“pictures of urticaria -cholinergic urticaria pictures”

In some patients, foods such as egg white, shellfish and strawberries seem to trigger direct histamine release from mast cells and episodes of urticaria are related to ingestion of these foods. Again, skin prick testing and SIgE tests to the foods are negative, as the reaction is not IgE-mediated.
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Allergy symptoms are an example of an overreaction by the immune system to otherwise harmless substances, says Gailen D. Marshall, MD, PhD, professor of medicine and pediatrics at the University of Mississippi.
There is just not enough evidence to support using antihistamines and playing roulette with your patient’s health,” he said, noting that the degree of disability, both socially and occupationally, that accompanies chronic urticaria is on par with that of a patient awaiting triple coronary bypass.
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).
Harumi Jyonouchi, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American Association of Immunologists, American Medical Association, Clinical Immunology Society, New York Academy of Sciences, Society for Experimental Biology and Medicine, Society for Mucosal Immunology, and Society for Pediatric Research
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.
The rash that develops from poison ivy, poison oak, and poison sumac contact is commonly mistaken for urticaria. This rash is caused by contact with urushiol and results in a form of contact dermatitis called urushiol-induced contact dermatitis. Urushiol is spread by contact, but can be washed off with a strong grease- or oil-dissolving detergent and cool water and rubbing ointments.
Clinical Context:  Dapsone is the preferred sulfone. Other sulfones must be metabolized to dapsone for their effect. The mechanism of action is similar to that of sulfonamides in which competitive antagonists of PABA prevent the formation of folic acid, inhibiting bacterial growth.
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“In the late 1960s, we’d ask people how many had allergies and an estimated 1 in 10 people reported some form of allergy,” Marshall says. “Now compare that with 1 in 3 people in 2000 having some form of allergy.”
Hives (AKA urticaria) is not contagious by any means. They are a skin disorder that results in red, sometimes itching patches of raised skin. The patches of skin can be small or large, and generally appear quite fast and disappear on their own within hours or days. They can be as small as a few millimeters and as large as inches, and can even join together to become large areas called plaques. When they join together all over your body, they are generally known as body hives. This form of rash is often quite itchy in nature and can burn. Learn more on our page title “Are Hives Contagious?”
EU sometimes occurs only when someone exercises within 30 minutes of eating particular foods, such as wheat or shellfish. For these individuals, exercising alone or eating the injuring food without exercising produces no symptoms. EU can be diagnosed by having the patient exercise and then observing the symptoms. This method must be used with caution and only with the appropriate resuscitative measures at hand. EU can be differentiated from cholinergic urticaria by the hot water immersion test. In this test, the patient is immersed in water at 43 °C (109.4 °F). Someone with EU will not develop hives, while a person with cholinergic urticaria will develop the characteristic small hives, especially on the neck and chest.[citation needed]
This oral antihistamine can reduce the rash and other symptoms, like itching, by working from the inside out. Be sure to follow the dosage instructions on the package. The medicine usually kicks in within an hour, and you should see symptom reduction the same day.
As noted above, many cases of ordinary hives are “idiopathic,” meaning no cause is known. Others may be triggered by viral infections. A few may be caused by medications, usually when they have been taken for the first time a few weeks before. (It is less likely for drugs taken continuously for long periods to cause hives but certainly not impossible.) When a medication is implicated as a cause of hives, the drug must be stopped, since testing is rarely available to confirm the cause. In cases, drug-induced hives will go away in a few days. If a drug is stopped and the hives do not go away, this is a strong indication that the medication was not the cause of the hives.
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.
Treatment depends on the extent of symptoms and organ involvement. When levels of complement are normal and there is no internal organ involvement or underlying disease, the symptoms may improve on their own or with minimal treatment. In this case, antihistamines or nonsteroidal drugs such as ibuprofen or naproxen may be helpful. For more severe cases, other drugs which affect the immune system may be needed, such as corticosteroids (prednisone, others), hydroxychloroquine, colchicine, dapsone; and chemotherapies like azathioprine or cyclophosphamide. Treatment may be intermittent, although it is not uncommon for patients to need treatment for several years.

“definition of urticaria _urticaria en ingles”

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.
I have suffered for 2 years, intense itching from head to foot. After trying few types of medicines, finally homeopathy could cure me. Please make sure, the homeopath must be really well qualified to diagnose root cause. I strongly recommend homeopathy for urticaria.
papular urticaria (urticaria papulo´sa) an allergic reaction to the bite of various insects, with appearance of lesions that evolve into inflammatory, increasingly hard, red or brownish, persistent papules.
Research shows that up to 50% of people with CIU continue to have hives after treatment with antihistamines. Omalizumab, which is injected under the skin, has been shown to relieve the itch and clear hives in some people with CIU. In one research study, 36% of patients treated with omalizumab reported no itch and no hives after treatment.
Antihistamines – available either over the counter or by prescription – are a frequently recommended treatment for hives. They work by blocking the effect of histamine, a chemical in the skin that can cause allergy symptoms, including welts. Low-sedating or nonsedating antihistamines are preferred. They are effective and long-lasting (may be taken once a day) and have few side effects. Your allergist may recommend a combination of two or three antihistamines to treat your hives, along with cold compresses or anti-itch salves to ease the symptoms.
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.
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.
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.
“The patient who presents with relatively minor dermatological symptoms and a seemingly disproportionate amount of distress about these symptoms is telling you something,” she says. “They are telling you that they are experiencing significant distress but may not have the capacity to recognize the psychological contribution to their suffering.”
In some cases, the trigger is obvious – a person eats peanuts or shrimp, and then breaks out within a short time. Other cases require detective work by both the patient and the physician because there are many possible causes. In a few cases, the cause cannot be identified.
Once the cause of the rash is identified, it may be possible to avoid situations that trigger it. However, in many cases it is difficult to stop sweating, particularly in warm climates and if exercising is part of a daily routine. Sometimes rapid cooling can prevent an attack. For most patients regular administration of an oral antihistamine such as cetirizine can be helpful in preventing the condition from arising. Beta-blockers such as propranolol have also been reported to be useful.
In Chronic Urticaria it is far more difficult to identify a specific cause and the actual trigger in over 50% of cases remains unknown (Spontaneous Urticaria).  We call this urticaria due to unknown cause Chronic “Idiopathic” Urticaria (CIU) or Chronic Spontaneous Urticaria (CSU). Chronic Urticaria may be triggered by generalised illnesses such as autoimmune thyroid disease, collagen joint and vascular disease, chronic parasitic infections, chronic sinusitis, urinary infections, Helicobacter pylori and chronic dental infections. About one third of cases are due to auto-antibodies directed against IgE or the Mast Cell IgE receptor.  Sometimes food additives and preservatives (Benzoate, Sulphites and Artificial dyes) can continuously trigger chronic urticaria, but true food allergy is unlikely to cause Chronic Urticaria.
^ Jump up to: a b American Academy of Allergy, Asthma, and Immunology. “Five Things Physicians and Patients Should Question” (PDF). Choosing Wisely: an initiative of the ABIM Foundation. American Academy of Allergy, Asthma, and Immunology. Archived from the original (PDF) on November 3, 2012. Retrieved August 14, 2012
Solar urticaria is a rare disorder in which urticaria develops on areas of the body which are exposed to sunlight. Itching and urticaria may develop within a few minutes and may progress to angioedema. The symptoms usually resolve in a few hours. (Polymorphic light eruption may also cause an itchy rash on sun-exposed skin, but this rash is papular or eczematous; usually starts 6–8 h after sun exposure and lasts for several days.) Very rarely, patients may develop ‘aquagenic’ urticaria where their skin has been in contact with water (irrespective of its temperature) or urticaria in response to vibration.
Skin biopsy may be performed to confirm urticarial vasculitis. Microscopic findings of early lesions include a neutrophil leukocytoclastic vasculitis, in which there is damage to small vessels in the middle layers of the skin (dermis). In later lesions, a lymphocytic vasculitis may be seen.
Your doctor will be able to tell if you have hives by looking at your skin. If you suffer from any allergies and have a history of hives, it is even easier to reach a diagnosis. If you need to find out the cause of the allergic reaction, a blood test or a skin biopsy may be needed.
If these agents fail, colchicine, hydroxychloroquine, or dapsone may be effective. If all other treatment modalities have failed or if the patient has systemic involvement, consider initiating treatment with glucocorticoids. If the patient requires long-term treatment with corticosteroids, consider every-other-day dosing of the steroid or the addition of azathioprine as a steroid-reducing agent. Response to newer agents, including mycophenolate mofetil[20, 21] and rituximab, has been reported in the literature. Rituximab-based treatment can provide higher response rates compared with corticosteroids and conventional immunosuppressive agents, which supports its use in relapsing, refractory, or severe disease.[12]
In so many words, stress hives are caused by excessive stress. When you’re stressed out, your immune system is thrown off a little bit. In an effort to try to “fix” the problem (stress), your immune system sends out histamine. It’s as if your body becomes allergic to stress.Since histamine can’t cure stress, it causes your body to develop hives instead.
In some people hives are caused by physical triggers, including cold (such as cold air, water or ice), heat, sunlight (solar), vibration, rubbing or scratching of the skin (dermatographism) and delayed pressure (such as after carrying heavy bags.  In other people, exercise (sweating), stress, alcohol, spicy food or coffee may cause symptoms.
While hives do have many factors that can be used in the distinguishing of them, perhaps the most common of all symptoms is the appearance of urticaria, or welts. These welts are red, itchy and usually appear quickly, only to dissipate shortly after, but depending on the allergen, can come back and are replaced by others.
If your stress hives are accompanied by swelling of any part of the throat or face (see hives on face) that results in restricted breathing, seek treatment immediately from your nearest emergency room. Stress is bad enough, dying from not being able to get air into your lungs is a horrible way to go.
Urticarial vasculitis is a variant of cutaneous small vessel vasculitis. It is characterised by inflamed and reddened patches or weals on the skin that appear to resemble urticaria, but when the skin is examined closely under a microscope, a vasculitis is found (inflamed blood vessels).
What is cholinergic urticaria and how is it treated? Learn about cholinergic urticaria, a rash that can appear when the body gets warm and sweats. We look at symptoms, treatment, diagnosis, and prevention. Read now
A trigger causes cells in the skin to release chemicals such as histamine. These chemicals cause fluid to leak from tiny blood vessels under the skin surface. The fluid pools to form weals. The chemicals also cause the blood vessels to open wide (dilate) which causes the flare around the weals. The trigger is not known or identified in about half of cases. Some known triggers include:
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Okubo Y, Shigoka Y, Yamazaki M, Tsuboi R. Double dose of cetirizine hydrochloride is effective for patients with urticaria resistant: a prospective, randomized, non-blinded, comparative clinical study and assessment of quality of life. J Dermatolog Treat. 2013 Apr. 24(2):153-60. [Medline].
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]
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.
If the disease is very large doses of Methylprednisolone or Plasmapheresis (plasma exchange) may also be given. When the disease becomes quiet less toxic drugs are used to keep control and these include: Azathioprine, Methotrexate and Mycophenolate Mofetil usually in combination with low dose prednisolone.
If your reaction is severe, especially if the swelling involves your throat, you may need an emergency shot of epinephrine (adrenaline) or steroids. Hives in the throat can block your airway, making it difficult to breathe.

“urticaria chronic idiopathic +urticaria treatment”

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If hives are making it difficult to sleep, then it may be necessary to see a physician. This would be especially important if you are taking nonprescription antihistamines. If your hives last longer than two months, it is also likely you will benefit from visiting a physician.
There are two forms of heat urticaria. The more common form is also called cholinergic urticaria or generalized heat urticaria. In this form, it occurs when the body temperature is raised such as in a hot bath or shower, from a fever or exercise. The outbreak begins with a few small hives and gradually become more widespread. If the reaction is very severe, the wheals will run together, leading to a drop in blood pressure and loss of consciousness. Cholinergic urticaria is helped by antihistamines given regularly in severe cases or intermittently upon exposure to milder cases.
Many medications can cause hives, but only about 10% of hives are caused by medications. Hives will most often occur in the first 36 hours after starting the medication, but hives can occur even after taking a medicine for a long time. You can see that antibiotics are a common culprit.
Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.
Hide M, Francis DM, Grattan CE, Hakimi J, Kochan JP, Greaves MW. Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med. 1993 Jun 3. 328(22):1599-604. [Medline].
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.
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.
Other potential triggers of chronic hives include heat and aggravating your skin by scratching it or putting pressure on it (for example, by wearing tight clothes or sitting on a hard surface). Keeping a diary in which you record when and where your symptoms developed or worsened can help you and your doctor find clues and pinpoint your triggers, says Anand. But if even that doesn’t help, don’t lose heart: For most people, even hives whose cause is unknown gradually disappear on their own over time.
Protect yourself from pollen. There are some cases where environmental agents can cause hives. If you react to pollen, avoid being outside in the morning and in the evening when pollen levels are at their highest. Keep your windows closed during these times as well and avoid drying clothes outside. Change into “indoor clothes” as soon as possible and wash your “outdoor clothes” right away.
“My allergist tested me for everything but we still couldn’t figure out a cause for the hives. It was so frustrating to keep searching for a cause. And as much as I was seeking answers, I wasn’t getting any, and wasn’t getting any relief either. Weeks passed, but the hives didn’t. Friends and family offered suggestions and their own explanations but they didn’t understand what I was going through.
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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]
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.
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.
4. Rockwell WJ. Reactions to molds in foods. In: Chiaramonte LT, Schneider AT, Lifshitz F, editors. Food allergy: a practical approach to diagnosis and management. New York: Marcel Dekker; 1988. pp. 153–70.
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.
Dermatographism, the ability to write on the skin, can occur as an isolated disorder that often presents as traumatically induced urticaria. It can be diagnosed by observing the skin after stroking it with a tongue depressor or fingernail (click for picture). A white line secondary to reflex vasoconstriction is followed by pruritus, erythema, and a linear wheal, as is seen in a classic wheal-and-flare reaction. It is rarely severe enough to require treatment.
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It stands in contrast to the linear reddening that does not itch seen in healthy people who are scratched. In most cases, the cause is unknown, although it may be preceded by a viral infection, antibiotic therapy, or emotional upset. Dermographism is diagnosed by taking a tongue blade and drawing it over the skin of the arm or back. The hives should develop within a few minutes. Unless the skin is highly sensitive and reacts continually, treatment is not needed. Taking antihistamines can reduce the response in cases that are annoying to the patient.[citation needed]
Non-sedating H1 antihistamines are the mainstay of treatment. Cetirizine, loratadine and fexofenadine are usual choices. Studies comparing antihistamines are limited and so far no single antihistamine has shown itself to be superior for chronic spontaneous urticaria[6]. Once symptom control has been achieved, the antihistamine should be continued for 3-6 months.
There has been a high incidence of autoantibody to thyroid glands reported among those with anti-Fc-receptor antibodies and it is suggested that yearly thyroid testing be done by the primary care physician.
Hives can be caused by an allergic reaction to foods, drugs, insect bites, infections or substances which can cause other allergic reactions. However not all cases are caused by allergy; frequently they are caused by viruses. It can sometimes be extremely difficult to find the cause. Triggers include medications, food, viruses, latex, heat, cold and direct exposure to sun. If the cause is known, the trigger should be avoided.
The majority of the time, a doctor will know that you have hives just by looking at your skin. To get to the root of your hives, a doctor also, hopefully, will  ask you about any recent life stressors, or exposure to possible or known allergens.  If a patient complains of itchiness, he or she will often recommend diphenhydramine. Common side effects of antihistamines include drowsiness, dizziness, dry mouth/nose/throat, upset stomach, increased appetite and weight gain, thickening of mucus, vision changes and feeling nervous, excited or irritable. (12)

“urticaria vasculitis hives natural treatment”

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.
What causes hives? Hives are typically caused by an allergic reaction. The allergy can be to a food or medication. When your body is allergic to something, it can release chemicals that make your skin develop hives. An infection or emotional stress can also cause hives.
AAFA provides practical information, community based services and support to people through a network of Regional Chapters, Support Groups and other Local Partners around the U.S. AAFA develops health education, organizes state and national advocacy efforts and funds research to find better treatments and cures.
Though we may not fight wild animals anymore, there are still “wild animals” facing us daily in the form of arguments, a phone that won’t stop ringing, and perpetually full in-boxes. Now when you add miserable allergy symptoms, you’ve got a recipe for disaster — unless you take time to do something for stress relief.
This is a common disorder of unknown origin, whose subjects need not be atopic individuals; that is, they do not have an increased incidence of atopic dermatitis, allergic rhinitis, or asthma compared to the incidence of these disorders in the absence of chronic urticaria although their IgE level, as a group, is higher than normal. Some patients are dermatographic, although this is usually of milder degree than is seen with the IgE-dependent dermatographism described earlier. The dermatographism may wax and wane, and the urticaria may vary from severe to mild or may intermittently subside. These individuals have a normal white-blood-cell count and erythrocyte sedimentation rate (ESR) and have no evidence of systemic disease. CSU does not appear to be an allergic reaction in the classic sense, because IgE antibody is not involved and no external allergen is needed to initiate or perpetuate the process. It differs from allergen-induced skin reactions or from physically induced urticaria (e.g., dermatographia or cold urticaria) in that histologic studies reveal a prominent cellular infiltrate around small venules, with an increased number of mast cells. External examination reveals hives with palpably elevated borders, sometimes varying greatly in size and/or shape but generally being rounded.
This is termed scombroid food poisoning. Ingestion of free histamine released by bacterial decay in fish flesh may result in a rapid-onset, allergic-type symptom complex which includes hives. However, the hives produced by scombroid is reported not to include wheals.[21]
Angioedema is a related type of swelling that affects deeper layers in your skin, often around your face and lips. In most cases, hives and angioedema are harmless and don’t leave any lasting marks, even without treatment.
When a small child gets hives, it’s almost always due to an allergy. Hives on a baby, or hives on a toddler, can be particularly disturbing. Many parents wonder how can you tell hives vs rash. There is a quick skin test called “wheal and flare” that can help confirm whether or not it’s hives. According to Jon McCullers, M.D., pediatrician-in-chief at Le Bonheur Children’s Hospital in Memphis, if your child has a big red patch on his or her skin and you see swelling (that’s the “wheal”), drag a fingernail over the area and if you see a brighter redness (“flare”) then it’s an allergic reaction. (11)
San Francisco — Although the expression “I was so stressed I broke out in hives” is quite common, it can be a challenge for dermatologists to identify the psychosocial precipitants of chronic urticaria, according to Josie Howard, M.D., a psychiatrist in private practice, and clinical instructor departments of psychiatry and dermatology, University of California, San Francisco. But that is beginning to change, she says.
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.
Change in temperature. Cold urticaria is caused by exposure to low temperatures followed by re-warming. This can be severe and life-threatening if there is a general body cooling – for example, after a plunge into a swimming pool.
Robert A Schwartz, MD, MPH Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School
EU sometimes occurs only when someone exercises within 30 minutes of eating particular foods, such as wheat or shellfish. For these individuals, exercising alone or eating the injuring food without exercising produces no symptoms. EU can be diagnosed by having the patient exercise and then observing the symptoms. This method must be used with caution and only with the appropriate resuscitative measures at hand. EU can be differentiated from cholinergic urticaria by the hot water immersion test. In this test, the patient is immersed in water at 43 °C (109.4 °F). Someone with EU will not develop hives, while a person with cholinergic urticaria will develop the characteristic small hives, especially on the neck and chest.[citation needed]
Anti-inflammation medications. Oral corticosteroids, such as prednisone, can help lessen swelling, redness and itching. These are generally for short-term control of severe hives or angioedema because they can cause serious side effects if taken for a long time.
In some people hives are caused by physical triggers, including cold (such as cold air, water or ice), heat, sunlight (solar), vibration, rubbing or scratching of the skin (dermatographism) and delayed pressure (such as after carrying heavy bags.  In other people, exercise (sweating), stress, alcohol, spicy food or coffee may cause symptoms.
Blanchable, raised, palpable wheals, which can be linear, annular (circular), or arcuate (serpiginous); can occur on any skin area; are usually transient and migratory; and may coalesce rapidly to form large areas of erythematous, raised lesions that blanch with pressure
Pronounced “ur-ti-kair-ee-uh,” this is the medical term for hives. Urticaria appear as red, itchy bumps or welts on the skin that can appear anywhere on the body. A red hive will turn pale when pressed in the center, which is called “blanching.” For every 10 whose hives are chronic, at least seven of them have CIU.
Hives fall into two categories on the basis of the time they have been present: acute urticaria (ordinary hives, which resolve after six to eight weeks) and chronic urticaria (that continues longer than six to eight weeks). Since hives are so common and acute urticaria, by definition, resolves spontaneously, physicians do not generally expend much time or expense to evaluate the cause of hives of less than eight weeks’ duration.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include:
“There is more and more evidence that antidepressants may be less useful than psychotherapy and cognitive behavioral therapy in treating mild-to-moderate depression,” Dr. Howard says. “Any patient who starts an antidepressant needs to be followed closely and monitored for the emergence of manic or hypomanic symptoms.”
An itchy skin eruption characterized by weals with pale interiors and well-defined red margins; usually the result of an allergic response to insect bites or food or drugs. – (Source – Diseases Database)
There has been a high incidence of autoantibody to thyroid glands reported among those with anti-Fc-receptor antibodies and it is suggested that yearly thyroid testing be done by the primary care physician.
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.
Once it has been discovered that the anti-IgE Fc-receptor antibody is present in a patient’s blood, it is no longer necessary to look for any other cause for hives. Why this autoantibody triggers hives only intermittently is unknown. Many people with this autoantibody feel that their hives are more likely to occur when they are stressed. Some women feel that hormonal changes that occur just prior to their menstrual periods also trigger their hives. Some medications, especially aspirin, ibuprofen (Advil), or naproxsen (Aleve) are also more likely to trigger hives. However, Tylenol (acetominophen) does not usually trigger hives or swelling.
As noted above, many cases of ordinary hives are “idiopathic,” meaning no cause is known. Others may be triggered by viral infections. A few may be caused by medications, usually when they have been taken for the first time a few weeks before. (It is less likely for drugs taken continuously for long periods to cause hives but certainly not impossible.) When a medication is implicated as a cause of hives, the drug must be stopped, since testing is rarely available to confirm the cause. In most cases, drug-induced hives will go away in a few days. If a drug is stopped and the hives do not go away, this is a strong indication that the medication was not the cause of the hives.
Physical factors such as cold, heat, sweating, exercise, pressure, sunlight, water and vibration may all trigger urticarial reactions. The weals of physical urticarias tend to be short-lived (less than an hour), apart from those of delayed pressure urticaria, which develop over a few hours and may take up to 2 days to disappear. International standards for diagnosing physical urticarias have been proposed [14].
Certain soaps may dry your skin and cause more itching when you have hives. Make sure to use a soap that’s marketed for sensitive skin. Find a great selection here. These typically omit fragrance and other irritating chemicals.
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.

“welts treatment urticaria pruritus”

Text: “Skin Conditions: Hives (Urticaria and Angioedema)”,- WebMD Medical Reference provided in collaboration with the Cleveland Clinic,”Understanding Hives- Treatment”, – WebMD Medical Reference, “Allergic Reaction”- WebMD Medical Reference from eMedicineHealth
Urticaria, also known as hives, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly — either as a result of the body’s adverse reaction to certain allergens, or for unknown reasons.
Use a cold compress. Since skin irritation is the main symptom of hives, you should treat the skin to help alleviate the hives. Take a clean, cotton towel and soak it in cool water. Squeeze out the extra water and place over the affected areas. Leave it on for 10 minutes, then re-soak the towel to keep the water cool, which will in turn keep your skin cool.
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
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.
There are other medications that may be added to the antihistamines, but these non-standard therapies are not always effective. However, if the hives are not responding, they are worth a try. Examples are anti-acid pills (cimetidine, ranitidine), dapsone and sulfasalazine (anti-inflammatory antibiotics), nifedipine (a blood pressure medicine), Accolate (an asthma drug), colchicine (a drug for gout), and several others.
Sometimes hives go away on their own without treatment. Otherwise, hives can generally be treated at home. The most common treatment for hives is an over-the-counter (OTC) antihistamine. Antihistamines can relieve symptoms like itching. You can find a great selection of OTC antihistamines here.
In this rare form of physical urticaria, hives occur after exposure to the sun or to certain artificial light sources. It is believed that the condition is an allergic reaction to an antigen formed by the interaction of light waves on the skin. Antihistamines are helpful to relieve the itch.
This process is caused by several mechanisms. The type I allergic IgE 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. The type II allergic response is mediated by cytotoxic T cells, causing deposits of immunoglobulins, complement, and fibrin around blood vessels. This leads to urticarial vasculitis. The type III immune-complex disease is associated with systemic lupus erythematosus and other autoimmune diseases that cause urticaria. [15]
It has been recently discovered that some persons who suffer with hives or angioedema also have an autoimmune disease. In these cases, autoantibodies have been formed that bind to the Fc-receptor on mast cells. The normal function of the Fc-receptor is to anchor allergic antibodies, called IgE, to the mast cell surface (see the mast cell diagram below). IgE is formed in allergic persons and binds specifically to allergens in the environment. When airborne allergens land on nasal tissues or eye conjunctiva, or are eaten (foods) and enter the body through the intestinal tract they bind to the specific IgE. As a result of this interaction, a signal is sent by the IgE antibody to the mast cell causing it to release its histamine. Histamine release causes the nasal and eye symptoms seen in those who suffer with “hay fever” and can produce hives, angioedema, or even life-threatening symptoms such as respiratory compromise or low blood pressure.
If the cause of the urticaria is known or suspected, such as a food or medication, avoidance of this trigger may resolve the symptoms. In cases of chronic idiopathic urticaria, triggers such as acute infections of any kind (such as the common cold), stress, and use of non-steroidal anti-inflammatory medications (aspirin and ibuprofen, for example), may trigger the symptoms.
CIU & You is an educational program focused on supporting the specific needs of people suffering with chronic idiopathic urticaria. Developed in partnership with the Asthma and Allergy Foundation of America (AAFA), and made possible by Novartis Pharmaceuticals Corporation and Genentech, CIU & You aims to educate patients and encourage patients to better communicate their symptoms to their healthcare provider.
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 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.
Initially it is helpful to explain to patients what urticaria is and that very often it is not due to ‘an allergy’. They may be reassured that in nearly all cases there is no serious underlying medical problem causing the rash; that safe, effective treatments are available and that the long-term prognosis is usually good. A patient information leaflet, such as that available from the British Association of Dermatologists [48], is helpful.
There are some researches that link post-traumatic stress disorder (PTSD), a classic stress-mediated syndrome with urticaria (the medical term for hives or nettle-rash), clearing the possible co-morbidity.
Certain soaps may dry your skin and cause more itching when you have hives. Make sure to use a soap that’s marketed for sensitive skin. Find a great selection here. These typically omit fragrance and other irritating chemicals.
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.
Angioedema, on the other hand, is usually not red or itchy, but tends to sting and burn, and can be described as “numbness.” This swelling can be severe, and if it affects a person’s ability to breathe, can be life-threatening.
The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.
Methods of stress relief may include taking a much-deserved vacation, starting a hobby as a distraction from stress, practicing meditation and mindfulness, and exercising. If stress-relieving activities don’t help to reduce your hives, treatment with oral antihistamines will likely help. You can also work with your doctor or a psychologist to address specific causes of stress and develop coping mechanisms.
Cicardi M, Aberer W, Banerji A, Bas M, Bernstein JA, Bork K, Caballero T, Farkas H, Grumach A, Kaplan AP, Riedl MA, Triggiani M, Zanichelli A, Zuraw B; HAWK under the patronage of EAACI (European Academy of Allergy and Clinical Immunology). Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group. Allergy. 2014 May;69(5):602-16. doi: 10.1111/all.12380. Epub 2014 Mar 27. PubMed PMID: 24673465.
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]
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.
As in other types of vasculitis, diagnosis will depend on the doctor recognising the pattern of symptoms and examination findings. Blood is commonly taken to test for raised levels of “C-reactive protein” (CRP) and “Erythrocyte Sedimentation Rate” (ESR) which indicate inflammation in the body. Skin and kidney biopsies may also be taken to confirm the diagnosis.

” +tricardia”

There are many causes of hives including foods, drugs, infections, and diseases. Oddly enough, even though there are many potential causes, in the majority of cases of hives, the cause is unknown. Hives causes can be broken down into 3 broad groups:
Omalizumab, an anti-IgE antibody[9]. It is effective in 80% but requires monthly injections and relapse is common when it is stopped. The National Institute for Health and Care Excellence (NICE) recommends omalizumab as an add-on treatment for refractory severe chronic spontaneous urticaria[10].
a vascular reaction of the skin that is commonly immunologically based or may be due to direct exposure to a chemical. Marked by transient appearance of slightly elevated patches (wheals) which are redder or paler than the surrounding skin and often attended by severe itching; called also hives. The wheals may be in very large numbers, mostly over the body, 0.5 to 2 inches in diameter and there is no discontinuity of the epithelium. Called also nettle rash.
Steroid-sparing options:  The older tricyclic antidepressant Doxepin (10 to 50mg daily) has histamine blocking properties and is useful as an adjunct especially if there is co-existent depression with the urticaria.  Leukotriene Receptor antagonists, Singulair or Montelukast (10mg at night) has been used with variable success, and is most effective when used in combination with non-sedating anti-histamines.  Montelukast is very useful in aspirin sensitive individuals (who are prone to urticaria, nasal polyps and asthma).
Hives are very common. They usually go away on their own, but if you have a serious case, you might need medicine or a shot. In rare cases, hives can cause a dangerous swelling in your airways, making it hard to breathe – which is a medical emergency.
Getting to the bottom of what caused your hives is not easy and it’s possible that you may never know. However, it’s also likely that you can check many of these known causes off your list of potential triggers. Since most cases have no known cause, what is important is properly treating hives, which is typically done with done with antihistamines.
Lesions of urticarial vasculitis initially appear as erythematous wheals (see image below). As the lesions progress, purpura may develop. Often, the urticarial vasculitis lesions resolve with postinflammatory pigmentation. Annular or targetoid lesions may be observed.
Angioedema is swelling of the deeper tissue that sometimes occurs with hives. Like hives, angioedema can occur on any part of the body. When it occurs around the mouth or throat, the symptoms can be severe, including airway blockage.
Chronic hives can go on for months and years. They can interfere with sleep, work and other activities. The following precautions may help prevent or soothe the recurring skin reactions of chronic hives:
Chronic hives should be evaluated by an allergist, who will ask about your and your family’s medical history, substances to which you are exposed at home and at work, exposure to pets or other animals and any medications you’ve taken recently. If you have been keeping a food diary, show it to your allergist.
Urticaria results from the release of histamine, bradykinin, kallikrein, and other vasoactive substances from mast cells and basophils in the superficial dermis, resulting in intradermal edema caused by capillary and venous vasodilation and occasionally caused by leukocyte infiltration.
Urticaria, commonly known as hives, is a distressing disorder affecting up to 20 percent of the population at some point in their lives. The swelling that sometimes accompanies urticaria, called angioedema, can lead to swelling of the face, hands and feet.
Get medical help. In rare cases, hives can cause swelling in the throat and can cause an emergency situation that requires epinephrine. Epinephrine can also be used as an EpiPen in those who are severely allergic to a particular substance and require epinephrine to avoid anaphylaxis, which is a severe allergic reaction that may occur with or without the appearance of hives. The symptoms of an anaphylactic reaction include:
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].
I bought some Sovereign Silver from a health shop in America. It is an immune builder. My Urticaria was gone I swear within THREE days. You have to buy it online here but if you haven’t tried it then please do as it may work for you as it has for me. My rash was horrendous and covered every bit of my body.
Angioedema is swelling in the deeper layers of a person’s skin. It’s often severe and is caused by a build-up of fluid. The symptoms of angioedema can affect any part of the body, but usually affect the:
Genetics. Hereditary angioedema is a rare inherited (genetic) form of the condition. It’s related to low levels or abnormal functioning of certain blood proteins that play a role in regulating how your immune system functions.
Patients with chronic idiopathic urticaria often do not respond to antihistamines or other drugs commonly used. Omalizumab, a monoclonal antibody that can suppress certain allergic reactions, may help relieve symptoms, but experience with this use is limited.
If your reaction is severe, especially if the swelling involves your throat, you may need an emergency shot of epinephrine (adrenaline) or steroids. Hives in the throat can block your airway, making it difficult to breathe.
The goal of treating most cases of ordinary acute urticaria is to relieve symptoms while the condition goes away by itself. The most commonly used oral treatments are antihistamines, which help oppose the effects of the histamine leaked by mast cells. The main side effect of antihistamines is drowsiness.
Urticaria is a common condition – it is estimated that lifetime incidence of urticaria is approximately 15%, with females being affected more often than males. Both children and adults may develop urticaria, with the peak age of onset in adults being between 20 and 40 years. Urticaria is defined as ‘acute’ if it lasts for less than 6 weeks and ‘chronic’ if it lasts for more than 6 weeks. ‘Episodic’ urticaria, which occurs intermittently, but recurrently over months or years, is also recognized. Most urticarial reactions are acute and self-limiting; however, patients referred to allergy clinics usually have chronic urticaria or episodic urticaria. Histology shows oedema of the upper dermis, dilatation of blood vessels and lymphatics and a cellular infiltrate in the dermis. The nature of this cell infiltrate varies depending on the type of urticaria and the duration of the weal.
The intense discomfort may tempt you to self-medicate but this is not advisable as certain medications may aggravate your condition. It would be wise to seek medical attention as soon as possible so that you recover quickly. However, if you experience fever and/or breathing problems, you may require immediate medical attention. Make a list of all your symptoms, no matter how trivial they may seem, so that your doctor is able to make an accurate diagnosis.
You might also want to take the time to review your priorities and the sources of stress in your life. Are there things you can do to reduce or eliminate stressful activities? Pay attention to when your stress appears, and then make a list of ways you can change the situation or your reaction to the situation. For example, you might decide to look for a new job, or, decide you need to change your perception of your job. Working with a cognitive behavioral therapist may also help change your thought process and bring more balance to your life.
^ Jump up to: a b c d e f g h i j k l m n o p q r s Jafilan, L; James, C (December 2015). “Urticaria and Allergy-Mediated Conditions”. Primary care. 42 (4): 473–83. doi:10.1016/j.pop.2015.08.002. PMID 26612369.
While hives do have many factors that can be used in the distinguishing of them, perhaps the most common of all symptoms is the appearance of urticaria, or welts. These welts are red, itchy and usually appear quickly, only to dissipate shortly after, but depending on the allergen, can come back and are replaced by others.

“hive help _what is chronic urticaria”

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].
Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2006 Oct. 55(4):705-9. [Medline].
Urticaria, otherwise known as hives, is an itchy red blotchy rash resulting from swelling of the superficial part of the skin. It can be localised or more widespread. Angio-oedema occurs when the deeper tissues, the lower dermis and subcutaneous tissues, are involved and become swollen.
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.
What we do know: hives, also known as urticaria, can appear anywhere on the body, including your face, torso, arms, legs, and even inside your mouth and ears. They may range in size from as tiny as a pencil tip to as large as a dinner plate. Hives typically crop up when you have an allergic reaction to a substance—pet dander, pollen, latex—triggering your body to release histamine and other chemicals into your blood. That’s what causes the itching, swelling, and other symptoms.  
Patients with CSU have an increased frequency of Hashimoto’s thyroiditis. An association has been noted with the presence of antibodies to thyroglobulin, or a microsomal-derived antigen (peroxidase) even if patients are euthyroid. The incidence of thyroid autoantibodies in patients with chronic urticaria is approximately 24%. Thyroid function and thyroid antibodies should be checked in all patients with chronic urticaria. There are no data to suggest that either of these antibodies are pathogenic in terms of hive formation and it is believed that these are associated, parallel, autoimmune events.
Di Campli C, Gasbarrini A, Nucera E, Franceschi F, Ojetti V, Sanz Torre E, et al. Beneficial effects of Helicobacter pylori eradication on idiopathic chronic urticaria. Dig Dis Sci. 1998 Jun. 43(6):1226-9. [Medline].
Hives are an unpleasant inflammatory skin condition that 20 percent of the population will experience at some point in time. Thankfully, hives typically are  not serious. With some simple natural remedies, you can calm a hives outbreak on yourself or your child quite quickly. Inexpensive, common household items like oatmeal, witch hazel and baking soda are really effective at calming the itching and redness that usually accompany hives. If your child experiences hives, you should make sure you aren’t using any harsh body care products on his or her skin. You should also avoid hot baths and tight-fitting clothes. I hope that you won’t experience hives anytime soon, but if you do, a natural hives treatment will really come in handy.
In this rare form of physical urticaria, hives occur after exposure to the sun or to certain artificial light sources. It is believed that the condition is an allergic reaction to an antigen formed by the interaction of light waves on the skin. Antihistamines are helpful to relieve the itch.
A much rarer type of urticaria, known as urticaria vasculitis, can cause blood vessels inside the skin to become inflamed. In these the weals last longer than 24 hours, are more painful, and can leave a bruise.
Angioedema – swelling of tissue beneath the surface of the skin – can be mistaken for or associated with hives. It can be caused by allergic reactions, medications or a hereditary deficiency of some enzymes. The following symptoms may indicate angioedema:
Usually not. The rash is itchy but normally fades within a day or so and causes no harm. Most people with hives (acute urticaria) do not feel too unwell unless they have a cold or flu that is triggering the rash. The cause of the rash is not known in more than half of cases and it is commonly a one-off event.
Skin biopsy may be performed to confirm urticarial vasculitis. Microscopic findings of early lesions include a neutrophil leukocytoclastic vasculitis, in which there is damage to small vessels in the middle layers of the skin (dermis). In later lesions, a lymphocytic vasculitis may be seen.

“articurial -where do hives come from”

Urticarial vasculitis is a variant of cutaneous small vessel vasculitis. It is characterised by inflamed and reddened patches or weals on the skin that appear to resemble urticaria, but when the skin is examined closely under a microscope, a vasculitis is found (inflamed blood vessels).
New-onset episodes of urticaria can be associated with identifiable causes, and the method of exposure (ie, direct contact, oral or intravenous [IV] routes) can be deduced by taking a careful history. (See Etiology.)
Allergic hives and angioedema form when, in response to histamine, blood plasma leaks out of small blood vessels in the skin. Histamine is a chemical released from specialized cells along the skin’s blood vessels.
[Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009 Oct. 64(10):1427-43. [Medline].
When hives occur due to an allergy, high levels of histamine and other chemical messengers are released into the skin. These substances cause your blood vessels to up. This often results in pinkness or redness, as well as extra fluid in the tissues, which causes swelling and itching. (7)
Clinical Context:  Colchicine is an alkaloid extract that inhibits microtubule formation. It is often used for the treatment of acute gout. Colchicine has been reported effective for urticarial vasculitis. It concentrates well in leukocytes and reduces neutrophilic chemotaxis and motility. Histologically, urticarial vasculitis presents with neutrophil involvement; therefore, colchicine possibly is useful. However, drug’s effect has not been proven in clinical trials.
Management of urticaria is focused on treating the symptoms and typically is not altered by underlying etiology. The mainstay is avoidance of further exposure to the antigen causing urticaria. Pharmacologic treatment options include the following:
Temperature: If you develop hives when exposed to cold, do not swim alone in cold water and always carry an epinephrine auto-injector. Avoid exposure to cold air and use a scarf around your nose and mouth in cold weather. If you must be out in the cold, wear warm clothing.
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.
Urticaria (hives) is a vascular reaction of the skin marked by the transient appearance of smooth, slightly elevated papules or plaques (wheals) that are erythematous and that are often attended by severe pruritus. Individual lesions resolve without scarring in several hours. Most cases of urticaria are self-limited and of short duration; the eruption rarely lasts more than several days, it but may be recurrent over weeks. Chronic urticaria is defined as urticaria with recurrent episodes lasting longer than 6 weeks).
Cholinergic or generalized heat urticaria is characterized by the onset of small (1 mm) punctate wheals surrounded by a prominent erythematous flare associated with exercise, hot showers, sweating, and anxiety (click for picture). Typically, lesions first appear about the neck and upper thorax; when viewed from a distance, hives may not be perceived and the patient appears flushed. Pruritus is a prominent feature of the reaction. Gradually the lesions spread distally to involve the face, back and extremities, and the wheals increase in size. In some patients the hives become confluent and resemble angioedema. Although uncommon, symptoms of more generalized cholinergic stimulation such as lacrimation, salivation, and diarrhea may occasionally be seen. These various stimuli have the common feature of being mediated by cholinergic nerve fibers. Cholinergic urticaria is the only form of hives in which emotional stimuli can, in some patients, initiate an urticarial reaction.  One study suggests that a subpopulation of patients has IgE antibody to an antigen in sweat.

“hives in throat |urticaria pregnancy”

Okubo Y, Shigoka Y, Yamazaki M, Tsuboi R. Double dose of cetirizine hydrochloride is effective for patients with urticaria resistant: a prospective, randomized, non-blinded, comparative clinical study and assessment of quality of life. J Dermatolog Treat. 2013 Apr. 24(2):153-60. [Medline].
A weal (or wheal) is a superficial skin-coloured or pale skin swelling, usually surrounded by erythema (redness) that lasts anything from a few minutes to 24 hours. Usually very itchy, it may have a burning sensation.
Patients with CSU have an increased frequency of Hashimoto’s thyroiditis. An association has been noted with the presence of antibodies to thyroglobulin, or a microsomal-derived antigen (peroxidase) even if patients are euthyroid. The incidence of thyroid autoantibodies in patients with chronic urticaria is approximately 24%. Thyroid function and thyroid antibodies should be checked in all patients with chronic urticaria. There are no data to suggest that either of these antibodies are pathogenic in terms of hive formation and it is believed that these are associated, parallel, autoimmune events.
In Chronic Urticaria it is far more difficult to identify a specific cause and the actual trigger in over 50% of cases remains unknown (Spontaneous Urticaria).  We call this urticaria due to unknown cause Chronic “Idiopathic” Urticaria (CIU) or Chronic Spontaneous Urticaria (CSU). Chronic Urticaria may be triggered by generalised illnesses such as autoimmune thyroid disease, collagen joint and vascular disease, chronic parasitic infections, chronic sinusitis, urinary infections, Helicobacter pylori and chronic dental infections. About one third of cases are due to auto-antibodies directed against IgE or the Mast Cell IgE receptor.  Sometimes food additives and preservatives (Benzoate, Sulphites and Artificial dyes) can continuously trigger chronic urticaria, but true food allergy is unlikely to cause Chronic Urticaria.
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Serhat Inaloz H, Ozturk S, Akcali C, Kirtak N, Tarakcioglu M. Low-dose and short-term cyclosporine treatment in patients with chronic idiopathic urticaria: a clinical and immunological evaluation. J Dermatol. 2008 May. 35(5):276-82. [Medline].
Immunotherapy: Allergy shots help only if a person has hives because of what they breathe. These people can be successfully desensitized. Cross reacting proteins from inhalants that are also found in foods can help drop the degree of reactivity to those foods.
Usually not. The rash is itchy but normally fades within a day or so and causes no harm. Most people with hives (acute urticaria) do not feel too unwell unless they have a cold or flu that is triggering the rash. The cause of the rash is not known in more than half of cases and it is commonly a one-off event.
If you have chronic hives, it’s important to try to identify your triggers, if and take steps to avoid them so you can lower the risk of an exacerbation. While you may already be aware of common triggers, such as allergies to pollen, pet dander, and shellfish, here are some lesser-known triggers of chronic hives:
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)
“Sometimes, it’s just a matter of planting a seed that somatic symptoms respond to stress reduction techniques that can motivate a patient to pursue treatment,” Dr. Howard says. “This can also lead to diagnosis and treatment of previously unidentified psychiatric comorbidities such as mood and anxiety disorders.
There are two types of hives: ordinary hives and physical hives. Ordinary hives appear suddenly, in several different places and for no apparent reason. These hives come and go in waves and can last minutes or several hours. Ordinary hives tend to be itchy, swell and turn red. Breakout episodes can last a few days, weeks and in some cases, years. Physical hives, on the other hand, are caused from dermatographism, physical stimulation.
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].
The autologous serum skin test is sometimes carried out in chronic spontaneous urtciaria, but its value is uncertain. It is positive if an injection of the patien’s serum under the skin causes a red weal.
Mutations in the CIAS1 gene, which codes for cryopyrin, cause autoinflammatory syndromes, one of which is Muckle–Wells syndrome [85], also known as urticaria–deafness–amyloidosis (UDA). It is a rare, autosomal dominant condition which presents with spontaneous urticaria, sensorineural deafness, episodic fevers and arthralgia and it may progress to renal amyloid.
Medications: Topical ointments can be applied to the skin to relieve the itch. Antihistamines will reduce the itching and swelling. Cortisone drugs used as an ointment or given by mouth may be needed.
The Food Standards Code requires that certain foods must be listed on the package of a food, or made known to the customer upon request. If you experience an allergic reaction to a known allergen not…
If you have a bad allergic reaction, like shortness of breath, talk to your doctor about a prescription medicine called an “auto-injector.” This medicine stops the allergic reaction when you inject it into your thigh. Follow your doctor’s advice on how to use this medicine.
Acute urticaria, which is an allergic (IgE-mediated) reaction, is common in both children and adults. This type of urticaria is a self-limiting process that occurs when mast cells in the skin are activated, degranulate, and secrete histamine, leukotrienes, platelet activating factor (PAF), enzymes such as tryptase and chymase, cytokines, and chemotactic cytokines (chemokines). When an allergen (for example, a food) to which the person is allergic arrives via the bloodstream to mast cells in the skin, it binds to the IgE, and the mast cells become activated, and degranulate. Allergens that can result in acute urticaria include foods, drugs (particularly antibiotics such as penicillin), and venoms from bee, wasp, yellow jacket, hornet, or fire ants. Virtually any allergen that can be disseminated throughout the body, and to which there is an IgE response, has the potential to cause generalized urticaria.
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 hives urticarial dermatitis”

Rashes caused by stress may vary in treatment and length. Stress rash caused by hives will likely disappear with time and mild-to-moderate treatments. You may need to see a doctor to treat stress-related skin conditions such as acne, dermatitis, or severe or long-lasting hives. If you have chronic conditions like psoriasis and rosacea, you should work with your doctor to develop an appropriate treatment plan to use in the long term.
Mechanisms other than allergen-antibody interactions are known to cause histamine release from mast cells. Many drugs, for example morphine, can induce direct histamine release not involving any immunoglobulin molecule. Also, a diverse group of signaling substances, called neuropeptides, have been found to be involved in emotionally induced hives. Dominantly inherited cutaneous and neurocutaneous porphyrias (porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria and erythropoietic protoporphyria) have been associated with solar urticaria. The occurrence of drug-induced solar urticaria may be associated with porphyrias. This may be caused by IgG binding, not IgE.
Insect venoms, animal danders and/or saliva, penicillin, protease enzymes in biological detergents [6] and latex proteins are other common causes of IgE-mediated urticaria, which again are often identified by the patient. Patients who are latex-protein allergic may also react to a wide variety of foods [7] (Table 2) because of cross-reactivity between the latex protein antigens and food antigens or, if they are highly sensitized, they may develop symptoms after eating foodstuffs which have been handled by workers wearing latex gloves [8].
Other medical conditions that can cause pruritus (usually without rash), such as diabetes mellitus, chronic renal insufficiency, primary biliary cirrhosis, or other nonurticarial dermatologic disorders
The Hives’ official website was overhauled in the second week of August 2007, with a grungier, “emergency broadcast” layout. The new site revealed the album’s cover and the title of the first single, “Tick Tick Boom”, with a release date of August 14 in the United States and 8 October in the United Kingdom. The release dates for the new record, The Black and White Album, were 15 October in the UK on Polydor and November 13 in the US on A&M/Octone in 2007. It was mostly recorded in Oxford, Mississippi, Miami, and in their native Sweden.
FCAAIA Notes: Chronic urticaria (hives lasting 6 weeks or longer) is a frustrating problem for patients and their doctors.  The frustration arises because the majority of cases are “idiopathic”, meaning there is no identifiable trigger. We now know that about 1/3 or more of chronic idiopathic urticaria are not idiopathic at all; in those cases, patients make an autoantibody to a certain molecule on the surface of cells called mast cells.  When mast cells are activated by that autoantibody, they release histamine and other chemicals that cause hives.  Technically then, those hives are not idiopathic.  But, there is still no specific therapy for them and no way to avoid an external trigger.  Idiopathic urticaria are uncomfortable and can be unsightly, but are completely benign.
Lastly, some forms of urticaria and angioedema are related to other diseases, such as autoimmune diseases (for example, lupus and rheumatoid arthritis), certain cancers, chronic infections (for example, viral hepatitis, and some hereditary forms.
Special diets appear to have a limited role to play in the management of hives. Unfortunately, it is difficult to predict who will or will not respond to diet on the basis of history or allergy testing. A temporary elimination diet under close medical supervision, followed by challenges may be useful in a small number of cases. 
Hives frequently occur following an infection or as a result of an allergic reaction such as to medication, insect bites, or food.[2] Psychological stress, cold temperature, or vibration may also be a trigger.[1][2] In half of cases the cause remains unknown.[2] Risk factors include having conditions such as hay fever or asthma.[3] Diagnosis is typically based on the appearance. Patch testing may be useful to determine the allergy.[2]
Certain people can develop recurrent hives from sunlight, cold, pressure, vibration or exercise. These are called the physical urticarias. If hives develop from scratching or firmly rubbing the skin it is called dermatographism. It is the most common of the physical urticarias and it affects about 5 percent of the population. It doesn’t always itch. This condition sometimes also occurs along with other forms of hives.
As noted above, many cases of ordinary hives are “idiopathic,” meaning no cause is known. Others may be triggered by viral infections. A few may be caused by medications, usually when they have been taken for the first time a few weeks before. (It is less likely for drugs taken continuously for long periods to cause hives but certainly not impossible.) When a medication is implicated as a cause of hives, the drug must be stopped, since testing is rarely available to confirm the In most cases, drug-induced hives will go away in a few days. If a drug is stopped and the hives do not go away, this is a strong indication that the medication was not the cause of the hives.
Sarna lotion with menthol and camphor will settle down the itch. Wipe the skin with a damp cloth and dry it before applying. Switch to Cetaphil Cleansing Bar from your current soap for the shower. If your skin tends to be dry, apply Cetaphil moisturizing cream after your shower. Keep the Sarna in your car so you will always have it near. If all else fails, use an ice pack for about 20 minutes. Talk to a doctor to see if you have any food allergies, if you haven’t already.
Patients may become sensitized to a very wide range of allergens and produce specific IgE (SIgE) against these substances. Subsequent contact with the relevant allergen, either directly on the skin or through mucous membranes, may result in urticaria.
Urticaria, otherwise known as hives, is an itchy red blotchy rash resulting from swelling of the superficial part of the skin. It can be localised or more widespread. Angio-oedema occurs when the deeper tissues, the lower dermis and subcutaneous tissues, are involved and become swollen.
If a non-drowsy antihistamine doesn’t work, the doctor may suggest a stronger antihistamine or another medicine or a combination of medicines. In rare cases, a doctor may prescribe a steroid pill or liquid to treat chronic hives. Usually this is done for just a short period (5 days to 2 weeks) to prevent harmful steroid side effects.
Pityriasis rosea typically fades without treatment in six to eight weeks. During this time, you can use an OTC anti-itch medication, like diphenhydramine (Benadryl) or cetirizine (Zyrtec) to ease your symptoms.
This process is caused by several mechanisms. The type I allergic IgE 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. The type II allergic response is mediated by cytotoxic T cells, causing deposits of immunoglobulins, complement, and fibrin around blood vessels. This leads to urticarial vasculitis. The type III immune-complex disease is associated with systemic lupus erythematosus and other autoimmune diseases that cause urticaria. [15]
See an allergist, who will try to look for triggers to your hives and may recommend medications to prevent the hives or reduce the severity of symptoms. Whether the treatment is available only by prescription or over the counter will depend on several factors, including how uncomfortable the hives are making you.
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.