettle, you can take an infusion of its flowers orally, which helps cleanse the blood and accelerate the removal of allergens from the body. How to prepare a water infusion is written on the packaging of the pharmaceutical herbal remedy; you should drink about 2 glasses per day in 3-4 doses.
- To reduce the intensity of itching and speed up the healing of damaged skin, 20-minute baths with a water infusion of wild rosemary herb are helpful. To take a bath, 1 liter of ready-made infusion is enough.
Forecast
The prognosis of the disease is ambiguous, since it depends on the form of manifestation of the disease. The prognosis is more optimistic for idiopathic and allergic urticaria, less favorable for physical, infectious or autoimmune urticaria. Remission of urticaria occurs only six months or even a year after the onset of the disease in 50% of patients.
Urticaria is one of the most common diseases treated by an allergist. In general, the term urticaria refers to a number of specific diseases characterized by different specific nature of occurrence, but manifesting themselves in the same way.
What is the cause of the occurrence, what are the first signs in adults and what is prescribed as treatment, we will look further in the article and show how the rashes look in the photo in different forms.
What is hives?
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.
As a rule, urticaria is more of a symptom than an independent disease. For example, it may be a skin manifestation of allergic shock, bronchial asthma, or some kind of autoimmune disease. It is extremely rare for urticaria to be an independent allergic reaction, without accompanying symptoms.
The incidence of urticaria in the population is quite high, which, accordingly, defines it as a common disease. Moreover, at least once in a lifetime, about 10 to 35% of the population faced its manifestation. The most unfavorable course of the course is chronic urticaria, the duration of which is over 5-7 weeks.
Kinds
Depending on the prevalence in the body, the disease is divided into options:
- localized - on a certain limited area of \u200b\u200bthe body;
- generalized (spread of rash elements throughout the body), which is a life-threatening condition, especially when localized in the area of organs of vital importance.
Types of urticaria depending on the duration of the disease:
- Acute urticaria. In the case when the urticaria lasts up to 6 weeks, it is considered acute. The duration of the course of the disease is determined from the appearance of the first rash until the disappearance of the latter.
- Chronic form. If urticaria lasts more than 6 weeks, it is considered chronic. Associated with autointoxication and occur in diseases of the digestive system, liver. Foci of chronic infection in the tonsils and gallbladder, caries and various can also sensitize the body and cause a chronic form.
- Chronic recurrent urticaria- can proceed for several decades with periods of partial or complete remission (weakening). It is often accompanied by Quincke's edema. Severe itching causes patients to comb the skin to the blood.
Acute form, with the development of Quincke's edema. This type of urticaria is accompanied by swelling of the subcutaneous fat and mucous membranes. Such edema in the larynx is especially dangerous., as they can cause asphyxia (suffocation). Quincke's edema is accompanied by blurred vision, severe itching and the appearance of white-pink blisters.
Demographic
Dermographic urticaria (dermographism) is a type of urticaria in which blisters similar to scars appear on the patient's skin, resulting from mechanical action. The characteristic feature of this disorder is the abrupt onset and rapid disappearance of symptoms. Often, patients with dermographism experience self-healing.
solar urticaria
With hypersensitivity to ultraviolet radiation, solar urticaria appears; in people with sensitive skin in the spring and summer, blisters appear on exposed areas of the skin after sun exposure. Solar urticaria mainly affects women with fair skin and blond hair.
Cold form
Cold urticaria develops a few minutes after contact with such influencing factors as cold water or excessively cold air, icy wind. Manifestations of symptoms are reduced to the appearance of itching, burning, erythema (severe redness of the skin), as well as a blister and/or swelling. The predominant concentration of these manifestations is similar to the previous case with solar urticaria.
Medicinal
Pathology caused by medications may develop immediately, a few minutes after taking the medication, or may only appear several weeks later, when the drug is stopped. Most often the dosage form is provoked by:
- aspirin;
- other NSAIDs;
- steroids, etc.
Contact urticaria
Occurs due to an allergy to any material. For example, with a wool allergy, this type of disease develops if a person wears woolen clothing. Blisters and itching appear where the allergen comes into contact with the skin.
Causes
The progression of external signs of urticaria is explained by an increase in local vascular permeability, which causes swelling to develop in a short time. An important factor in the possibility of the occurrence of this pathology is a hereditary predisposition to allergies.
Urticaria is a polyetiological disease with a variable onset of course, and it is sometimes not possible to say which allergen caused it in each specific case. They could be:
- various physical factors (temperature, humidity, pressure);
- direct contact with the allergen or its entry into the body;
- various endogenous factors (pathological processes in the gastrointestinal tract, bacterial infection, diseases of internal organs, disruption of the endocrine system, metabolic processes or neurohumoral regulation).
Among all chronic forms of urticaria, idiopathic (with an unknown cause) occurs on average in 75-80%, in 15% - caused by a physical factor, in 5% - caused by other factors, including allergic ones.
Various diseases can serve as a trigger, often these are:
The main signs of urticaria are: the sudden appearance of a specific rash and the accompanying itching. Rashes are small areas of skin redness (erythema) that quickly transform into blisters.
In addition to severe itching and burning, depending on the extent of the lesion, a person may experience:
- headache,
- nausea,
- drowsiness,
- weakness.
Possible increase in temperature - nettle fever. Blisters and symptoms may disappear without a trace after a few hours, or the condition may be stable or wave-like over several days or even months. Usually, after disappearing, there are no traces left on the skin.
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 on 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.
Symptoms of acute urticaria:
- sudden appearance of rashes without clear boundaries;
- increased body temperature, malaise, chills;
- painful itching;
- sudden cessation after a few hours or days (if the course is favorable).
Features of the rash in chronic urticaria:
- chronic urticaria is characterized by a rash that is not as profuse as in the acute form of the disease;
- blisters rise above the surface of the skin, have a flat shape and clearly defined edges;
- visually, the elements of the rash resemble marks from insect bites, and their diameter can vary from a millimeter to several centimeters;
- At first, the blisters are pink or red in color, but become lighter over time;
- the skin rashes are itchy and can form large solid formations;
- the rash appears spontaneously, without obvious reasons;
- in some cases, the appearance of blisters is preceded by factors such as climate change, various colds, and exposure to stress.
What does urticaria look like: photo
The appearance of blisters on the skin due to urticaria
Symptoms of danger
It is often one of the manifestations, and is also often combined with Quincke's edema. In this regard, if the following symptoms appear, immediate medical attention should be provided:
- Reduced blood pressure;
- Breathing disorders (the appearance of hoarseness, hoarseness, lack of air);
- Swelling of the tongue, neck;
- Acute pain in the abdominal area;
- Loss of consciousness.
Complications
The most serious consequences are caused by Quincke's edema. In some cases, the tongue and larynx rapidly swell, and there is a risk of suffocation. Scratching your body can cause:
- the addition of a fungal or bacterial infection;
- pyoderma (purulent skin lesions);
- folliculitis;
- furunculosis.
Diagnostics
Diagnosis usually begins with a thorough history. The doctor clarifies:
- when and under what circumstances did the rash appear;
- how long did the attack last?
- what foods and medications were used;
- whether vaccination was done.
Urticaria can be difficult to distinguish from toxicoderma or insect bites.
Doctors often prescribe tests aimed at provoking the occurrence of an allergic reaction.
The most effective way to treat hives is to identify and eliminate the allergen. But if it is not possible to identify the allergen or the urticaria is episodic, then local therapy and antihistamines help to quickly eliminate the symptoms. During the treatment period, it is important to follow a hypoallergenic diet, not use perfumes and come into contact with aggressive substances, so as not to provoke a new attack of urticaria.
Special points in treatment:
- The initial choice of medication primarily depends on the severity.
- In most cases, treatment of chronic urticaria requires a long time (from several weeks to months).
- It is worth remembering that the disease often stops spontaneously in 50% of cases.
- It is necessary to treat existing chronic foci of infection and restore normal intestinal microflora.
Etiotropic treatment involves eliminating the provoking factor. It is important to exclude possible contacts with allergens of any nature. It is necessary to adjust the diet and thoroughly clean the premises. If urticaria was caused by taking certain medications, then their use becomes unacceptable for life.
The following medications are used as systemic therapy in adult patients:
- Antihistamines. These include diphenhydramine, loratadine and other drugs.
- Systemic glucocorticosteroid drugs in the case of a generalized form of pathology (dexamethasone, prednisolone).
- Means for desensitization. These include: cocarboxylase, unithiol, calcium chloride.
- Adrenaline hydrochloride in case of acute edema and threat to the patient's life.
Antihistamines belonging to the second and third generation.
If there is severe swelling, difficulty breathing, or blisters, call an ambulance immediately. Before the medical team arrives:
- stop contact with the allergen;
- loosen all tight clothing;
- open a window or window;
- give the victim any antihistamine medication;
- any sorbents that you find in the first aid kit are recommended - activated or white carbon, Enterosgel;
- apply vasoconstrictor drops to your nose;
- give the person mineral water;
- If you are allergic to an insect bite, apply a cold compress to the affected area.
Diet
Diet for urticaria is an integral part of treatment, since this disease belongs to a heterogeneous group of dermatoses, which in most cases develop as allergic reactions to various provoking factors.
The diet should be based on the following principles:
- exclude from your diet food agents known to you that provoke allergic reactions and foods that cause a cross-reaction in you (for example, all red vegetables, berries and fruits);
- Avoid excess protein content in the diet;
- do not include unknown or genetically modified products on the menu;
- eat simple food containing a minimum of ingredients, exclude complex dishes, including various seasonings and sauces;
- use only fresh products, avoid shelf-stable products (canned food, preserves);
- give preference to homemade dishes, do not include semi-finished products in your diet;
- try to optimally diversify the menu, since a product that is often eaten can have a sensitizing effect;
- limit the consumption of table salt and simple carbohydrates, as well as fried, spicy and salty foods;
- Completely avoid drinking alcoholic beverages.
When prescribing a diet for acute urticaria, it is recommended to include the following foods in the diet:
- cereals, with the exception of semolina;
- fermented milk products (without any additives);
- mild cheese;
- lean meat (beef, rabbit, turkey);
- all types of cabbage (except red cabbage), zucchini, pumpkin, fresh green peas and green beans, dill and parsley;
- apples (with green or yellow skin), pears, yellow cherries, white currants and gooseberries;
- butter, refined vegetable oil;
- grain bread or crispbread.
As the clinical manifestations subside, various vegetables and fruits are introduced into the diet in small doses: first, green or yellow in color, and after a few days, in the absence of rashes, representatives of these families of orange (pumpkin) and red color.
Doctors recommend keeping a food diary. In it, the patient needs to record what he ate and when, and most importantly, hives did not appear. In this way, you can accurately determine the allergen product and determine as correctly as possible which foods should be excluded from the diet after urticaria.
Folk remedies
Before using any folk remedy for urticaria, you need to consult a specialist.
- As a sedative and tonic use tincture of hawthorn and valerian. To do this, the ingredients are mixed in equal proportions and taken before bed in the amount of 30 drops, washed down with water.
- Good decongestant and diuretic effect has celery root. It is grated, the mass is squeezed through cheesecloth, the resulting juice is taken one tablespoon three times a day before meals.
- Yarrow infusion(1 tbsp per 200 g of boiling water, let it brew for 45 minutes) drink a third of a glass three times a day before meals. The herbal decoction is prepared in the same proportion as the infusion, cook for 10 minutes. Take in the same way as the infusion.
- Small pieces (10-15g) of licorice root take twice daily before meals.
- Prepare an infusion of mint leaves and take it three times a day, 50 g each. The infusion has a slight calming effect and has a beneficial effect on the functioning of the digestive tract.
When the first symptoms of urticaria appear, immediately contact a dermatologist or allergist. If assistance is not provided in a timely manner, complications are possible. Take care of yourself and your health!
Urticaria is a disease whose main symptom is the appearance of blisters on the skin. They are similar in appearance to the blisters that arise from a nettle burn. According to statistics, every fourth inhabitant of the earth has had symptoms of urticaria during their lifetime. People between 20 and 40 years old are more likely to get sick.
Need to know! This disease is not contagious. Communication with people who have this disease is absolutely safe.
You can watch a video that describes in detail the mechanism of urticaria and its symptoms.
Symptoms
When you get urticaria, blisters appear on the skin, looking like a bubble from an insect bite or a nettle burn. The sizes of blisters vary. The skin around them is usually red.
The rash can occur on any part of the body and is sometimes accompanied by itching. There are no painful sensations. After the end of the inflammatory process, the skin takes on its previous appearance. No scars, pigmentation or ulcers are formed.
Kinds
According to the nature of the occurrence and course of the disease, urticaria is:
- Spicy.
- Chronic.
According to statistics, the acute form usually occurs in childhood and adolescence. The disease lasts about 6 weeks, the chronic course is typical for the adult population. Women get sick 20% more often than men.
Need to know! The disease can be inherited.
You should not think that the chronic form of the disease will accompany a person throughout his life. With properly organized treatment, healing occurs within a year. There are cases when the acute form for some reason becomes chronic.
Causes
It is not always possible to identify the causes of the disease, but most often it is:
The main causes are allergic in nature. A sharp development of the disease can provoke:
- Taking medications - antibiotics, anti-inflammatory drugs.
- Eating foods that contain allergens - milk, nuts, eggs, chocolate, fish, shrimp.
- A bite of an insect.
- Physical contact with chemicals that cause allergies.
- ARVI in children.
- Hormonal disorders.
Chronic urticaria
In 30% of cases of chronic urticaria, the causes of the disease remain unidentified. The remaining 70% is due to the presence of autoimmune diseases in patients. Autoimmune urticaria occurs due to problems with the immune system. The body produces antibodies that fight not against infection from the outside, but against the cells of the body. The result of this struggle is bubbles.
Types of urticaria
- Physical.
- Solar.
- Aquagenic.
- Mechanical.
- Thermal.
- Cold.
- Papular.
- Nervous.
Physical impact on the skin with hard objects or fabrics causes blisters to appear on the body.
Bubbles form when a person is in the sun. Radiation of a certain spectrum provokes the occurrence of the disease.
Aquagenic urticaria
It is extremely rare. When a person comes into contact with water, itching begins, swelling appears, and blisters form.
Small single blisters form on the skin. The affected area is large. Causes them to secrete sweat, which increases due to physical exertion, stress or increased temperature.
Heat urticaria
It is rare and occurs when the patient comes into direct contact with a warm object.
Cold urticaria
Very common. Causes:
- being in a cold room or outside;
- eating cold food or drinks;
- tactile contact with a cold object.
Papular urticaria
Papules appear on the skin - small blisters that cause their bites:
- mosquitoes;
- fleas;
- bedbugs
Nervous urticaria
It is provoked by severe stress or anxiety.
Need to know! If you have urticaria, there should be no increase in body temperature. If it increases during illness, this is a sign of another disease.
Diagnosis of urticaria
Diagnosis of the acute form comes down to a visual examination of the patient. In the chronic form, the patient is examined by an allergist. Tests for antibodies in the blood are prescribed. Various tests are performed to identify allergens.
Treatment
Acute urticaria
To relieve the symptoms of acute urticaria, the doctor prescribes antihistamines to the patient, which must be taken until complete recovery. If you go to the clinic in a timely manner, already on the third day the rash disappears and the patient’s condition improves.
Chronic urticaria
For chronic urticaria the following is prescribed:
- Medicines: loratadine, ceterizine, ranitidine.
- Physiotherapeutic procedures.
- Ointments.
- Individual diet.
During the diagnosis of the disease, the allergen that caused the hives may be identified. If it is a food product, it is recommended to exclude it from consumption. Also exclude all products containing it. The same applies to allergies to medications.
Urticaria in infants
Infants develop an acute form of urticaria when they are allergic to:
- artificial mixtures;
- mother's milk, if the mother ate allergenic foods;
- medicines.
To eliminate the causes of the disease, avoid foods and medications that cause allergies.
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What is urticaria?
Hives- This is a variant of a rash, mainly of allergic origin, which occurs with dermatitis and other skin diseases. Synonyms for urticaria, which will be used further in the article, are the terms nettle rash, urticaria, and urticaria. As a rule, urticaria is more of a symptom than an independent disease. For example, it may be a skin manifestation of allergic shock, bronchial asthma, or some kind of autoimmune disease. It is extremely rare for urticaria to be an independent allergic reaction, without accompanying symptoms.
According to statistics, every third person on the planet has suffered at least one episode of urticaria, and more than 15 percent of people have suffered this episode twice. The peak incidence occurs between the ages of 20 and 40 years, and predominantly females suffer from this disease.
Causes of urticaria
The reasons that provoke urticaria can be both external and internal. According to statistics, urticaria develops 2 times more often in women than in men. Based on this, scientists suggest that this disease may be triggered by hormonal disorders that are characteristic of the female body. Conditions that alter the balance of hormones include:
- taking oral contraceptives.
There are the following causes of chronic urticaria:
- infectious diseases;
- immune system disorders;
- Food;
- physical factors;
- dermatitis;
Infections
According to recent studies, infectious diseases initiate urticaria in approximately 15 percent of cases. The disease can be caused by infections of both viral and bacterial types. The role of foci of chronic inflammation is especially important in the development of this pathology. This could be caries, tonsillitis, adnexitis. In modern medicine, inflammatory diseases such as gastritis, cholecystitis, and ulcerative lesions of the gastrointestinal tract are also considered possible causes of urticaria.Immune system disorders ( autoimmune urticaria)
In about 20 percent of cases, the cause of urticaria is an autoimmune reaction, in which the body perceives its own cells as foreign and begins to attack them. Hives caused by a malfunctioning immune system is called autoimmune urticaria. In this case, the disease has a number of distinctive features. Thus, autoimmune urticaria has a longer and more severe course. The use of antihistamines, which are one of the main methods of treatment, gives weak results or does not help at all.Food ( allergic urticaria)
Foods and the allergic reaction they provoke can cause the allergic form of this pathology. In adults, urticaria due to food occurs rarely and the number of all cases does not exceed 10 percent of the total number of identified episodes of urticaria. However, food allergies are almost always accompanied by other factors ( most often these are chronic inflammatory processes), which may act as the causes of this disease.Physical factors ( sun, cold)
Various environmental factors cause urticaria in 20 percent of cases. In this case, the disease is called physical urticaria. Depending on the specific circumstances that provoked the disease, there are several types of physical urticaria.There are the following physical factors that can cause hives:
- Sun. In some patients ( most often women) due to exposure to sunlight, blisters characteristic of this pathology appear on the skin. The rash appears on those parts of the body that are not covered by clothing ( shoulders, face). Solar urticaria develops a few minutes after exposure to sunlight.
- Cold. In this case, cold water or air can trigger hives. Some people show signs of the disease when they eat food that is too cold. Blisters with cold urticaria do not appear on cooled areas of the skin, but around them.
- Water. The body's reaction to contact with water, resulting in an itchy rash on the skin, is called aquagenic urticaria. In some cases, the rash is absent or almost invisible, and the only symptoms are itching.
- Vibrations. In this case, the rash appears as a result of vibration exposure. Vibration urticaria most often affects people whose work involves the use of certain equipment ( for example, a jackhammer).
- Allergens. Dust, pollen, animal dander and other traditional allergens get on the skin and cause a rash. Symptoms of contact urticaria disappear after interrupting contact with the allergen.
- A sharp increase in body temperature. Body temperature may change due to excessive emotional or physical stress, eating too hot and/or spicy food, or visiting a steam room. Experts call this type of disease cholinergic urticaria. This form of the disease is characterized by the appearance of small, pale blisters that are located on the upper part of the body.
- Mechanical irritation. The most common skin irritants are tight clothing, a too-tight belt, or digging buttons. For symptoms to appear, as a rule, prolonged exposure to a mechanical factor is necessary. This disease is called dermographic urticaria. Blisters with this disease have a linear shape and appear on the skin not together with itching, but after some time.
Urticaria and dermatitis
Dermatitis is a skin lesion, most often of an autoimmune nature. This disease can be either the cause of urticaria or simply a concomitant disease. Most often, a combination of urticaria and dermatitis occurs in children. One third of young children suffering from urticaria have atopic dermatitis. This suggests that the pathogenesis ( formation mechanism) of these diseases are similar in many ways. Their development is based on an inadequate response of the immune system. Since atopy ( predisposition to allergies), is mainly characteristic of children, then the combination of these two diseases is mainly found in them.Dermatitis can also occur as a secondary disease, against the background of allergic urticaria.
Urticaria and diabetes mellitus
Diabetes mellitus is a pathology in which adequate absorption of glucose by tissues does not occur. Instead, the concentration of glucose in the blood increases to more than 5.5 millimoles per liter of blood, and numerous disorders develop at the microcirculation level. As a result, disturbances in the nutrition of body tissues and a decrease in their resistance to infections also occur. Ultimately, diabetes mellitus leads to a decrease in immunity, against the background of which chronic diseases worsen and new ones develop.Against the background of reduced immunity and low resistance ( sustainability) the skin often develops dermatitis, less commonly urticaria. The favorite place for rashes in diabetes mellitus is the feet, ankle joints, and palms. This is explained by the fact that these parts of the body are the most distal, that is, located on the periphery. They have the worst blood circulation, which is the basis for the development of a rash. The manifestation of urticaria in diabetes mellitus, as in other diseases, is a small, blistering rash.
Urticaria and hepatitis
Hepatitis is an inflammatory lesion of the liver, mainly caused by a viral infection. Thus, there are hepatitis A, hepatitis B, and hepatitis C. This pathology may be one of the risk factors in the development of urticaria. This is explained by several reasons. Firstly, with hepatitis there is a deficiency of certain vitamins, namely A, E, K. These vitamins, especially A and E, play an important role in maintaining the integrity of the skin. When there are not enough of them, tissues become more vulnerable. This is why vitamins play an important role in the treatment of urticaria. The second reason is the dysfunction of the immune system, which is observed in hepatitis. This becomes an additional risk factor in the development of urticaria.Urticaria and gastritis
Gastritis and other pathologies of the gastrointestinal tract can sometimes cause urticaria. Most often they become a risk factor for the development of cholinergic urticaria. This is explained by the fact that these diseases cause increased sensitivity to acetylcholine ( neurotransmitter). It is this abnormal sensitivity that underlies cholinergic urticaria or pruritic dermatosis. The attack of acetylcholine leads to the formation of numerous itchy nodules on the skin.Hives and herpes
In exceptional cases, herpes can lead to the development of urticaria. This may be the case if it develops against a background of reduced immunity in people with a predisposition to allergies. Herpes can also develop in people with chronic urticaria. Very often, these two diseases can manifest themselves with the same symptoms - small itchy nodules. However, urticaria is distinguished by the migratory nature of the rash, as well as the relationship with external factors ( food, medication).Urticaria and leukemia
Leukemia is a malignant pathology of the hematopoietic system, popularly often called blood cancer. Sometimes this pathology may be accompanied by changes in the skin. Thus, leukemia is characterized by increased sweating, redness and small spots on the skin. These elements are mainly a manifestation of increased vascular bleeding. Sometimes they can be mistaken for hives. However, a combination of urticaria and leukemia cannot be ruled out. This is typical for people with a predisposition to allergic reactions.What does hives look like on the face, arms, legs, back and other parts of the body?
Hives manifest themselves as red, itchy blisters or spots that are very similar to those that appear with a nettle burn. Hence its name follows. The number of itchy nodules, as well as their size, depends on the severity of the urticaria. A distinctive feature of urticaria is its migratory and fickle nature. For example, a rash may disappear several hours after it appears and then reappear. Symptoms of acute urticaria in adults
According to the nature of the course, acute and chronic urticaria are distinguished. The duration of acute urticaria is several weeks, while chronic urticaria lasts from several months to several years. Also, the difference between acute and chronic urticaria is the nature of the development of symptoms. In the chronic version of the disease, the main symptoms constantly appear and then disappear; scientifically, this course is called recurrent. Symptoms may come and go over many years. With acute urticaria, only the rash can disappear, but other symptoms ( fever, malaise) remain. Thus, acute urticaria is not characterized by light intervals that are observed in chronic urticaria.Rash due to hives
The classic manifestation of acute urticaria in adults is a rash. The rash mainly consists of small blisters ( bubbles). The blister is a small, pale pink cavity that rises slightly above the surface of the skin. The skin around the blister is always dark red. When pressed, the bubble turns pale. Regardless of the size and number of blisters, they are always accompanied by itching.The peculiarity of urticaria in adults is that it appears quickly and suddenly and disappears just as quickly.
Itching with hives
An important diagnostic symptom of acute urticaria is itching. The cause of itching in urticaria is irritation of the nerve endings in the skin by histamine. Thus, with urticaria, a large amount of the neurotransmitter histamine is released into the blood. This substance dilates blood vessels, facilitating the penetration of fluid into tissues and the formation of edema. Histamine also irritates nerve endings, thus causing severe itching. The intensity of itching can vary from moderate to excruciating.Quincke's edema and other manifestations of urticaria
With mild urticaria, the patient feels normal, but when it becomes more severe, his condition begins to worsen. The skin rash is accompanied by symptoms such as aches in the joints and muscles, headaches, and an increase in body temperature to 38 - 39 degrees.As the severity of the disease worsens, giant urticaria, called Quincke's edema, may develop. This condition is characterized by severe swelling, which involves not only the skin, but also the subcutaneous tissue and mucous tissues. Quincke's edema ( also called angioedema) is one of the most dangerous manifestations of urticaria, since in the absence of timely medical intervention it can cause death.
The first sign that indicates angioedema is rapid swelling of the skin, causing the affected part of the body to increase in size. The shade of the skin remains natural, and the itching is replaced by pain and severe burning. Most often, Quincke's edema develops in the area of the cheeks, lips, mouth, genitals and other places rich in subcutaneous tissue. The most dangerous is edema, which affects the mucous tissues of the respiratory tract, as this creates an obstacle to normal breathing.
The following signs of Quincke's edema of the respiratory tract are distinguished:
- hoarse voice;
- wheezing difficulty breathing;
- bluish tint to the skin around the lips and nose;
- bouts of severe coughing that resembles barking;
- the skin on the face turns red and then quickly becomes pale.
Is hives contagious?
Urticaria falls into the category of common diseases, so many people are interested in the question of whether it is possible to catch it from another person. Since this disease is not infectious, infection from a patient is impossible even with fairly close contact. It should be noted that urticaria may be a symptom of some kind of infectious process. In this case, there is a high probability of transmission of the infectious agent from a sick person to a healthy person. But this does not mean that the infection will also manifest itself in skin rashes in an infected patient.Is it possible to swim if you have hives?
Swimming with hives is not only possible, but also necessary, since lack of normal hygiene can lead to the development of a bacterial infection. To prevent water procedures from worsening the patient’s condition, a number of rules must be followed when performing them.The following rules of water procedures for urticaria are distinguished:
- The water temperature should not exceed 35 degrees. Higher temperature water increases the permeability of blood vessels, as a result of which the rash may increase in size after a bath or shower.
- Do not use hard sponges, detergents with abrasive particles, or any other devices that may injure the skin. The best option is soft foam sponges.
- During water procedures, you should not use products that are brightly colored and/or have a strong aroma, as they contain fragrances and other chemicals that irritate the skin. It is best to use special hypoallergenic products for hives.
- The duration of any water procedure should not exceed 15 minutes. For acute urticaria, bathing time should be reduced to 5 minutes.
- After hygiene procedures, you should blot the moisture from the skin with a soft natural towel, and then apply a medicinal ointment or other external product used by the patient.
- If there are manifestations of a secondary bacterial infection on the skin ( ulcers) taking a bath is prohibited. In this case, the patient should take a quick shower, trying not to touch areas with ulcers.
How long does hives last?
The duration of urticaria can vary from 2 – 3 days to several years. The duration of the disease is individual for each individual patient and depends on the type of skin disease and the characteristics of the patient. For example, in acute pathology, a rash may appear and disappear without a trace in 1 to 2 days. Most often, urticaria goes away so quickly in young children, in whom the common cause of the disease is a food allergen. As soon as the product is removed from the diet, after a few hours the rashes disappear.In adult patients, the acute form of urticaria, as a rule, has a longer course, and skin changes can last up to one and a half months. The fact is that in adults it is quite difficult to identify the cause of the pathology and therefore difficulties arise in eliminating the factor that provokes the disease.
If the symptoms of the disease do not go away after a month and a half, the disease is defined as chronic, which can last from several months to 5 ( and sometimes more) years. The duration of the chronic form depends on the state of the patient's immune function, the lifestyle he leads and other general factors.
Complications and consequences of urticaria
Urticaria, like any other disease, can cause various complications that manifest themselves in both physical and mental health.There are the following consequences that urticaria can lead to:
- Quincke's edema. The most dangerous consequence of this pathology is Quincke's edema, which affects the larynx, since in this case there is an obstacle to the respiratory process. In the absence of timely medical attention, swelling can cause death.
- Bacterial infection. A common consequence of hives is a bacterial infection that develops in the rash-affected areas of the skin. Most often, this complication develops in acute forms of the disease, when pronounced large blisters appear on the patient’s body. Due to the addition of a bacterial process, ulcers and boils appear on the patient’s skin, which can be painful.
- Depression. Emotional disturbances occur in approximately 15 percent of adult patients who suffer from chronic urticaria. The cause of depression is poor sleep, as severe night itching prevents the patient from getting enough sleep. In addition, blisters are a cosmetic defect, which negatively affects the patient’s self-esteem and entails emotional distress.
Urticaria in children
Children are no less likely than adults to suffer from urticaria. Thus, from 5 to 7 percent of school-age children suffer from some form of urticaria. In early childhood ( up to 2 – 3 years) predominantly acute urticaria predominates. Both acute and chronic urticaria occur in children from 3 to 13 years of age. Regarding infants ( up to a year), then in them urticaria is a common cause of urgent ( urgent) states. For this reason, they are often hospitalized in the hospital. As a rule, acute urticaria is observed in children with atopy ( predisposition to allergic reactions). Studies have shown that one in five children admitted to hospital with acute urticaria also suffers from atopic dermatitis. More than half of hospitalized children have other allergic reactions.
Symptoms of urticaria in children
The key symptom of childhood urticaria is a blistering rash on the skin. When an allergen enters the body, a lot of histamine begins to be produced, which causes the vascular walls to become fragile. As a result, a lot of fluid accumulates in the skin, swelling develops and blisters appear. In complicated forms of urticaria, skin changes may be supplemented by symptoms from the respiratory, digestive or other body systems.Features of skin changes in urticaria
Skin rashes in children with urticaria occur suddenly and are not accompanied by any preliminary symptoms. Blisters appear on the child’s body, rising above the skin, which can be of a distinct pink or red hue. Most often, rash elements appear in skin folds or areas where the skin comes into contact with clothing. Blisters may also appear on the buttocks, inside the elbows and knees, and on other parts of the body. With gentle pressure, a dense white nodule appears in the center of the blister. A characteristic feature of urticaria rashes is severe itching, which causes the child to scratch the skin. This leads to the fact that the blisters begin to increase in size, and red crusts form on their surface.
There are the following distinctive signs of urticaria rash in children:
- a skin rash appears suddenly and also disappears abruptly;
- on a specific area of the body, blisters last no more than 2 hours ( in rare cases up to 2 days), after which they may appear in another place;
- with strong scratching, the elements of the rash can merge, forming large continuous blisters;
- the swellings have an irregular shape, but their edges are clearly defined;
- after the rash disappears, there are no scars, pigmentation or any other marks left on the skin.
Urticaria in infants
Urticaria in infants ( children under one year of age) is common. According to statistics, approximately 20 percent of young patients experience this pathology, while the disease is much more common in girls.Causes of urticaria in infants
In most cases, the appearance of a rash characteristic of urticaria in children is associated with exposure to a food allergen, which is the food included in the diet of a child or a nursing mother. A common concomitant factor is various infectious diseases, which occur in approximately 60 percent of infants suffering from urticaria. There are other reasons that can trigger this disease in children under one year of age.
The following causes of urticaria in infants are distinguished:
- physical factors (heat or cold, dry air, synthetic fabrics, friction from the diaper);
- chemical substances (cosmetics and baby skin care products, washing powders and fabric softeners);
- medicines (antibiotics, anti-inflammatory drugs, vitamins);
- air components (dust, pollen, tobacco smoke, fluff);
- insect bites (mosquitoes, bedbugs, bees).
The key symptom of this disease is small itchy blisters that are bright red in color. Despite their small size, blisters appear in large numbers, forming large continuous rashes on the child’s body. Most often the rash appears on the face ( chin and cheeks), arms, shoulders, back, buttocks. The rash migrates throughout the body, disappearing within 2 to 3 hours from one area and appearing in another place. In some cases, blisters may remain on the skin for 2 days. The rash usually appears 1 to 2 hours after contact with the allergen.
In addition to skin changes and itching, urticaria in infants may be accompanied by other symptoms. Children lose their appetite, their skin becomes dry, and they may develop diarrhea or vomiting. Due to itching, the child becomes restless and whiny, sleeps poorly, looks apathetic and lethargic.
Treatment of urticaria in infants
Urticaria in infants rarely becomes chronic and usually goes away within 2 to 3 days. Treatment of this pathology involves eliminating the factor that initiates the appearance of the rash. Medications may also be prescribed to reduce itching and strengthen the child’s general condition.
Therapy for urticaria in infants includes the following:
- Eliminating the allergen. If any food product is the causative agent of the disease, it must be excluded from the diet of the child and mother ( if she is breastfeeding). You should also remove foods that may cause cross-allergy. If the cause of urticaria is a non-food allergen, the child must be provided with conditions that will prevent contact with this substance/factor.
- Cleansing the body. Sometimes, in cases where hives are the result of a food allergy, the child is prescribed a cleansing enema. This is necessary in order to speed up the process of removing the disease provocateur from the body.
- Use of medications. For urticaria, non-hormonal ointments are indicated that reduce itching, soften and nourish children's skin. For severe rashes, which are characteristic of a severe form of the disease, antihistamines may be prescribed ( usually taken before bed to help ensure your baby has a comfortable night's rest). Some children are advised to take sorbents and/or drugs intended to normalize intestinal function.
- Dieting. A special diet is indicated for all children with urticaria ( and mothers, if their child is breastfed) regardless of what factor is the cause of the disease. The diet allows you to reduce the amount of histamine released in the body, as a result of which the symptoms of the disease appear less intense.
Types of urticaria
In addition to acute and chronic urticaria, there are other types of this disease. The most common type of urticaria is photodermatitis, which is popularly called solar urticaria or sun allergy. Cold urticaria is no less common. Types of urticaria include:
- solar urticaria;
- cold urticaria;
- aquagenic urticaria;
- food urticaria;
- dermographic urticaria;
- urticaria due to stress;
- cholinergic urticaria.
Solar urticaria
Solar urticaria is caused by rashes and blisters on the skin caused by exposure to direct sunlight. This pathology is diagnosed in one fifth of the adult population, which allows it to be classified as a common disease. Most often, episodes of solar urticaria are detected in female patients.Symptoms of solar urticaria
Signs of urticaria appear after a person prone to this disease has been exposed to sunlight for 15 to 20 minutes. With less prolonged exposure, as a rule, a rash does not occur. The longer the patient was exposed to the sun, the more pronounced the symptoms. The blisters characteristic of solar urticaria are small in size and, most often, do not exceed a few millimeters in diameter. In rare cases, when the patient has been under the sun for a long time, individual elements of the rash can increase up to 1 - 2 centimeters.
The blisters in solar urticaria are pink in color and outlined with a red line at the edges. As with other forms of this disease, the rash is accompanied by severe itching. These elements appear on the skin a few minutes after exposure to the sun and disappear a few hours after stopping contact with the sun's rays. The localization zone of the rash is those areas of the body that are not protected by clothing. Also, skin symptoms of solar urticaria may appear on those areas of the skin that are covered with thin fabrics such as chiffon.
In addition to the rash, this pathology may be accompanied by other symptoms, which do not develop as often.
The following symptoms of solar urticaria are distinguished:
- temperature increase;
- feeling of lack of air;
- nausea, vomiting;
- general malaise.
The symptoms of solar urticaria are caused by substances that increase the skin's sensitivity to sun exposure ( photosensitizers). Today, medicine distinguishes between internal and external factors that can provoke this disease.
External factors include various chemical components present in cosmetic, medicinal and care products that are applied to the skin. These can be anti-sweat deodorants, creams with a moisturizing or nourishing effect, products for problem skin. Some types of perfume products can also cause solar urticaria ( especially those containing lavender, vanilla or sandalwood essential oil). The difference between a rash that occurs due to external factors is its clear outline.
Internal causes of solar urticaria include toxic substances that are formed in the body due to dysfunction of certain organs. This pathology can be caused by diseases of such organs as the kidneys, liver, and thyroid gland. Another category of internal causes of solar urticaria are medications.
There are the following medications that can cause solar urticaria:
- non-steroidal anti-inflammatory drugs;
- tetracycline antibiotics;
- oral contraceptives;
Cold urticaria
Cold urticaria appears as blisters on the skin that occur after a person has been exposed to cold temperatures. This pathology is diagnosed in patients of different genders and ages, but is most often found in middle-aged females. Factors that provoke the appearance of a rash can be various natural phenomena ( snow, rain, cold air). Symptoms of cold urticaria can also be caused by eating cold food or drinks, drafts, cold showers, or other circumstances that cause a sharp drop in body temperature.Symptoms of cold urticaria
The key symptom of cold urticaria is an itchy rash. Depending on the time of appearance of skin changes, immediate and delayed forms of cold urticaria are distinguished. In immediate urticaria, the rash appears almost immediately after exposure to cold. In the delayed type of the disease, blisters appear 9 to 10 hours after exposure to the cold factor.
The sizes of the formations can vary - from small flat blisters to solid spots covering large areas of the skin. Just as with other forms of urticaria, skin changes are accompanied by severe itching. Elements of a rash appear on those areas of the skin that come into contact with a cold irritant ( cheeks, arms, neck). In addition, blisters can appear under the knees, on the inner thighs, and on the calves. If large areas of skin are exposed to cold or contact with cold is prolonged, other symptoms may appear in addition to the rash.
Causes of cold urticaria
Modern medicine currently does not have specific facts regarding the causes of cold urticaria. One of the most common versions is the assumption that the disease develops due to a hereditary abnormality in the structure of proteins in the human body. Due to a defect, under the influence of cold, the protein forms a certain structure, which the immune system begins to perceive as a foreign body. Cold urticaria develops as a result of the immune system's response.
Aquagenic urticaria
Aquagenic urticaria is a type of urticaria in which symptoms characteristic of the disease appear in the patient after contact with water. This form is one of the rarest and is most often detected in adult patients. Experts also call this disorder water allergy. A feature of this form of urticaria is its tendency to progress, that is, as the disease progresses, the symptoms become more pronounced and occur more and more often.Causes of aquagenic urticaria
Aquagenic urticaria is caused by various forms of moisture that enter the human skin or mucous membranes. It should be noted that the pathological reaction is provoked not by water, but by the chemical compounds present in it. Rashes may appear after contact with tap or sea water, rain, or snow. There are cases where the cause of aquagenic urticaria was the patient's own sweat. The disease can be provoked by either a single type of liquid or any form of water, which significantly reduces the patient’s quality of life. At the moment, experts have identified several factors that may be the cause of the body’s inadequate reaction to water.
There are the following causes of aquagenic urticaria:
- weakened immune system ( most often due to medications that suppress immune function);
- chronic liver and/or kidney diseases;
- Deficiency of class E immunoglobulin in the body.
The symptoms of aquagenic urticaria have some differences from the symptoms of other forms of this disease. Upon contact with water, itching begins in the contact areas, which intensifies over time. In some patients, itching is the only symptom. In other patients, after some time a rash may appear on the skin, which takes the form of red, painful spots that visually resemble burn marks. If the entire body has been in contact with moisture ( for example, when swimming), elements of the rash appear in places with the highest sensitivity, namely on the inside of the knees and elbows, neck, and inner thighs. Aquagenic urticaria is often accompanied by severe dry skin, which increases itching. Due to loss of elasticity, cracks appear on the skin, which are entry points for infection. Other manifestations of aquagenic urticaria include cough, headache, and redness of the mucous membrane of the eyes.
Food urticaria
Food urticaria is a disorder that is the body's response to a food product. This pathology most often occurs in infants during the period of introducing complementary foods. Often older children also suffer from food urticaria. In adult patients, this type of urticaria is rare and most often occurs in a chronic form against the background of chronic diseases of the digestive tract.Symptoms of food urticaria
In children, food-borne urticaria appears as small, bright red blisters that are very itchy. Food-borne urticaria, more often than all other forms of this disease, is accompanied by angioedema, which in most cases develops in adult patients. As a rule, the patient's lips, larynx, and cheeks swell.
A common manifestation of food-borne urticaria is dysfunction of the digestive tract, which is equally common in both children and adults. Patients complain of discomfort in the abdomen ( sometimes severe pain), diarrhea, vomiting, and nausea may occur.
Causes of food urticaria
In modern medical practice, there are a number of food products that belong to the group of obligate ( traditional) allergens, that is, those products that most often provoke food urticaria. A patient may have an allergic reaction to one specific food or several different foods.
The following traditional food allergens are distinguished:
- whole cow's milk;
- chicken eggs;
- honey and beekeeping products;
- nuts;
- citrus;
- berries, fruits, red vegetables ( strawberries, apples, tomatoes, bell peppers).
Dermographic urticaria
Dermographic urticaria ( dermographism) is a type of urticaria in which scar-like blisters appear on the patient's skin due to mechanical stress. A characteristic feature of this disorder is the sudden onset and rapid disappearance of symptoms. Often, patients with dermographism experience self-healing.Symptoms of dermographic urticaria
The main sign of dermographism is linear blisters that appear after any mechanical impact has been applied to the patient’s skin. The role of irritant most often is the elements of the wardrobe ( a tight shirt collar, a tightly tightened belt buckle). Depending on the time of appearance of blisters, immediate and delayed dermographism are distinguished. In the first type of urticaria, blisters appear immediately after pressure is applied to the skin. In delayed dermographism, skin symptoms occur only after prolonged skin irritation.
The blisters that occur with dermographic urticaria are light in color, and the color of the surrounding skin can vary from pink to dark red. There is also a form of dermographism that appears exclusively as white lines on the skin, with no signs of redness. Linear blisters swell and therefore rise significantly above the surface of the skin.
A consistent symptom for all forms of dermographic urticaria is severe itching, which intensifies as night falls. In most cases, with an increase in body or environmental temperature, itching and other symptoms of dermographic urticaria appear more intensely. Deterioration of the general condition and symptoms from other organs with this dermographism are extremely rare.
Causes of dermographic urticaria
At the moment, there are no specific factors that can be indicated as causes of dermographic urticaria. At the same time, experts note that there are a number of circumstances that increase the likelihood of developing this pathology.
The following factors contribute to dermographism:
- heredity;
- pathologies of the thyroid gland;
- ulcerative lesions of the digestive tract;
- emotional and/or physical exhaustion.
Urticaria due to stress
Often, due to stress, people develop rashes on the skin characteristic of hives, which are also accompanied by itching. This pathology is called psychogenic or neurogenic urticaria.Symptoms of neurogenic urticaria
Psychogenic urticaria is characterized by large blisters that merge with each other, covering large areas of the body. Individual elements of the rash have an oval or round shape, but when they are combined, the formations acquire smooth polygonal outlines. The color of the blisters can vary from white to pink, and in some cases the blisters can be two colors ( white in the center and pink around the edges). A mandatory symptom of neurogenic urticaria is intense itching.
In some cases, some time after the appearance of the rash, patients develop angioedema, which most often affects the larynx or the mucous membrane of the digestive tract. When the larynx is swollen, the patient experiences pain in the throat, it is difficult for him to breathe, speak and swallow food. If the swelling spreads to the organs of the digestive tract, the patient experiences vomiting, nausea, and pain in the navel and lateral abdomen. Stool disorders in the form of diarrhea may also be present.
Causes of psychogenic urticaria
When a person is in a state of stress, the body begins to distortly perceive the impulses that the nervous system produces. Under the influence of irritating factors, blood vessels dilate, and the permeability of their walls increases and a lot of fluid begins to flow into the tissue. All this leads to the formation of blisters on the skin, which are accompanied by severe itching.
Most often, neurogenic urticaria is diagnosed in women and adolescent patients.
People who are prone to this pathology have some common character traits. Thus, such patients are distinguished by irritability and hot temper, emotional instability and are often in a state of nervous exhaustion. The appearance of symptoms of psychogenic urticaria is facilitated by such external factors as excessive physical or mental stress, conflicts in the family or at work, intrapersonal problems ( especially typical for teenagers). The high-risk group includes people who have impaired functionality of the digestive tract, genital organs, and cardiovascular system.
In the treatment of neurogenic urticaria, an important role is played by the elimination of factors that act as provocateurs of stress. In the absence of competent medical care, this disease becomes chronic ( most often in adult patients).
Cholinergic urticaria
Cholinergic urticaria is a type of urticaria that occurs when the skin is exposed to high temperatures, stress, and increased sweating. As a rule, such urticaria occurs when a person gets nervous or spends a long time in the sauna.The development of this urticaria is based on the body’s increased sensitivity to acetylcholine ( hence the name of urticaria - cholinergic). Acetylcholine is the main transmitter of the parasympathetic nervous system, which takes part in neuromuscular transmission. A sudden release of a large amount of acetylcholine into the blood leads to the appearance of itchy spots and blisters on the skin, which is a manifestation of cholinergic urticaria. A synonym for chronic urticaria is the term pruritic dermatosis.
Cases where there is increased production of acetylcholine include:
- stress;
- emotional stress ( fright, fear);
- prolonged stay in a sauna, steam room or in the sun.
Manifestations of cholinergic urticaria
The main symptom of this type of urticaria is a skin rash. As a rule, it is represented by small itchy blisters that appear 5 to 10 minutes after exposure to a traumatic factor. The rash primarily appears on the neck, upper chest and arms. The duration of the rash is very variable - it may last only a few minutes and quickly disappear. But it can also persist for several hours. Sometimes the rash may not appear at all or may be so small that the patient may not notice it. In this case, the main symptom is severe itching that appears after taking a hot shower or after visiting a sauna.
Cholinergic urticaria is typical for people with a predisposition to allergies. It also often accompanies diseases such as gastritis, hepatitis and other pathologies of the gastrointestinal tract. In these diseases, there is an increased sensitivity to acetylcholine, which determines the pathogenesis ( formation mechanism) urticaria.
Chronic ( idiopathic) urticaria
Chronic urticaria is urticaria, the manifestations of which do not disappear for more than a month and a half. As a rule, the causes of such urticaria are unknown, which is why it is called idiopathic. Chronic idiopathic urticaria is the most common skin disease. On average, the duration of the chronic form is from 3 to 5 years. Among children, chronic urticaria is rare and does not exceed one percent of all diagnosed cases of this disease. Among the adult population, the chronic form accounts for about 40 percent of all identified episodes of urticaria. Women are more susceptible to this disease than men. Depending on the regularity of the rash, a distinction is made between permanent and recurrent forms of chronic urticaria. With a permanent type of disease, blisters practically do not disappear from the skin, while for a recurrent type of disease, periods of remission are characteristic ( time for the rash to completely disappear).
Symptoms of chronic urticaria
In chronic urticaria, as in the case of the acute form, the key symptom is a rash, represented by blisters of various shapes and sizes.The following features of the rash in chronic urticaria are distinguished:
- chronic urticaria is characterized by a rash that is not as profuse as in the acute form of the disease;
- blisters rise above the surface of the skin, have a flat shape and clearly defined edges;
- visually, the elements of the rash resemble marks from insect bites, and their diameter can vary from a millimeter to several centimeters;
- At first, the blisters are pink or red in color, but become lighter over time;
- the skin rashes are itchy and can form large solid formations;
- the rash appears spontaneously, without obvious reasons;
- in some cases, the appearance of blisters is preceded by factors such as climate change, various colds, and exposure to stress.
Urticaria during pregnancy, after childbirth and during lactation
Urticaria during pregnancy or after childbirth occurs due to hormonal imbalance in a woman’s body. The disease can be contributed to by lack of proper rest, emotional stress and other similar factors that women who are pregnant or have given birth to a child often face. Weakened immune function is also a common cause of urticaria in this category of patients. Manifestations of urticaria during pregnancy or after childbirth
Urticaria during pregnancy is manifested by rashes, which in most cases first appear on the abdomen. The blisters then spread to the thighs, buttocks and other parts of the body. After childbirth, the initial elements of the rash do not necessarily appear on the stomach. Along with the rash, the woman begins to be bothered by severe itching, which is subsequently accompanied by symptoms such as irritability, sleep problems, and weakness. Often, urticaria during pregnancy transforms into a chronic form.Many women are interested in whether urticaria during pregnancy poses any danger to the fetus. This pathology does not pose a direct threat to the child. Disorders of the nervous system can negatively affect the development of the embryo ( nervousness, irritability) that accompany urticaria.
