“urticaria allergy -what to do for hives”

The red welts of hives happen when mast cells in the bloodstream release the chemical histamine, which causes tiny blood vessels under the skin to leak. The fluid pools within the skin to form spots and large welts. This can happen for a number of reasons, but in many cases a cause is never identified.
Cholinergic urticaria is a common physical urticaria that is caused by sweating. It is sometimes referred to as heat bumps, as the rash appears as very small (1-4mm) weals surrounded by bright red flares.
For some, the culprit is obvious—they’ll eat a peanut butter cookie, for example, and immediately break out in a rash. For others, it’s not so cut and dry; symptoms can take several hours to develop. Either way, make an appointment with your doctor if you suspect you have a food allergy. Dr. Jaliman says you’ll likely be put on an elimination diet where you reintroduce one potentially triggering food every week. “Let’s say you’re not eating any of the hives foods and then you add back shellfish and you get the hives again. Then you can pretty much figure it out,” Dr. Jaliman says. After you determine the culprit, nix it from your diet to prevent mild symptoms from becoming chronic. Dr. Jaliman says you’ll likely be prescribed an EpiPen—if you accidentally ingest a trigger food, you could get hives in your throat, which can be dangerous. 
Food allergies such as allergies to nuts, strawberries, citrus fruit, egg, food additives, spices, chocolate, or shellfish. Sometimes you can develop an allergy to a food even if you have eaten it without any problem many times before.
Urticaria may be classified on the basis of underlying aetiology (see Table 1) or by a clinical classification. In most cases of chronic urticaria it will not be possible to identify the underlying cause, i.e. the rash is idiopathic; however, when seeing a patient, it is helpful to use a clinical classification, as this guides history-taking and ensures that in any one individual all possible triggers for the urticaria are identified. In some patients several factors may cause/worsen the rash.
Regardless of what causes your hives, most people find that OxyHives eliminates their hives symptoms and outbreaks faster than any other medication on the market. Please see our treatment options page for more information.
1. Mint juice in small quantity of water without any additives to be taken twice a day. In winter, mint leaves can be boiled, water thereafter can be drunk. 2. 5 Gms of Soda Bicarbonate (cooking soda) dissolved in ordinary water at room temperature, can be applied to affected areas.
Other common causes are food, medication, chemicals such as acetone, a polymer such as latex, an viral, fungal, or bacterial infection, pet hair or dander, plants, and physical stimuli such as pressure, temperature, and sun exposure.[5]
raised circular weals that look like mosquito bites – these are red on the outer rim and white in the centre, and each weal lasts for around two to four hours (rarely up to 24 hours). Weals appear in batches or clusters, and as one batch fades away as a new batch appears
Take quercetin. Quercetin can also be effective in reducing inflammation and swelling. It is a flavonoid produced in the body from rutin.[18][19] Eat more fruits and vegetables, such as apples, citrus fruits, onions, sage, parsley, dark cherries, grapes, blueberries, blackberries, and bilberries, to get more quercetin in your diet. You can also drink more tea and red wine or use more olive oil to increase your intake of it. You can take quercetin as a dietary supplement as well.[20]
Yet another consideration is if you have an allergy to latex because a number of foods are known to produce a cross-reaction. Foods on this list include avocado, bananas, chestnuts, kiwi, and passion fruit.
Most weals disappear without a trace within a few hours, only to be replaced by a new one elsewhere on the skin. Weals that persist in exactly the same spot for more than 24 hours may indicate a different disorder known as urticarial vasculitis. 
The skin is the body’s largest organ, so it’s not uncommon for a variety of other medical conditions to affect it and this may result in hives. For instance, people with cancers like lymphoma may be prone to hives, as are those dealing with carcinomas (skin cancer).​
Infections and Infestations: Insect bites, frequent fungal and bacterial infections of the urinary tract, viral infections like hepatitis, worm infestations such as tapeworms and round worms can cause acute allergies.
Some people react to anything that makes them hot or sweaty with hives. This can be sunlight, exercise, hot baths, blushing or anger. These are tiny intensely itchy hives with a big red blotch around them and are called cholinergic urticarial.
If non-sedating antihistamines are not effective, a 4 to 5-day course of oral prednisone (prednisolone) may be warranted in severe acute urticaria, particularly if there is angioedema. Systemic steroids do not speed up resolution of symptoms.
Today, more research is being conducted on the connections between urticaria and stress. For example, some research is focusing on the relationship between stressful life events and the onset or exacerbation of chronic idiopathic urticaria; others are looking at ways to improve chronic urticaria using hypnosis and relaxation techniques. And new research is even looking at the relationship between post-traumatic stress disorder and the incidence and severity of chronic idiopathic up ^ Moore-Robinson, Miriam; Warin, Robert P. (1968). “Some Clikical Aspects of Cholhstergic Urticaria”. British Journal of Dermatology. 80 (12): 794–9. doi:10.1111/j.1365-2133.1968.tb11948.x. PMID 5706797.
These red areas will usually appear small, but can easily multiply and singular welts join together forming rashes. The area affected will be slightly elevated with a blanched center, especially when you press down your finger on the area of the rash. It is estimated that 20% of people will experience urticaria at some point in their lives. While it is common for the appearance of welts to form on the skin during an allergic reaction, it is also important to note that they can occur internally, which is why it is so important to speak to a doctor immediately, especially if you are unaware as to the cause of the reaction.
To know exactly what kind of hives one has, or to learn more about research into the immune basis of hives or about rarer forms of this condition, consult a physician. It is important, however, to keep in mind that most cases of urticaria are annoying, not serious, and almost always temporary.
In general, if an allergic reaction causes hives or swelling, it is usually ingested (food, oral drug) or injected (drugs, stings). If an allergen can penetrate the skin locally, hives will develop at the site of exposure. For example, contact urticaria may occur following exposure to latex gloves if sufficient latex penetrates through the skin.
Simply put, external stressors plus cognitive, behavioral and social stressors have been shown to play a significant role in the intensity of itch, often providing an ever greater correlation than the actual dermatologic disease severity, according to Dr. Howard.

“heat induced urticaria _urticaria water”

Kalogeromitros D, Kempuraj D, Katsarou-Katsari A, Gregoriou S, Makris M, Boucher W, et al. Theophylline as “add-on” therapy in patients with delayed pressure urticaria: a prospective self-controlled study. Int J Immunopathol Pharmacol. 2005 Jul-Sep. 18(3):595-602. [Medline].
It can be easy to mistake hives for other disorders because the allergy triggers can be difficult to find. Another problem with diagnosing hives is that the symptoms are relatively generic — red, itchy welts on your skin are a common symptom among many skin disorders.
The immune system normally protects us by making antibodies against foreign invaders such as bacteria and viruses. These antibodies are called IgG and are often referred to as gammaglobulins. Usually, IgG is not formed to any normal body tissue but occasionally, by error, this does happen. If antibody binds to normal tissues it can cause damage to the body or create other disease symptoms. Rheumatoid arthritis is a good example of an autoimmune disease. Antibodies that react with body tissues are felt to contribute to joint swelling and pain. Many other common diseases are caused by autoimmunity such as juvenile diabetes and low thyroid disease.
C1q is an integral component within the complement pathway – a complicated cascade of protein interactions, culminating in an immune response against a broad variety of pathogens. The anti-C1q antibodies found in patients with hypocomplementemic urticarial vasculitis activate C1q, which instigates activation of the entire complement pathway. Consequently, levels of all complement proteins become low.
Codeine and other opiate-derived medications can cause degranulation of mast cells by stimulation of opiate receptors. Urticaria and angioedema can result from agents that alter the metabolism of arachidonic acid, such as aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). These responses to NSAIDs have the potential to be fulminant with generalized hives and swelling. Angiotensin-converting enzyme inhibitors (ACEIs), drugs used to treat hypertension, (eg, Captopril) can cause recurrent episodes of angioedema, but urticarial skin lesions are not observed. Because ACE normally inactivates bradykinin, the angioedema is thought to be due elevated bradykinin levels causing dilation and leaking of vessels in deep layers of the skin. This is the most common cause of angioedema seen in emergency rooms. Tongue, throat and laryngeal swelling can be extremely severe and intubation may be necessary. The swelling resembles that seen in hereditary or acquired C1 inhibitor deficiency where bradykinin is also the mediator of swelling.
Once a diagnosis of urticarial vasculitis is made, follow-up care depends on the patient’s complement levels. If complement level findings are normal, follow patients for symptoms and response to treatment. If complement level findings are low, follow patients for attendant complications related to the cause of their hypocomplementemia (see History).
The reported adverse effects related to biological agents used for the treatment of rheumatic diseases in Turkey / Romatizmal Hastaliklarin Tedavisinde Biyolojik Ajanlarin Kullanimina Bagli Turkiye’de Bildirilmis Yan Etkiler
That said, no two people respond to stressful events in the same way either. What may be a source of emotional excitement for you may cause fear for a friend. For instance, you may love to skydive on your weekend while your best friend cringes even thinking about flying in an airplane. That’s because we all perceive and respond to stressors differently. Again, it’s the inappropriate responses that influence your health and may influence your allergy symptoms.
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Chronic idiopathic urticaria is the most common type of CU, comprising up to 90% of all cases of CU. It has been estimated that chronic idiopathic urticaria will affect between 0.6% to 5% of the population during their lifetime. Over half of all cases of chronic idiopathic urticaria are thought to be caused by an autoimmune mechanism. This is supported by the observation that 60% of patients with chronic idiopathic urticaria will have a wheal and flare reaction to intradermal autologous serum injections in the autologous serum skin test (ASST). Approximately 50% of patients with chronic idiopathic urticaria have IgG antibodies that are specific for the high affinity IgE receptor (FcεRI). These autoantibodies activate mast cells in the skin, circulating basophils, and the complement system.  Additional immunological abnormalities described to play a causative role in CU include IgG antibodies directed against IgE antibodies and the low affinity IgE receptor (FcεRII), antiendothelial antibodies, and complement C8 alpha-gamma (C8α-γ) deficiency.
Examination of the head should note any swelling of the face, lips, or tongue; scleral icterus; malar rash; tender and enlarged thyroid; lymphadenopathy; or dry eyes and dry mouth. The oropharynx should be inspected and the sinuses should be palpated and transilluminated for signs of occult infection (eg, sinus infection, tooth abscess).
Asthma drugs with antihistamines. Medications that interfere with the action of leukotriene modifiers may be helpful when used with antihistamines. Examples are montelukast (Singulair) and zafirlukast (Accolate).
Asthma triggers are substances, conditions or activities that lead to symptoms of asthma.Asthma symptoms include difficulty breathing, coughing, wheezing and shortness of breath. These symptoms can…
Widespread hives usually are a reaction to a viral infection. Less commonly they are an allergic reaction to a food, medicine or bee sting. Often the cause is not found (more than 30%). Hives on just one part of the body (localized) are usually due to skin contact with plants, pollen, food, or pet saliva. Localized hives are not an allergy and not caused by drugs, infections, or swallowed foods. Hives are not contagious.
In many cases, mild hives won’t need treatment and will go away on their own. If a definite trigger is found, avoiding it is part of the treatment. If the hives feel itchy, the doctor may recommend an antihistamine medicine to block the release of histamine in the bloodstream and prevent breakouts.
To know exactly what kind of hives one has, or to learn more about research into the immune basis of hives or about rarer forms of this condition, consult a physician. It is important, however, to keep in mind that most cases of urticaria are annoying, not serious, and almost always temporary.
Pressure-induced urticaria typically occurs 4-6 hours after pressure has been applied. Patients may complain of swelling secondary to pressure with normal-appearing skin (i.e., no erythema or superficial infiltrating hive), so that the term angioedema is more appropriate. Others are predominantly urticarial and may or may not be associated with significant swelling. Symptoms occur about tight clothing; the hands may swell with activity such as hammering; foot swelling is common after walking in patients with normal heart function; and buttock swelling may be prominent after sitting for a few hours.
Histamine is the ligand for 2 membrane-bound receptors, the H1 and H2 receptors, which are present on many cell types. The activation of the H1 histamine receptors on endothelial and smooth muscle cells leads to increased capillary permeability. The activation of the H2 histamine receptors leads to arteriolar and venule vasodilation. [3, 4, 5] This process is caused by several mechanisms as follows:
Urticarial weals can be a few millimetres or several centimetres in diameter, coloured white or red, with or without a red flare. Each weal may last a few minutes or several hours, and may change shape. Weals may be round, or form rings, a map-like pattern or giant patches.
Taking care of yourself means giving yourself the tools you need to better manage stress in your life. Take steps to make sure you are eating a healthy diet and getting enough sleep. When you eat unhealthy foods or go through your day on just a few hours of sleep, your ability to deal with stress decreases.
For some, the culprit is obvious—they’ll eat a peanut butter cookie, for example, and immediately break out in a rash. For others, it’s not so cut and dry; symptoms can take several hours to develop. Either way, make an appointment with your doctor if you suspect you have a food allergy. Dr. Jaliman says you’ll likely be put on an elimination diet where you reintroduce one potentially triggering food every week. “Let’s say you’re not eating any of the hives foods and then you add back shellfish and you get the hives again. Then you can pretty much figure it out,” Dr. Jaliman says. After you determine the culprit, nix it from your diet to prevent mild symptoms from becoming chronic. Dr. Jaliman says you’ll likely be prescribed an EpiPen—if you accidentally ingest a trigger food, you could get hives in your throat, which can be dangerous. 
Past medical history should include a detailed allergy history, including known atopic conditions (eg, allergies, asthma, eczema) and known possible causes (eg, autoimmune disorders, cancer). All drug use should be reviewed, including OTC drugs and herbal products, specifically any agents particularly associated with urticaria (see Table: Some Causes of Urticaria). Family history should elicit any history of rheumatoid disease, autoimmune disorders, or cancer. Social history should cover any recent travel and any risk factors for transmission of infectious disease (eg, hepatitis, HIV).
The purpose of this review is to discuss the association of CU with thyroid disease and other autoimmune diseases, as well as the implications that these associations hold for therapeutic intervention in CU.
We thank Dr Helen Griffiths (Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, UK) for the use of Fig. 1, and Dr M. Yousuf Karim (Frimley Park Hospital, Portsmouth Road, Frimley, Camberley, Surrey, UK) for the use of Fig. 3.
37. Sabroe RA, Fiebiger E, Francis DM, et al. Classification of anti-FcepsilonRI and anti-IgE autoantibodies in chronic idiopathic urticaria and correlation with disease severity. J Allergy Clin Immunol. 2002;110:492–9. [PubMed]

“non itchy hives +causes of hives on body”

Hives can also be classified by the purported causative agent. Many different substances in the environment may cause hives, including medications, food and physical agents. In perhaps more than 50% of people with chronic hives of unknown cause, it is due to an autoimmune reaction.[6]
Nonthrombocytopenic purpura: Cryofibrinogenemic purpura Drug-induced purpura Food-induced purpura IgA vasculitis Obstructive purpura Orthostatic purpura Purpura fulminans Purpura secondary to clotting disorders Purpuric agave dermatitis Pigmentary purpuric eruptions Solar purpura Traumatic purpura Waldenström hyperglobulinemic purpura Painful bruising syndrome
Yao, Q., Ye, Y., Liu, X., Qin, Z., & Liu, Z. (2015). The effectiveness and safety of acupuncture for patients with chronic urticarial: A systematic review. Biomed Research International . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897793/
Weals are due to release of chemical mediators from tissue mast cells and circulating basophils. These chemical mediators include histamine, platelet-activating factor and cytokines. The mediators activate sensory nerves and cause dilation of blood vessels and leakage of fluid into surrounding tissues. Bradykinin release causes angioedema.
These types of antihistamines usually work well and do not cause drowsiness. Occasionally an older antihistamine which makes you sleepy may be useful, particularly if the itch keeps you awake at night. In this case an antihistamine such as chlorphenamine may be useful.
Insect bites and exposure to pollen can make you break out in hives, but you probably already knew that. What you may not have realized is that direct sunlight, cold temperatures, or strong winds can also bring on hives. And no, this doesn’t mean you’re allergic to the elements. “It’s really more that your skin is very sensitive,” says Marilyn Li, MD, a Los Angeles-based allergist and immunologist.
Acute – if it develops suddenly and lasts less than six weeks. Most cases last 24-48 hours. In some cases the rash only lasts a few hours. About 1 in 6 people will have at least one bout of hives in their lives. It can affect anyone at any age. Some people have recurring bouts of acute hives.
Updated by: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
If you’re wondering how to get rid of your hives at home, then we can help. We’ve created a special Top 10 Best Ways To Get Rid Of Your Hives list that is going to be exactly what you need to determine what is causing your hives and how to stop them quickly and at home with natural remedies.
Italiano: Curare l’Orticaria in Maniera Naturale, Español: tratar la urticaria naturalmente, Português: Tratar a Urticária Naturalmente, Français: traiter l’urticaire naturellement, 中文: 自然地治疗荨麻疹, Русский: лечить крапивницу природными средствами, Deutsch: Nesselausschlag natürlich behandeln, Čeština: Jak vyléčit kopřivku přírodními metodami, Nederlands: Netelroos op natuurlijke wijze behandelen, العربية: علاج الشرى بعلاجات طبيعية, हिन्दी: शीतपित्त (urticaria या hives) का इलाज प्राकृतिक रूप से करें, Tiếng Việt: Trị chứng Phát Ban, 한국어: 두드러기 자연치유하는 법, ไทย: รักษาลมพิษตามธรรมชาติ
Get away from the allergens. The first step in treating hives is to ensure you are away from the source of the allergic response. If you know what it is, which is how most cases of hives are, remove the substance that is causing the allergic reaction from your skin or environment. Common allergens that are easy to determine are poison ivy, poison oak, insect bites, wool clothing, a cat, or a dog. Avoid these or any other known allergen as much as possible.
Complement-mediated urticaria includes viral and bacterial infections, serum sickness, and transfusion reactions. Urticarial transfusion reactions occur when allergenic substances in the plasma of the donated blood product react with preexisting IgE antibodies in the recipient. Certain drugs (opioids, vecuronium, succinylcholine, vancomycin, and others) as well as radiocontrast agents cause urticaria due to mast cell degranulation through a non-IgE-mediated mechanism. Urticaria from nonsteroidal anti-inflammatory drugs (NSAIDs) may be IgE-mediated or due to mast cell degranulation, and there may be significant cross-reactivity among the NSAIDs in causing urticaria and anaphylaxis. [6]
Hives can be caused from allergens as well as physical and environmental factors such as stress, heat, sunlight or water. Untreated, the symptoms can last from a couple hours up to six weeks. As we’ll see throughout this article, many skin disorders share these causes and triggers, so close attention to detail is key when figuring out the mystery of your skin disorder.
This nonsteroidal treatment option is taken orally. These drugs should be used only after steroid treatment and antihistamines have been unsuccessful. Common side effects are headache, stomach upset, cough, and a low fever.
If you don’t think stress is causing your hives or you have tried stress relief activities and still have hives, they may be caused by something other than stress, or in addition to stress. Other causes of hives include: 
Other options for refractory symptoms of chronic hives include anti-inflammatory medications, omalizumab, and immunosuppressants. Potential anti-inflammatory agents include dapsone, sulfasalazine, and hydroxychloroquine. Dapsone is a sulfone antimicrobial agent and is thought to suppress prostaglandin and leukotriene activity. It is helpful in therapy-refractory cases[44] and is contraindicated in patients with G6PD deficiency. Sulfasalazine, a 5-ASA derivative, is thought to alter adenosine release and inhibit IgE mediated mast cell degranulation, Sulfasalazine is a good option for people with anemia who cannot take dapsone. Hydroxychloroquine is an antimalarial agent that suppresses T lymphocytes. It has a low cost however it takes longer than dapsone or sulfasalazine to work.
The information on Health24 is for educational purposes only, and is not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health advice, please consult a healthcare professional. See additional information.
[Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau A, et al. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy. 2009 Oct. 64(10):1417-26. [Medline]. [Full Text].
Clinical Context:  Hydroxychloroquine is the preferred antimalarial agent because of its low toxicity and high effectiveness profile. It is usually well tolerated if carefully monitored by the prescribing physician. Therapy is required for 4-8 weeks before evaluating effectiveness.
Both urticaria and angioedema are a result of histamine and other chemicals released from mast cells in the skin and mucous membranes. This may occur through an allergic process or one in which mast cells release chemicals without IgE being involved.
If you have a severe episode of hives then you may be referred to a specialist. Skin specialists (called dermatologists) or allergy specialists (called immunologists) may be able to help. In particular, if angio-oedema or anaphylaxis occurred at the same time, you would be referred or admitted to hospital. This is to reverse the reaction quickly. It is also to confirm the diagnosis and, where possible, to identify a cause. For example, if a nut allergy is suspected to have caused a severe then this can confirmed by tests. You may then be given advice on how to avoid the cause and on what to do if it should occur again.
Clinical Context:  Hydroxyzine antagonizes H1 receptors in the periphery. It may suppress histamine activity in the subcortical region of the CNS. Hydroxyzine can be used for symptomatic control. The recommended antihistamine for pregnant patients is diphenhydramine. Hydroxyzine has been used safely in children.
Hives are patches of puffy, red, itchy or inflamed skin also known as urticaria, and they can be caused or worsened by significant stress in your life. In fact, stress is one of the most common causes of acute hives (hives that last less than six weeks), along with infectious causes and allergies. Stress has also been known to worsen chronic hives (hives that last more than six weeks), even when the chronic hives are primarily due to another cause.
Urticaria or hives, can be allergic or also non-allergic disease. For chronic and recurring Urticaria, you need homeopathy. After all, for how long will you keep taking antihistamines? At Life Force, Dr Shah is Urticaria expert having experience of Urticaria treatment of over 2700 cases.
The experts disagree when it comes to managing stress to ease allergy symptoms. Grossan tells WebMD that after weeks of sneezing, the body’s immune system is exhausted. “Going to bed and resting can help to restore the body’s resistance and is definitely good stress-relief therapy.”
If you have chronic stress or are experiencing symptoms that interfere with your life, or are causing frequent outbreaks of hives, it might be beneficial to talk to your doctor about medical treatments for stress. There are also a number of lifestyle changes you can make to help reduce overall stress.
61. Shahar E, Bergman R, Guttman-Yassky E, Pollack S. Treatment of severe chronic idiopathic urticaria with oral mycophenolate mofetil in patients not responding to antihistamines and/or corticosteroids. Int J Dermatol. 2006;45:1224–7. [PubMed]
Theoretically, almost any drug can cause an allergic reaction (see the images below); thus, allergic reactions to a wide variety of drugs can occur. Antibiotics, such as penicillin, have been implicated most frequently. [11] Urticarial reactions to penicillin can occur as long as 14 days after a course of treatment has stopped. In this situation, serum sickness may be present.
TREATMENT FOR CHRONIC URTICARIA: I HAVE CHRONIC URTICARIA FOR 11 YEARS,I HAVE BEEN TO SEE EVERYONE AND NOTHING SEEMS TO WORK .THE ONLY TIME I WENT IS WHEN I WAS IN INTENSIVE CARE BUT I CANT SLEEP FOREVER! ANY SUGGESTIONS, YOURS ITCHINGLY LEE GILLOTT
After the first outbreak of hives which were accompanied by an intense itch, Vicki tried to figure out the cause of her hives, with little success. “I was at my wit’s end. I didn’t know what I was going to do. I stopped drinking red wine, I changed soap, and I submerged my hands in bowls of ice water. I started avoiding things that I thought were causing the hives.
Infections and Infestations: Insect bites, frequent fungal and bacterial infections of the urinary tract, viral infections like hepatitis, worm infestations such as tapeworms and round worms can cause acute allergies.

“yurtcraft -pictures of cholinergic urticaria”

When my son came in contact with caterpillars he would break out in giant hives all over his body. THANK GOD FOR THE SASAFRASS TREE!!! I would make him a cup of tea and within 30 minutes the hives disappeared completely when Benadryl never did. Can be bought at your local grocers.
Skin examination should note the presence and distribution of urticarial lesions as well as any cutaneous ulceration, hyperpigmentation, small papules, or jaundice. Urticarial lesions usually appear as well-demarcated transient swellings involving the dermis. These swellings are typically red and vary in size from pinprick to covering wide areas. Some lesions can be very large. In other cases, smaller urticarial lesions may become confluent. However, skin lesions also may be absent at the time of the visit. Maneuvers to evoke physical urticaria can be done during the examination, including exposure to vibration (tuning fork), warmth (tuning fork held under warm water), cold (stethoscope or chilled tuning fork), water, or pressure (lightly scratching an unaffected area with a fingernail).
[Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau A, et al. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy. 2009 Oct. 64(10):1417-26. [Medline]. [Full Text].
Acute urticaria is most often a benign, self-limited skin disease. It usually occurs independently, but it may contribute to the more serious clinical manifestations of anaphylaxis: angioedema and anaphylactic shock. The etiologies of both acute and chronic urticaria are numerous (see Causes in Presentation). The etiologic agent is more likely to be identified in acute urticaria (40-60%) than in chronic urticaria (10-20%). The lesions of IgE-mediated urticaria usually last less than 24 hours and are often migratory, leaving no residual skin abnormalities. The lesions of urticarial vasculitis usually last longer, classically, but not always, longer than 24 hours. [8] They are both painful and pruritic and often leave purpuric and hyperpigmented lesions. [9] Unlike simple urticaria, urticarial vasculitis demonstrates leukocytoclastic vasculitis on histology. Like urticaria, it may occur with or without angioedema. It may be associated with systemic symptoms such as arthralgias and GI symptoms, which are more common in patients with low complement levels. Although it is most often idiopathic, it is more often associated with autoimmune diseases such as lupus and Sjögren syndrome, as well as viral infections, medications, and malignancy, when compared with classic urticaria. [13] If urticarial vasculitis is suspected, an autoimmune screen, including complement levels, should be included in the workup. Initial treatment options include antihistamines and NSAIDs.
Patches of raised bumps (also called wheals) that appear suddenly. Wheals are pale red in colour and can range in size from a millimetre to several centimetres. Individual hives can join together too.
Make a pineapple compress. Bromelain is an enzyme found in pineapples and can help reduce the swelling of hives. Crush some pineapple, either canned or fresh, and place it on a thin cotton towel. Pull the four corners of the towel together and tie them off with a rubber band. Place the damp, pineapple filled towel over the hives.
CU can occur in response to drugs, physical stimuli, as part of inflammatory or inherited diseases, or can be idiopathic in nature. Acetylsalicylic acid (ASA) or nonsteroidal anti-inflammatory drug (NSAID) intolerant CU is hypothesized to occur due to inhibition of the cyclooxygenase pathway, which causes enhanced production of leukotrienes. The physical urticarias (classically divided into heat, cold, solar, vibration, delayed-pressure, dermatographism, aquagenic and cholinergic induced urticaria) occur in response to external stimuli. Urticarial vasculitis involves the appearance of urticarial lesions lasting greater than 24 hours in the hisopathological setting of vasculitis. Inherited syndromes with CU include the spectrum of cryopyrinopathies, such as Familial Cold Autoinflammatory syndrome, Muckle-Wells syndrome, and Neonatal-Onset Multisystem Inflammatory Disease/Chronic Infantile Neurologic Cutaneous Articular syndrome (NOMID/CINCA). Urticaria presents as a feature of many inflammatory disorders, such Schnitzler syndrome, Still’s disease, and Gleich’s syndrome. Chronic idiopathic urticaria, unlike the physical urticarias and ASA or NSAID intolerant variants, has no discernable external cause.
Delayed-pressure urticaria: Application of deep pressure to the skin produces swelling after 1-5 hours, like sitting on one spot for a prolonged period of time. The area will be deep and tender to touch.
Starting with 10 minutes of exercise a day can lower your overall feelings of stress. The hormones produced by your exercise session can help you better deal with stressful situations, even long after you have finished exercising.
The type I allergic immunoglobulin (Ig) E response is initiated by antigen-mediated IgE immune complexes that bind and cross-link Fc receptors on the surface of mast cells and basophils, thus causing degranulation with histamine release.
When a cause for hives can be found, it’s most likely an infection. Viral upper respiratory infections cause about 40% of hives rashes. Fortunately, these hives outbreaks resolve as the infection resolves. A chronic bacterial infection, especially sinusitis, may be the culprit if a case of hives is lingering.
Evidence of systemic autoimmune disease, including hypothyroidism or hyperthyroidism (autoimmune thyroiditis); hepatitis, renal failure, and polyarthritis (cryoglobulinemia); malar rash, serositis, and polyarthritis (SLE); dry eyes and dry mouth (Sjögren syndrome); cutaneous ulcers or hypopigmented lesions after resolution of urticaria (urticarial vasculitis)
Urticaria predominantly affects adult females and up to 20% of the population sometime in their life.  It presents as a diffusely raised itchy wheal and flare reaction which migrates over the skin surface. All forms of Urticaria may occur in association with deeper skin swelling or angioedema and equally, angioedema may occur in isolation with no apparent urticaria (when Hereditary Angioedema (HAE) due to a deficiency of the C1 Esterase inhibitor enzyme should be suspected).
Living with any long-term condition can be difficult. Chronic urticaria can have a considerable negative impact on a person’s mood and quality of life. Living with itchy skin can be particularly upsetting.
Drugs that can cause hives and angioedema include aspirin and other nonsteroidal anti-inflammatory medications such as ibuprofen, high blood pressure drugs (ACE inhibitors), or painkillers such as codeine.
Allergic reactions, chemicals in foods, insect stings, sunlight, and medicines can make your body release a chemical called histamine. Histamine sometimes makes blood plasma leak out of small blood vessels in the skin, causing hives or angioedema.
Health advice on severe hives: I have had severe hives for 1 week. Treating with 300mg of benadryl ea day, Doxypin 10 mg at bedtime and prednisone 40 mg. I am very concerned about being on Prednisone especially since it is not doing any good. Does pred
Other drugs such as Colchicine, Warfarin, Nifedipine, Dapsone, Methotrexate and Sulfasalazine have been used with some success reported in chronic urticaria. Auto-immune thyroid disease with associated urticaria may respond to oral Thyroxine supplementation even if normal thyroid function. Immune suppressive therapy such as Cyclosporin is effective but can cause serious side effects such as kidney damage and uncontrolled hypertension.  Oral Sodium Cromoglycate may benefit Food related Exercise induced Urticaria. Stress (public speaking, examinations, exercise and arguments) may trigger Cholinergic Urticaria and Propranolol will reduce symptoms.
Try deep breathing techniques. Deep breathing techniques have been shown to help reduce stress. Start by lying flat on your back. Use pillows under your knees and neck to make sure you are comfortable. Put your hands, palm down, on your stomach right below the rib cage. Place the fingers of your hands together so you can feel them separate and know you are doing the exercise correctly. Take a long, slow deep breath by expanding your belly, breathing like a baby breathes, meaning from the diaphragm. Your fingers should separate as they lie on your belly.
Dr. Howard suggests dermatologists take time to educate patients about the link between stress, anxiety and the skin. “The one-on-one time gives dermatologists the opportunity to direct patients toward interventions that can improve their overall quality of life,” she says.
The main treatment of all forms of urticaria in adults and in children is with an oral second-generation antihistamine chosen from the list below. If the standard dose (eg 10 mg for cetirizine) is not effective, the dose can be increased up to fourfold (eg 40 mg cetirizine daily). They are stopped when the acute urticaria has settled down. There is not thought to be any benefit from adding a second antihistamine.
So, we agreed that stress-induced urticaria is a logical thing; what is not logical is to treat stress with drugs. Drug companies don’t have any single interest in jeopardizing their business in order to tell you the truth. Nobody exactly knows how it happens, but instead, they give you medicine that they are completely aware won’t work for you.
Urticaria occurs when a trigger causes high levels of histamine and other chemical messengers to be released in the skin.These substances cause the blood vessels in the affected area of skin to open up (often resulting in redness or pinkness) and become leaky. This extra fluid in the tissues causes swelling and itchiness.
Drugs: antibiotics like penicillin, vaccinations, anti –inflammatory drugs like aspirin and contraceptive pills are just some of the many drugs that can cause an allergic reaction. Animals treated with penicillin secrete a small amount of the drug in their milk, and sensitive individuals may experience a reaction after consuming this milk.
Could you be allergic to your own sweat? Yes, says Dr. Anand. Although the cause of hives triggered by exercise is sometimes thought to be an increase of body heat, what actually triggers hives when you work out is sweat. Does that mean you should skip exercise if you have chronic hives? Not necessarily. Talk to your doctor if you suspect this may be one of your triggers — he or she may recommend taking a dose of antihistamine just before you exercise to help prevent a flare-up.
There is a lot that we still do not understand about urticaria causes although we do know that there are certain triggers and certain reactions that could cause the symptoms associated with utricaria to flare up. The absence of any well defined or clear cause of urticaria does to a large extent limit our ability to deal with the problem. The point to note is that urticaria is not always caused through or because of an allergy and there is no definitive urticaria cure. Non–allergic causes are connected to auto- immunity, to hormone interplay to stress factors, and more. These are some of the more common urticaria causes or triggers:
Your doctor will likely recommend you treat your symptoms with home remedies, such as over-the-counter antihistamines. If self-care steps don’t help, talk with your doctor about finding the prescription medication or combination of drugs that works best for you. Usually, an effective treatment can be found.
An important variant to mention is urticarial vasculitis, which on initial presentation presents like urticaria but the lesions are non-migratory, last for more than 24 hours and resolve with postinflammatory hyperpigmentation.
Clinical Context:  Although prednisone is most effective, adverse effect profiles preclude it from use as a first-line agent. Consider it only after failure of antihistamines, indomethacin, colchicine, dapsone, or hydroxychloroquine. Its effect on urticarial vasculitis likely is mediated by its anti-inflammatory effect. This class of medications decreases capillary permeability and inhibits the mitotic rate of lymphocytes.
Food allergy should be considered in acute urticaria and urticaria in children. Such foods as tree nuts, peanuts, eggs, shellfish, and tomatoes should be considered (the involvement of food additives or preservatives is controversial). [10] ) Please visit our main article to learn more about food allergies.
There are many explanations out there: stress-related hives can be the result of an overactive sympathetic nervous system. It’s the same of the brain that is responsible for “fight or flight” situations. Something else might be the cause.

“welts on body hive heating”

[Guideline] Magerl M, Borzova E, Giménez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias–EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy. 2009 Dec. 64(12):1715-21. [Medline].
An allergic reaction marked by multiple discrete swellings on the skin (wheals) that are intensely itchy and last up to 24 hr. The wheals appear primarily on the chest, back, extremities, face, or scalp. Synonym: hives See: illustration; allergy; angioedema
Patients with chronic urticaria that has failed to respond to maximum-dose second generation oral antihistamines taken for 4 weeks should be referred to a dermatologist, immunologist or medical allergy specialist.
Yao, Q., Ye, Y., Liu, X., Qin, Z., & Liu, Z. (2015). The effectiveness and safety of acupuncture for patients with chronic urticarial: A systematic review. Biomed Research International . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897793/
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Chronic urticaria is estimated to affect between 0·1–3% of children in the United Kingdom [1]. Physical factors, such as pressure and cold, are the most common identifiable trigger children with chronic urticaria usually also have angioedema. Approximately 30% of children with chronic urticaria have a positive ASST [39] and approximately 4% have positive thyroid peroxidase antibodies. It is suggested that thyroid function be monitored in children with chronic urticaria and positive thyroid autoantibodies, even though it has not been well established that treatment of clinical thyroid disease, if it develops, will improve the urticaria [65]. It has also been reported that children with severe chronic urticaria have a higher incidence of coeliac disease than controls [66].
Dermatographic urticaria (also known as dermatographism or “skin writing”) is marked by the appearance of weals or welts on the skin as a result of scratching or firm stroking of the skin. Seen in 4–5% of the population, it is one of the most common types of urticaria,[11] in which the skin becomes raised and inflamed when stroked, scratched, rubbed, and sometimes even slapped.[12]
For chronic hives, the doctor may suggest a non-sedating (non-drowsy) prescription or over-the-counter antihistamine to be taken every day. Not everyone responds to the same medications, though, so it’s important to work with a doctor to find the right one for your child.
Both urticaria and angioedema are a result of histamine and other chemicals released from mast cells in the skin and mucous membranes. This may occur through an allergic process or one in which mast cells release chemicals without IgE being involved.
Other measures may be appropriate, such as continuous ECG, blood pressure and pulse oximetry monitoring; administering intravenous crystalloids if the patient is hypotensive; and administering oxygen.
If non-sedating antihistamines are not effective, a 4 to 5-day course of oral prednisone (prednisolone) may be warranted in severe acute urticaria, particularly if there is angioedema. Systemic steroids do not speed up resolution of symptoms.
It occurs in both men and women, but appears to be more common in men than women. The condition tends to first appear in people aged between 10 and 30 years and persists for a number of years before it becomes less severe or goes away altogether. The natural course of cholinergic urticaria is quite variable, with most patients experiencing slow resolution over several years.
About 20% of people are affected.[2] Cases of short duration occur equally in males and females while cases of long duration are more common in females.[4] Cases of short duration are more common among children while cases of long duration are more common among those who are middle aged.[4] Hives have been described at least since the time of Hippocrates.[4] The term urticaria is from the Latin urtica meaning “nettle”.[5]
Chronic lung diseases hard to diagnose: Some of the chronic lung diseases are difficult to diagnose. Even the well-knowns conditions such as asthma or lung cancer often fail to be diagnosed early. Some of the chronic lung…read more »
Antihistamines are also prescribed to treat chronic (lasting longer than 6 weeks) hives. When prescribed for chronic hives, you take this medicine every day to prevent hives from forming. There are many antihistamines on the market. Some make you drowsy, and some do not.
Certain foods or beverages, such as spoiled fish (scombroidosis), aged cheeses, or red wine, can contain histidine, which is closely related to histamine. These foods are often listed as causes of urticaria in the literature, but experimental evidence is scarce.
The rash appears rapidly, usually within a few minutes of sweating, and can last from 30 minutes to an hour or more before fading away. The mean duration is around 80 minutes. Typical signs and symptoms of the rash include:
Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Hives (Chronic Urticaria) article more useful, or one of our other health articles.
My rash ravaged my body after the prednisone ended and I drank a glass of wine…. Big mistake. I thought it was poison ivy but nothing helps. I’m getting it yearly and it follows the nerve paths so if you have some helpful guidance I will check it out.
Individuals who have urticaria due to aspirin may need to avoid foods that contain high levels of salicylates. As well as this, antihistamines are the mainstay of drug treatment for urticaria and angioedema. They may be taken just when required or regularly to prevent episodes occurring in chronic spontaneous urticaria.
Urticaria. This is a close-up view of wheals with white-to-light-pink color centrally and peripheral erythema. These are the classic lesions of hives, or urticaria. Some hives are caused by allergies to such things as foods, medications, and insect stings, but the large majority of cases are not allergic, and no specific cause for them is ever found. It is characteristic that they are transient and highly pruritic. The goal of treating most cases of ordinary urticaria is to relieve symptoms while the condition goes away by itself.
Urticarial vasculitis tends to run a chronic course. Mortality is low, unless renal or pulmonary disease occurs. The goal of treatment is to achieve long-term control with the least amount of toxicity.
What we are referring to is allergens, or substances that cause the body to react in the form of an allergic reaction. This reaction can take many forms from fever, to swelling, stuffy nose, and depending on the severity of the allergy, possible even death. However, for this purpose of this article, we are going to focus on one of the most common reactions to allergens, and that is hives.
Irinyi B, Szeles G, Gyimesi E, Tumpek J, Heredi E, Dimitrios G, et al. Clinical and laboratory examinations in the subgroups of chronic urticaria. Int Arch Allergy Immunol. 2007. 144(3):217-25. [Medline].
In addition to this, it would be wise to stick to a bland diet for a few days or until the symptoms subside. Avoid foods like shellfish, eggs, and pineapples as they could aggravate your condition. It would also be best if you also avoid milk and milk products, eggs, and soy products.
Hives, also known as urticaria, affects about 20 percent of people at some time during their lives. It can be triggered by many substances or situations and usually starts as an itchy patch of skin that turns into swollen red welts.
A much rarer type of urticaria, known as urticaria vasculitis, can cause blood vessels inside the skin to become inflamed. In these cases, the weals last longer than 24 hours, are more painful, and can leave a bruise.
This is variable. Most cases of idiopathic urticaria resolve over a period of six months but a minority can persist for many years. Some remit and then relapse. 50% of cases of chronic urticaria have resolved within 3-5 years. At least 20% of chronic urticaria patients requiring referral to secondary care are still symptomatic 10 years after first presentation. Factors associated with lasting duration include severe symptoms, associated angio-oedema and positive antithyroid antibodies.
Urticaria is due to activation of mast cells in the skin, resulting in the release of histamine and other mediators. These chemicals cause capillary leakage, which causes the swelling of the skin, and vasodilation causing the erythematous reaction. There may be a trigger identified which causes this release but often the cause is not identifiable, particularly in chronic urticaria. An autoimmune reaction is thought to be involved in many such cases.
Mast cells are the cells in the skin and mucous membranes that contain histamine. Release of histamine causes the allergic symptoms of hives and angioedema (swelling of large areas of the body). Itching is a common symptom when histamine is released. Anti-histamines are often prescribed to help control this symptom.
Urticaria is diagnosed in people with a history of weals that last less than 24 hours with or without angioedema. A family history should be elicited. A thorough physical examination should be undertaken.
Another possible explanation for your stress hives is that due to your weakened immune system, your skin is reacting to irritants that it never had problems with before: cold, heat, soaps, shampoos, lotions, laundry detergents, certain fabrics, sunlight, etc. In fact, there are even doctors that specialize in stress hives, known as psychodermatologists. These specialists work with skin illnesses and stress, and strongly feel that emotions that have not been properly dealt with can induce a rash in patients and that these deep seated emotions are the major cause of chronic hives.
Chronic hives (defined as lasting six weeks or more) can last from months to years. The evaluation of this condition is difficult, and allergy testing and other laboratory tests are only occasionally useful in such cases. The accurate evaluation of this condition requires the patient to give his or her physician precise information regarding their complete medical history, personal habits, and oral intake. Occasionally, it may be necessary to limit specific foods or drugs for a time to observe any affect upon the skin condition. Certain systemic diseases and infections, including parasitic infestations, may occasionally present in the skin as hives. If an inciting cause can be determined, then specific treatments for that condition ought to be effective, or in the case of food or drug allergy, strict avoidance would be necessary. There are additionally rare forms of chronic urticaria that are produced when the patient makes antibodies against molecules on the surface of their own mast cells. There are tests available to identify this type of hives.

“urticaria causes _hives treatment”

They released their second studio album Veni Vidi Vicious in April 2000 through Burning Heart Records. The band themselves described the album as being like “a velvet glove with brass knuckles, both brutal and sophisticated at the same time”. The album yielded the singles “Hate to Say I Told You So”, “Main Offender”, “Die, All Right!”, and “Supply and Demand.”
Identification of causative allergens, from the clinical history and blood testing for specific IgE antibodies, will enable the individual with urticaria and angioedema to avoid pathogenic allergens. Where a reaction to medication has been implicated, for example, NSAID’s or antibiotics, the physician should identify alternative drug groups for future treatment, and if possible perform skin testing with antibiotics to confirm or refute the diagnosis of specific antibiotic allergy. Acute attacks of urticaria or angioedema can be treated with H1 antihistamines. Treatment with 1% menthol in aqueous cream may suppress itching. As wheals can occur where tight clothing is in contact with the skin, loose clothing should be recommended. Itching is worse in warm conditions, and a cool temperature, particularly in the bedroom, is recommended. If urticaria and angioedema have occurred during a systemic anaphylaxis reaction, the patient should be prescribed an auto-injector of epinephrine to carry. Very often an episode of urticaria occurs without any explanation or lasting clinical significance, and without any risk of recurrence. Patients unresponsive to antihistamines can be treated with a tapering course of corticosteroid.  
Usually no tests are needed. The rash is very typical and is easily recognised as hives by doctors. In many cases you will know what caused the rash from the events leading up to it. (For example if you have just been put on a new medicine, or if your skin came into contact with a nettle, or if you were stung by a bee.) In some cases it may be helpful to have some allergy tests such as skin prick tests to help determine the specific cause. Sometimes blood tests for allergies can be helpful. Occasionally, if urticarial vasculitis is suspected, a sample of the skin may be taken (a skin biopsy) for further analysis.
If you are constantly worried about what causes hives then you should understand that when you expose your body to excessive stress either for a small amount of time or perhaps a long period of time your own body’s immune system sets out to falter and it starts sending histamine for the body to handle what is causing problem.
Mast cells are like land-mines, and contain bags filled with chemicals including histamine. When these are released into the skin in small amounts, they cause itching and irritation. When large amounts are released into the skin, fluid leaks out of blood vessels, resulting in swelling of the skin (hives). 
Loratadine (Claritin, 10 milligrams) and fexofenadine (Allegra) are antihistamines available over the counter that are less likely to cause drowsiness. Also approved for over-the-counter use is hydroxyzine (Atarax, Vistaril), which causes drowsiness, and its breakdown product, cetirizine (Zyrtec, 10 milligrams), which is less sedating.
To diagnose chronic hives the doctor will first make sure that the hives are not caused by infection or an underlying disease state. However, in the evaluation of patients with chronic urticaria, it is their history which is the most important diagnosis tool. The physician will look for clues regarding drug or chemical exposure, changes in dietary habits, changes in personal habits, alterations in residence or place of employment. She/he will also look for a pattern such as: Is there a relationship to eating? Does the patient wake-up with hives? Are they as likely to occur at home as at work/school? Are weekends or weekdays different in any way? The physician will often place a patient with chronic urticaria on a diet to see if elimination of the hive-trigger will bring relief. It is important to see a doctor before going on an elimination diet. Systemic diseases should be ruled out with this appointment. Sometimes these diseases can cause hives that are painful or burning in nature.
In acute (short-lived) hives, the weals may come and go for a few days or weeks. Rarely, they persist for more than six weeks. Chronic hives is much less common. The weals come and go for months or even years. 
The skin is the body’s largest organ, so it’s not uncommon for a variety of other medical conditions to affect it and this may result hives. For instance, people with cancers like lymphoma may be prone to hives, as are those dealing with carcinomas (skin cancer).​
68. Diav-Citrin O, Shechtman S, Aharonovich A, et al. Pregnancy outcome after gestational exposure to loratadine or antihistamines: a prospective controlled cohort study. J Allergy Clin Imunol. 2003;111:1239–43. [PubMed]
The medical term for hives is urticaria (ur-tih-CARE-ee-uh). When large welts occur deeper under the skin, the medical term is angioedema (an-gee-oh-eh-dee-ma). This can occur with hives, and often causes the eyelids and lips to swell.
Hives are patches of puffy, red, itchy or inflamed skin also known as urticaria, and they can be caused or worsened by significant stress in your life. In fact, stress is one of the most common causes of acute hives (hives that last less than six weeks), along with infectious causes and allergies. Stress has also been known to worsen chronic hives (hives that last more than six weeks), even when the chronic hives are primarily due to another cause.
Chronic or recurrent urticaria (>6 wk) – Basic laboratory studies should include complete blood count (CBC), erythrocyte sedimentation rate (ESR), thyroid-stimulating hormone (TSH), and antinuclear antibody (ANA) [4]
Diagnosis is by skin biopsy, taken ideally from a ‘new’ lesion (within 12 h of appearance), which shows a small vessel leucocytoclastic vasculitis involving post-capillary venules, with endothelial cell swelling, a neutrophil cell infiltrate, extravasation of red blood cells and fibrinoid deposits in and around blood vessels [75]. The condition is thought to be mediated via a type III/immune complex hypersensitivity reaction, in which antigen/antibody complexes deposit in vessel walls. This results in complement activation, neutrophil chemotaxis and infiltration and the release of proteolytic neutrophil enzymes, such as collagenases and elastases, which cause tissue damage. Immunofluorescence shows deposition of immunoglobulin and complement.
Greenberger PA. Chronic urticaria: new management options. World Allergy Organ J. 2014 Nov 5;7(1):31. doi: 10.1186/1939-4551-7-31. eCollection 2014. Review. PubMed PMID: 25383135; PubMed Central PMCID: PMC4223736.
The reported adverse effects related to biological agents used for the treatment of rheumatic diseases in Turkey / Romatizmal Hastaliklarin Tedavisinde Biyolojik Ajanlarin Kullanimina Bagli Turkiye’de Bildirilmis Yan Etkiler
In rare cases, hives or angioedema can be early symptoms of anaphylaxis. Anaphylaxis requires immediate medical attention. If you suspect you are having  an anaphylactic reaction, seek urgent medical treatment. Without proper treatment, anaphylaxis can be deadly.
In general, if an allergic reaction causes hives or swelling, it is usually ingested (food, oral drug) or injected (drugs, stings). If an allergen can penetrate the skin locally, hives will develop at the site of exposure. For example, contact urticaria may occur following exposure to latex gloves if sufficient latex penetrates through the skin.

“idiopathic urticaria -hives”

So, what’s changed? While genes don’t change that fast, probably our environment has. Marshall believes more air pollution, along with a “squeaky clean society,” each play a role in increasing allergies.
Chronic hives may be treated with antihistamines or a combination of medications. When antihistamines don’t provide relief, oral corticosteroids may be prescribed. A biologic drug, omalizumab (Xolair), is also approved to treat chronic hives in those at least 12 years of age.
Hives are red and sometimes itchy bumps on your skin. An allergic reaction to a drug or food usually causes them. Allergic reactions cause your body to release chemicals that can make your skin swell up in hives. People who have other allergies are more likely to get hives than other people. Other causes include infections and stress.
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An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
The main symptom of urticaria is a red, raised skin rash. They can appear anywhere on the body, including the face, hands, lips, tongue, throat or ears. Hives vary in size (from a pencil rubber to a dinner plate), and may join together to form larger areas known as plaques.
Although systemic treatment is best avoided during pregnancy and breast feeding, there have been no reports that second-generation antihistamines cause birth defects. If treatment is required, loratidine and cetirizine are currently preferred.
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Hives can further be categorized by how long they last. Acute hives last for less than six weeks; chronic hives can last longer. In many cases, a trigger causes acute hives is not the same as what causes chronic hives.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler’s educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Chronic lung diseases hard to diagnose: Some of the chronic lung diseases are difficult to diagnose. Even the well-knowns conditions such as asthma or lung cancer often fail to be diagnosed early. Some of the chronic lung…read more »
Clinical Context:  Hydroxychloroquine is the preferred antimalarial agent because of its low toxicity and high effectiveness profile. It is usually well tolerated if carefully monitored by the prescribing physician. Therapy is required for 4-8 weeks before evaluating effectiveness.
Jáuregui I, Ortiz de Frutos FJ, Ferrer M, Giménez-Arnau A, Sastre J, Bartra J, Labrador M, Silvestre JF, Valero A. Assessment of severity and quality of life in chronic urticaria. J Investig Allergol Clin Immunol. 2014;24(2):80-6. Review. PubMed PMID: 24834770.
In the overwhelming majority of cases it is not “something” causing the chronic hives, it is “nothing.” That is, in about 95% of chronic hives cases, the hives are “idiopathic” (a medical term that means there is no discernible cause). Because of those 5% of cases with a cause, it is worthwhile to see a physician to determine if any underlying disease is present (e.g. thyroid problems, liver problems, skin diseases, sinusitis) or if there is an allergic cause (i.e. a reaction to a drug, insect, food, etc.). This can be accomplished by a good history and physical, a few blood and urine tests and sometimes a skin biopsy. Some patients with chronic hives and elevated anti-thyroid antibodies in the blood improve when given thyroid supplement even if the thyroid function is normal.
Psoriasis is a buildup of too many skin cells that form silvery, scaly patches on the body. It’s caused by inflammation, which can be fueled by stress. That’s why people with psoriasis often get flare-ups when they’re tense.
Jump up ^ Sharma, M; Bennett, C; Cohen, SN; Carter, B (14 November 2014). “H1-antihistamines for chronic spontaneous urticaria”. The Cochrane Database of Systematic Reviews (11): CD006137. doi:10.1002/14651858.CD006137.pub2. PMID 25397904.
Research shows that stress can play a major role in many physical and mental illnesses, including chronic idiopathic hives. “Stress can bring on and exacerbate chronic hives,” says Anand. “It’s not uncommon to see chronic idiopathic hives developing following a stressful period of time.” In several studies, people with chronic hives have been found to have higher levels of stress. Researchers have also found a link between post-traumatic stress disorder and hives. To lower stress, try relaxation techniques — for example, mindfulness meditation, which was found to lower the stress hormone cortisol in a study published in 2013 in the journal Health Psychology.
Stress hives are also known as a stress rash or as stress bumps. They develop due to chronic stress or tension, and appear as red raised areas and swollen areas on the skin that seem to suddenly appear. They cause itching most of the time, and some people report having a burning or stinging sensation wherever they appear. Learn more about how stress can cause chronic urticaria on our stress rash page.
A hive often goes away in 24 hours or less. New hives may appear as old ones fade, so hives may last for a few days or longer. A bout of hives usually lasts less than 6 weeks. These hives are called acute hives. If hives last more than 6 weeks, they are called chronic hives.

“urticaria dermatographic |urticaria cronica”

In this study 5 persons reported with lice and fleas (same species of parasites had been collected from the pigeons nest) and all of them had itching in their head and allergic urticarial reaction, Haag wackermagel (2004) has reported concerns a married couple who were repeatedly invaded by pigeon fleas (Ceratophyllus columbae) over a period of 2 months.
Curing a stress rash is actually pretty simple and doesn’t require any type of medical procedure. In fact, it’s as simple as reducing the amount of stress in your life. As you become less stressed, the hives will naturally go away. Read my post — 170 Stress Management Techniques — to help lower the amount of stress in your life.
Hives can also develop as a result of sun or cold exposure, infections, excessive perspiration, and emotional stress. The reason why stress seems to precipitate an outbreak of hives in many people is not completely understood but is likely related to the known effects of stress on the immune system. In many cases, the cause of hives in a given individual cannot be identified.
I went in some hay and got the hives on the back of my legs so close together it looked like one big red/pink spot on the back of my legs so i took 2 cold rags and put them on the back of my legs for about 8-10 minutes and TOTALLY relieved itching.
Check CH50, C3, C4, Clq, and antibodies to Clq in urticarial vasculitis patients. If these test results are positive, evaluate renal function and urinalysis to check for the effects of vasculitis on the kidneys.
When you have an allergic reaction to a substance, your body releases histamine and other chemicals into the blood. This causes itching, swelling, and other symptoms. Hives are a common reaction. People with other allergies, such as hay fever, often get hives.
Urticaria and angioedema are commonly classified by duration. Lesions of less than six weeks’ duration are considered acute; episodes that persist beyond six weeks are designated chronic. The causes mechanisms of hive formation are different in each instance, as are the prognosis and approaches to treatment.
Chronic spontaneous urticaria is mainly idiopathic (cause unknown). An autoimmune cause is likely. About half of investigated patients carry functional IgG autoantibodies to immunoglobulin IgE or high-affinity receptor FcεRIα.
In a small percentage of patients with chronic urticaria, perhaps about 2% [71], there is an underlying small vessel vasculitis. It is important to diagnose these patients because they may have an associated systemic illness which can lead to severe complications and because the treatment of urticarial vasculitis differs from that of ordinary chronic urticaria. Clinically, the lesions of urticarial vasculitis are longer-lasting (3–7 days) than those of ordinary chronic urticaria. They are often painful or ‘burning’ and they may leave residual bruising or hyperpigmentation of the skin. Approximately 40% of patients with urticarial vasculitis will have associated angioedema. Urticarial vasculitis may occur at any age, but the median age of incidence is 43 years. Women are affected twice as often as men. Two categories of urticarial vasculitis are recognized – hypocomplementaemic and normocomplementaemic [72]. Patients with hypocomplementaemic urticarial vasculitis syndrome (HUVS) are more likely to have an associated connective tissue disease and systemic symptoms than patients with normal complement levels [73] and may have IgG antibodies to the collagen-like domain of C1q [74]. There may be associated fever, arthralgia (50%), gastrointestinal involvement with abdominal pain, nausea, vomiting and diarrhoea (20%); pulmonary disease with dyspnoea or pulmonary effusions (20%); and glomerulonephritis with haematuria and proteinuria (5–10%). Progressive renal disease is rare, unless the urticarial vasculitis is associated with SLE. Other rare manifestations include eye involvement, lymphadenopathy, splenomegaly and pericardial effusions.
Complement-mediated urticaria includes viral and bacterial infections, serum sickness, and transfusion reactions. Urticarial transfusion reactions occur when allergenic substances in the plasma of the donated blood product react with preexisting IgE antibodies in the recipient. Certain drugs (opioids, vecuronium, succinylcholine, vancomycin, and others) as well as radiocontrast agents cause urticaria due to mast cell degranulation through a non-IgE-mediated mechanism. Urticaria from nonsteroidal anti-inflammatory drugs (NSAIDs) may be IgE-mediated or due to mast cell degranulation, and there may be significant cross-reactivity among the NSAIDs in causing urticaria and anaphylaxis. [6]
Get away from the allergens. The first step in treating hives is to ensure you are away from the source of the allergic response. If you know what it is, which is how most cases of hives are, remove the substance that is causing the allergic reaction from your skin or environment. Common allergens that are easy to determine are poison ivy, poison oak, insect bites, wool clothing, a cat, or a dog. Avoid these or any other known allergen as much as possible.

“causes of urticaria _exercise induced urticaria”

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In other words, when a person is stressed, any inflammatory reactions are likely to be more severe in a person who is susceptible to a reaction. In this way, hives, or urticaria, can be linked to stress.
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Grattan CE, O’Donnell BF, Francis DM, Niimi N, Barlow RJ, Seed PT, et al. Randomized double-blind study of cyclosporin in chronic ‘idiopathic’ urticaria. Br J Dermatol. 2000 Aug. 143(2):365-72. [Medline].
Jump up ^ Engin, B; Uguz, F; Yilmaz, E; Ozdemir, M; Mevlitoglu, I (2007). “The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria”. Journal of the European Academy of Dermatology and Venereology. 22 (1): 36–40. doi:10.1111/j.1468-3083.2007.02324.x. PMID 18181971.
Acute urticaria is diagnosed in people with a short history of weals that last less than 24 hours, with or without angioedema. A thorough physical examination should be undertaken to look for underlying causes.
These red areas will usually appear small, but can easily multiply and singular welts join together forming rashes. The area affected will be slightly elevated with a blanched center, especially when you press down your finger on the area of the rash. It is estimated that 20% of people will experience urticaria at some point in their lives. While it is common for the appearance of welts to form on the skin during an allergic reaction, it is also important to note that they can occur internally, which is why it is so important to speak to a doctor immediately, especially if you are unaware as to the cause of the reaction.
Exercise daily. Even if you only have time to take a walk, exercise helps reduce stress hormones that may cause you to feel keyed up. And remember, exercise produces epinephrine, which acts as a natural decongestant, helping you breathe better.
Food allergy should be considered in acute urticaria and urticaria in children. Such foods as tree nuts, peanuts, eggs, shellfish, and tomatoes should be considered (the involvement of food additives or preservatives is controversial). [10] ) Please visit our main article to learn more about food allergies.
No. Seriously, stress is a mental state. And we treat mental problems with mind treatment, not with supplements. This advice, unfortunately, fails to find and explain the real cause of your stress problem.
Antihistamines are the first line medication for acute or chronic urticaria. Some of these are over-the-counter preparations. The newer anti-histamines are less sedating and therefore can be used in the daytime as well. Most of them are long-acting and can be taken once-a-day only. Normal prescribed dosages may not be of benefit and your doctor may often prescribe larger doses or the addition of a second medication. Sometimes a specific anti-ulcer treatment which also has some effect on blocking urticaria may be used. If no relief is obtained a doctor should be consulted.
The most common stressful events that were related to the occurrence of hives included the death of a family member, family conflicts, financial problems, sexual dysfunction, illness of a family member, problems in the workplace, and extramarital affairs. Even forms of good stress—such as getting married or engaged, and going on a vacation—can cause hives. The authors propose that the treatment of stress through relaxation techniques and stress management programs may be useful for the treatment of hives caused or worsened by stress.
The best treatment for hives and angiodema is to identify and remove the trigger, but this is not an easy task. Antihistamines are usually prescribed by your doctor to provide relief from symptoms. Antihistamines work best if taken on a regular schedule to prevent hives from forming in the first place.
Oral glucocorticoids are effective in controlling symptoms of chronic hives however they have an extensive list of adverse effects such as adrenal suppression, weight gain, osteoporosis, hyperglycemia, etc. Therefore, their use should be limited to a couple of weeks. In addition, one study found that systemic glucocorticoids combined with antihistamines did not hasten the time to symptom control compared with antihistamines alone.[41]
Acute urticaria may be, in a short time, associated with life-threatening angioedema and/or anaphylactic shock, although it usually presents as rapid-onset shock without urticaria or angioedema. (See Emergency Care and Complications.)
It occurs in both men and women, but appears to be more common in men than women. The condition tends to first appear in people aged between 10 and 30 years and persists for a number of years before it becomes less severe or goes away altogether. The natural course of cholinergic urticaria is quite variable, with most patients experiencing slow resolution over several years.
The Hives have released five studio albums: Barely Legal (1997), Veni Vidi Vicious (2000), Tyrannosaurus Hives (2004), The Black and White Album (2007) and Lex Hives (2012). They have one compilation album, Your New Favourite Band (2001) and they have issued a live DVD, Tussles in Brussels (2005).[3] The Black and White Album has been their most successful as of December 2017.
Clinical Context:  Although prednisone is most effective, adverse effect profiles preclude it from use as a first-line agent. Consider it only after failure of antihistamines, indomethacin, colchicine, dapsone, or hydroxychloroquine. Its effect on urticarial vasculitis likely is mediated by its anti-inflammatory effect. This class of medications decreases capillary permeability and inhibits the mitotic rate of lymphocytes.
The reported adverse effects related to biological agents used for the treatment of rheumatic diseases in Turkey / Romatizmal Hastaliklarin Tedavisinde Biyolojik Ajanlarin Kullanimina Bagli Turkiye’de Bildirilmis Yan Etkiler
Stress hives are red, raised swollen areas and bumps (AKA stress bumps) that appear on your skin, that develop due to too much stress or anxiety in your life. Stress hives can itch like crazy, giving you the feeling like ants or spiders are crawling over your skin. The only way to get rid of your stress hives is to remove all the stress and anxiety form your life. Because this is a near impossibility for most people, there is one stress hives treatment, known as OxyHives, that can be taken that reduces the swelling and itchy feeling within 2 hours.
Early lesions show a perivascular neutrophilic infiltrate involving postcapillary venules. Leukocytoclasis is present, expansion of the vessel wall occurs, and the endothelium is intact. Eosinophils may be noted early. Fibrin deposition and extravasation of red blood cells ensue.
Fortunately, it’s easy to find out whether cold is one of your triggers: Your doctor can administer a simple test that involves placing an ice cube on your skin for five minutes to see if a reaction occurs. If it turns out that cold is a trigger for you, your doctor will recommend that you protect your skin from the cold and take your medications as prescribed.
Hives usually cause itching, but may also burn or sting. They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to one day before fading. Read more about hives (urticaria and angioedema).
Angioedema is another skin allergy and is the name given to deeper swelling affecting the skin over the arms, legs, torso or face. It may also affect the tongue, mouth, throat and sometimes the upper airway. These swellings commonly last for more than 24hrs, and usually there is no itching. It is not possible to identify an underlying cause for angioedema in the vast majority of cases.
Your doctor will need to ask many questions in an attempt to find the possible cause of hives or angiodema. Since there are no specific tests for hives — or the associated swelling of angioedema — testing will depend on your medical history and a thorough exam by your primary care doctor or dermatologist.
Most chronic urticaria is idiopathic. The next most common cause is an autoimmune disorder. The causative autoimmune disease is sometimes clinically apparent. Urticarial vasculitis sometimes is associated with connective tissue disorders (particularly SLE or Sjögren syndrome). In urticarial vasculitis, urticaria is accompanied by findings of cutaneous vasculitis; it should be considered when the urticaria is painful rather than pruritic, lasts > 48 h, does not blanch, or is accompanied by vesicles or purpura.
The most common food allergies are to eggs, nuts, milk, peanuts, fish, shellfish, strawberries and tomatoes. Symptoms and signs include nausea, vomiting, diarrhea, abdominal pain, itching, hives, eczema, asthma, lightheadedness, and anaphylaxis. Allergy skin tests, RAST, and ELISA tests may be used to diagnose a food allergy. Though dietary avoidance may be sufficient treatment for mild allergies, the use of an Epipen may be necessary for severe food allergies.
Question on Papular Urticaria: Is Urticaria & Papuller Urticaria the same? My 15 yr old sis is suffering from Papullar Urticaria since 2 yrs. We tried all medication including Allopathic (also Steroids), homeopathy. But no improvement. Pls suggest a remed
Idiopathic cold urticaria is characterized by the rapid onset of pruritus, erythema, and swelling after exposure to a cold stimulus. The location of the swelling is confined to those parts of the body that have been exposed. When suspected, an ice-cube test can be performed in which an ice cube is placed on the subject’s forearm for 4-5 minutes. A positive reaction leads to formation of a hive in the shape of the ice cube within 10 minutes after the stimulus is removed (click for picture). The time course of this reaction (i.e., cold challenge followed by hive formation as the area returns to body temperature) demonstrates that a two-step reaction has occurred in which exposure to cold is a prerequisite, but hive formation actually occurs as the temperature increases.
Information regarding history of previous urticaria and duration of rash and itching is useful for categorizing urticaria as acute, recurrent, or chronic. For chronic or recurrent urticaria, important considerations include previous causative factors and the effectiveness of various treatments, as follows [2] :
Acute viral illnesses in children can be associated with urticarial eruptions which last a few weeks and then spontaneously subside. This typically accompanies symptoms of viral rhinitis, pharyngitis, or bronchitis. When such patients are given an antibiotic, the cause of the hives becomes less clear because a drug reaction becomes an alternative possibility. If penicillin or related antibiotics have been given it is worth performing skin testing for penicillin and/or cephalosporin allergy, rather than making unsubstantiated assumption that the child is “penicillin allergic.” Hepatitis B, infectious mononucleosis (EB virus) and a large number of helminthic parasites may be associated with hives in all age groups.
Get away from the allergens. The first step in treating hives is to ensure you are away from the source of the allergic response. If you know what it is, which is how most cases of hives are, remove the substance that is causing the allergic reaction from your skin or environment. Common allergens that are easy to determine are poison ivy, poison oak, insect bites, wool clothing, a cat, or a dog. Avoid these or any other known allergen as much as possible.

“que es la urticaria _what is urticaria”

While there are several different types of hives that can appear as a result of a reaction, most of their signs and symptoms are similar. Bearing that in mind, we have taken the time to put together 10 of the most common signs of hives, so you can be prepared in the event they occur, and can reach out to a medical professional to get to the bottom of it.
How do you get hives? Hives are not something you can “catch” from anyone. Rather, they are your body’s response to something it ingests or experiences. The cause of hives can be a certain food, drug, infection or stress. You might be surprised to learn that stress is one of the most common causes of acute hives, along with allergies and infectious causes. Hives can literally occur at any age and appear anywhere on the body. It is estimated that one in every five people will be affected by a hives outbreak at some point in his or her life. (2)
Acute hives can be related to other infections such as strep throat, athlete’s foot, mononucleosis, and coxsackie viruses. Though they’re not viral infections, both intestinal worms and malaria can also cause urticaria.
Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Hives (Chronic Urticaria) article more useful, or one of our other health articles.
When we’re exposed to a stressful situation, our bodies prepare for confrontation. This “fight or flight” response is controlled by our hormones and nervous system and dates back to prehistory, as we prepared to fight or flee our stressor.
There are no routine diagnostic tests in chronic spontaneous urticaria apart from blood count and C-reactive protein (CBC, CRP), but investigations may be undertaken if an underlying disorder is suspected.
Antihistamines are also prescribed to treat chronic (lasting longer than 6 weeks) hives. When prescribed for chronic hives, you take this medicine every day to prevent hives from forming. There are many antihistamines on the market. Some make you drowsy, and some do not.
[Guideline] Magerl M, Borzova E, Giménez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias–EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy. 2009 Dec. 64(12):1715-21. [Medline].
Codeine and other opiate-derived medications can cause degranulation of mast cells by stimulation of opiate receptors. Urticaria and angioedema can result from agents that alter the metabolism of arachidonic acid, such as aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). These responses to NSAIDs have the potential to be fulminant with generalized hives swelling. Angiotensin-converting enzyme inhibitors (ACEIs), drugs used to treat hypertension, (eg, Captopril) can cause recurrent episodes of angioedema, but urticarial skin lesions are not observed. Because ACE normally inactivates bradykinin, the angioedema is thought to be due to elevated bradykinin levels causing dilation and leaking of vessels in deep layers of the skin. This is the most common cause of angioedema seen in emergency rooms. Tongue, throat and laryngeal swelling can be extremely severe and intubation may be necessary. The swelling resembles that seen in hereditary or acquired C1 inhibitor deficiency where bradykinin is also the mediator of swelling.
The most common food allergies in adults are shellfish and nuts. The most common food allergies in children are shellfish, nuts, eggs, wheat, and soy. One study showed Balsam of Peru, which is in many processed foods, to be the most common cause of immediate contact urticaria.[8] A less common cause is exposure to certain bacteria, such as Streptococcus species or possibly Helicobacter pylori.[9]
In patients with chronic idiopathic urticaria, approximately 35% will experience episodes of angioedema and 25% are positive for dermatographism. Like many autoimmune diseases, chronic idiopathic urticaria has a higher incidence in women than men, with the reported ratio of females to males ranging from 2:1 to 4:1. Numerous autoimmune conditions have been associated with chronic idiopathic urticaria, including thyroid disease, celiac disease, and rheumatoid arthritis (RA).
Yang, H. Y., Sun, C. C., Wu, Y. C, & Wang, J. D. (2005, April). Stress, insomnia, and chronic idiopathic urticaria, a case-control study. Journal of the Formosan Medical Association,104(4):254-63. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15909063
Drugs that block histamine-1 (H1) receptors (antihistamines) are the primary treatment for urticaria. The use of both H1 and H2 receptor blockers has been recommended but has not been proven more effective. Patients should avoid identified allergens. Doxepin, calcium channel blockers, or immunosuppresive drugs may be needed for symptoms that are not well controlled with antihistamines. Known triggers of urticaria should be avoided.
They also play a central role in allergy. Mast cells contain sacks filled with chemicals, including histamine. These chemicals are released in response to certain external triggers, e.g., allergens, physical causes. Some individuals’ mast cells are unstable and cause urticaria without being triggered by an external factor. When these chemicals are released in small amounts, they cause local itch, irritation and redness of the overlying skin. In larger amounts, they will cause fluid to leak out of blood vessels, resulting in swelling of the skin. When released in massive amounts, it may result in shock (anaphylaxis).
Have you ever had red, raised, itchy bumps that came out of nowhere? If the answer is “yes,” then you likely have already experienced hives at some point in your life. Hives can really startle you when they suddenly appear on your skin. Most often they are due to some type of allergic reaction. Thankfully, they’re typically not long lasting and relatively harmless. But, sometimes hives can indicate a life-threatening allergic reaction, or they can become chronic. (1)
Urticaria results from the release of histamine, bradykinin, leukotriene C4, prostaglandin D2, and other vasoactive substances from mast cells and basophils in the dermis. [2] These substances cause extravasation of plasma into the dermis, leading to the urticarial lesion. The intense pruritus of urticaria is a result of histamine released into the dermis. One study showed that D-dimer levels correlate with the severity of acute urticaria and may serve as a marker of disease severity. [75]  
Studies have shown that a substantial number of patients with chronic urticaria have a positive autologous skin test, meaning that injection of the patient’s serum in a skin test leads to a significant wheal and flare reaction. A proportion of such patients (about 35%) have been found to have an IgG antibody directed against the alpha- subunit of the IgE receptor which experimentally can cause degranulation of histamine-containing cells (blood basophils or mast cells). A smaller proportion have anti-IgE antibodies (5%). This accounts for 40% of patients with CSU. Fifty percent of patients with CSU have circulating basophils that are hyporesponsive to activation by anti IgE due to high intracellular phosphatase levels and this reverts to normal during therapy or remission.  Mechanisms for histamine release caused by the aforementioned autoantibodies have been described but proof of their pathogenicity is lacking.  Yet virtually all diseases strongly associated with autoimmunity turn out to be autoimmune.
If you suffer with allergy symptoms, you know all about the stress of having a chronic condition. Not only is it difficult to breathe with allergy symptoms, but poor sleep can lead to fatigue and problems concentrating. Allergy medicines can cause appetite changes, low energy, and even irritability. All you want is relief: from the stress, the symptoms, all of it.
Idiopathic cold urticaria is characterized by the rapid onset of pruritus, erythema, and swelling after exposure to a cold stimulus. The location of the swelling is confined to those parts of the body that have been exposed. When suspected, an ice-cube test can be performed in which an ice cube is placed on the subject’s forearm for 4-5 minutes. A positive reaction leads to formation of a hive in the shape of the ice cube within 10 minutes after the stimulus is removed (click for picture). The time course of this reaction (i.e., cold challenge followed by hive formation as the area returns to body temperature) demonstrates that a two-step reaction has occurred in which exposure to cold is a prerequisite, but hive formation actually occurs as the temperature increases.
When a patient has hives, a dermatologist can often make the diagnosis by looking at the skin. Finding the cause of hives, however, can be a challenge. This is especially true for hives that have been around for more than 6 weeks.
In 50% of patients with acute urticaria, a specific etiology can be identified. Brief episodes of urticaria can be associated with identifiable causes, and the method of exposure (ie, direct contact, oral or intravenous routes) is usually known. Urticaria is often associated with a recent infection.
Psychological stress exacerbates chronic urticaria through a variety of mechanisms, including heightened basophil response to corticotrophin releasing factor and adrenocorticotropic hormone (ACTH) and a derangement of the hypothalamic-pituitary-adrenal (HPA) axis (Dyke SM, Carey BS, Kaminski ER. Clin Exp Allergy. 2008;38(1):86-92).
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Acute urticaria may be, in a short time, associated with life-threatening angioedema and/or anaphylactic shock, although it usually presents as rapid-onset shock without urticaria or angioedema. (See Emergency Care and Complications.)