“urticaria en ingles urticaria treatment home remedies”

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.
Jump up ^ Hirschmann, J. V.; Lawlor, F; English, JS; Louback, JB; Winkelmann, RK; Greaves, MW (1987). “Cholinergic Urticaria – A Clinical and Histologic Study”. Archives of Dermatology. 123 (4): 462–7. doi:10.1001/archderm.1987.01660280064024. PMID 3827277.
Physical urticaria are hives caused by direct physical stimulation of the skin — for example, cold, heat, sunlight, vibration, pressure, sweating, and exercise. They usually happen right where the skin was affected and rarely appear anywhere else. Most appear within 1 hour after exposure.
Allergic reactions to foods such as nuts, seafood (including fish), chocolate, berries and milk common causes of ordinary hives. Viral infections, insect bites and medications can also cause ordinary hives.
cold urticaria urticaria precipitated by cold air, water, or objects, occurring in two forms: In the autosomal dominant form, which is associated with fever, arthralgias, and leukocytosis, the lesions occur as erythematous, burning papules and macules. The more common acquired form is usually idiopathic and self-limited.
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.
Dermatographism: This is the ability to ‘write on the skin’. If the skin is stroked firmly with a solid object a characteristic wheal and flare reaction occurs. You would be able to read what was “written” on the skin for a prolonged period of time.
a pruritic skin eruption characterized by transient wheals of varying shapes and sizes with well-defined erythematous margins and pale centers. It is caused by capillary dilation in the dermis that results from the release of vasoactive mediators, including histamine, kinin, and the slow reactive substance of anaphylaxis associated with antigen-antibody reaction. It may be a reaction to drugs, food, insect bites, inhalants, emotional stress, exposure to heat or cold, or exercise. Treatment includes antihistamines and removal of the stimulus or allergen. Also called hives. See also angioedema, cholinergic urticaria. urticarial, adj.
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
The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.
urticaria pigmentosa, juvenile urticaria pigmentosa present at birth or in the first few weeks of life, usually disappearing before puberty, taking the form of a single nodule or tumor or of a disseminated eruption of yellowish brown to yellowish red macules, plaques, or bullae.
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.
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 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.

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Physical urticaria: Where the skin is affected by things like cold, heat, sun exposure, vibration, pressure, sweating and exercise. The hives may only be found where the skin was affected can appear within an hour of the exposure.
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.
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.
Hives are a skin rash condition known medically as urticaria. Hives are a type of skin allergy or rash that is caused by an allergen in most cases. Hives are raised welts on the skin’s surface that are generally circular with a pale center and red halo. These welts can be different sizes and shapes, and can be found on any part of the body. There are many types of hives, and hives causes vary based on the type of hives experienced.
The first single to be released from the album, “Go Right Ahead,” was made available for public streaming alongside this announcement.[18] Five teaser videos were posted on their official YouTube channel, each showing a member of the band playing their part of the song in the lead up to the announcement.[19] The song was also played live at the Norwegian/Swedish talkshow “Skavlan”, broadcast on March 30, 2012.[20]
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.
Urticaria is a common skin disease characterised by itching weals or hives that can appear anywhere on the surface of the skin. Weals may be pinpoint in size or several inches in diameter. Most sufferers experience hives continuously or intermittently for less than six weeks, but they may last longer (when they are then called ‘chronic’). Urticaria can also be accompanied by angioedema (swelling of a deeper layer of the skin). There are several varieties of urticaria, but the most common forms are acute urticaria and chronic urticaria. Common causes of acute urticaria are infections and adverse reactions to medications and foods, whereas in chronic urticaria the cause is often unknown. Intense itching is common, and it can lead to disturbed sleep and even depression, having a serious impact on a person’s quality of life. As the face and other exposed body parts can be affected, hives and angioedema can prove embarrassing for the individual.
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).
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.
Further investigation may find associated diseases. Laboratory studies may include renal function and immunological status. Chest x-ray should be performed in patients with hypocomplementaemia and breathing problems.
Engaging in social activities (in person, not online) can help reduce stress. Talking about challenging situations can release hormones that reduce stress. When feeling stressed, call a friend or involve yourself in a social situation to help yourself feel better.
Inducible urticaria – sometimes called physical urticaria. This is a type of hives in which a rash appears when the skin is physically stimulated. The most common is called dermatographism (dermatographia) when a rash develops over areas of skin which are firmly stroked. In other cases, an urticarial rash is caused by heat, cold, emotion, exercise, or strong sunlight. See separate leaflet called Hives (Inducible Urticaria) for more details.
When hives are severe, some doctors may suggest a course of oral steroids. Some common side effects of oral steroids include acne, blurred vision, cataracts or glaucoma, easy bruising, difficulty sleeping, high blood pressure, increased appetite and weight gain, increased growth of body hair, insomnia, lower resistance to infection, muscle weakness, nervousness, osteoporosis, stomach irritation or bleeding, sudden mood swings, puffy face, water retention, swelling and worsening of diabetes. (13)
In many cases, a single attack of hives is due to an infection or virus and these go away within a few days to a few weeks. Some people get repeated attacks that occur as an allergic reaction to a variety of things (foods, most commonly nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk, insect stings, and medications). In this case, they usually break out within a few hours of the exposure. Usually, the patients figure out the cause by themselves, and they never bother coming to a doctor.
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.
If your hives last more than a month or if they recur over time, see an allergist, who will take a history and perform a thorough physical exam to determine the cause of your symptoms. A skin test and challenge test may also be needed to identify triggers.
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.
Jump up ^ Pacor ML, Di Lorenzo G, Corrocher R (2001). “Efficacy of leukotriene receptor antagonist in chronic urticaria. A double-blind, placebo-controlled comparison of treatment with montelukast and cetirizine in patients with chronic urticaria with intolerance to food additive and/or acetylsalicylic acid”. Clin Exp Allergy. 31 (10): 1607–1614. doi:10.1046/j.1365-2222.2001.01189.x. PMID 11678862.
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:
This corticosteroid is taken orally. You should only use it for a short period of time as directed by your doctor. Corticosteroids can have side effects, especially if taken for extended periods of time. Side effects can include:
Use nettles. Nettles have been traditionally used to treat hives because it is natural antihistamine. You can make nettles into tea, eat it, or take it as a supplement. To make a cup of nettles tea, take 1 tsp of the dried herb and add it to a cup of hot water. Let it steep and allow it to cool. Soak a cotton towel with the nettles tea, wring out the excess tea, and place the damp towel over the hives. Use as often as needed.
Urticarial vasculitis tends to become a chronic condition and patients should be educated about its course. For most patients, this is a disease that affects the skin, with a minority of patients developing systemic complications.
You may have a sensitivity to detergent, soap, clothing, perfumes and/or foods. Have you changed any daily habit in the last 16 months? New detergent or soap? Try using only natural detergents and soaps for a while to see it helps. Wear only cotton or linen clothing. Keep a diet diary, writing down all the foods you eat — see if the itching gets worse after you eat certain foods.
Frequently, more than one type of physical urticaria may occur in a patient and it may be difficult for the individual to avoid the triggering stimulus/stimuli. The physical urticarias may, therefore, be difficult to treat and may be long-lasting.
In most cases urticarial vasculitis is idiopathic, but it may be associated with connective tissue diseases such as SLE or Sjögren’s syndrome; infections such as hepatitis B and C, Lyme disease and infectious mononucleosis; treatment with drugs, including ACEI, cimetidine, diltiazem, penicillins, sulphonamides and thiazides; and lymphoproliferative diseases such as mixed cryoglobulinaemia and IgM gammopathy. A specific syndrome of urticarial vasculitis and IgM gammopathy with fever, bone pain and arthralgia or arthritis –‘Schnitzler’s syndrome’ – was first described in 1972 [76,77].
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.
urticaria pigmentosa, juvenile urticaria pigmentosa present at birth or in the first few weeks of life, usually disappearing before puberty, taking the form of a single nodule or tumor or of a disseminated eruption of yellowish brown to yellowish red macules, plaques, or bullae.

“urticaria rash |hives on legs only”

Allergy shots are given to increase your tolerance to allergens that cause allergy symptoms. At the beginning, allergy shots will be administered once or twice a week for several months. The dose is increased each time until a maintenance dose is reached. Side effects of allergy shots include itchy eyes, shortness of breath, runny nose, tight throat, redness, swelling, and irritation.
If home and natural remedies aren’t enough to help your hives, over-the-counter (OTC) treatments may be your best bet. Not only can OTC options relieve itching and irritation, they can target your body’s histamine response, which is what causes hives to appear.
Whenever possible, drug treatment should be avoided during pregnancy. Fortunately, chronic urticaria often improves in pregnancy; however, if symptoms are very severe and treatment is considered absolutely necessary, either chlorphenamine or loratidine may be prescribed. Data from several thousand women who had taken either chlorphenamine or loratidine in pregnancy, including data from several hundred who took anti-histamines during the first trimester [67,68], showed no increase in the incidence of fetal malformations. The lowest dose which controls symptoms should be used and the possibility of adverse effects should be discussed and documented. There is less clinical experience with cetirizine and therefore cetirizine is not recommended in pregnancy. Hydroxyzine is the only anti-histamine which is specifically contraindicated in pregnancy in the summary of product characteristics.
Hives, which is also called urticaria, is a very itchy rash. It is sometimes caused by an infection and sometimes by an allergy to something (such as some foods), but often no cause is found. Many people get hives at some time in their life, but only a few have major trouble with it.
Lindsay Nixon has been writing since 2007. Her work has appeared in “Vegetarian Times,” “Women’s Health Magazine” and online for The Huffington Post. She is also a published author, lawyer and certified personal trainer. Nixon has two Bachelors of Arts in classics and communications from the College of Charleston and a Juris Doctor from the New England School of Law.
In many cases, a single attack of hives is due to an infection or virus and these go away within a few days to a few weeks. Some people get repeated attacks that occur as an allergic reaction to a variety of things (foods, most commonly nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk, insect stings, and medications). In this case, they usually break out within a few hours of the exposure. Usually, the patients figure out the cause by themselves, and they never bother coming to a doctor.
Prevention is by avoiding whatever it is that causes the condition.[2] Treatment is typically with antihistamines such as diphenhydramine and ranitidine.[2] In severe cases, corticosteroids or leukotriene inhibitors may also be used.[2] Keeping the environmental temperature cool is also useful.[2] For cases that last more than six weeks immunosuppressants such as ciclosporin may be used.[2]
SOURCES: MedicineNet: “Stress.” American Academy of Allergy Asthma & Immunology (AAAAI): “‘Tis the Season for Allergic Reactions.” AAAAI: “Triggers of Allergic Disease.” CDC: “Workplace Stress.” Murray Grossan, MD, Los Angeles. Gailen D. Marshall, MD, PhD, professor of medicine and pediatrics, University of Mississippi; director, division of clinical immunology and allergy, University of Mississippi Medical Center. William E. Berger, MD, MBA, professor of University of California; author, Allergies and Asthma for Dummies. WebMD Live Event Transcript: “Signs of Sinusitis.” Marshall G.D. Am Osteopath Assoc, May 2004; vol 104(5 Suppl 5): pp S1-6. Breathe Right Now by Laurence A. Smolley, MD, and Debra Fulghum Bruce PhD. Jabaaij L, vanHattum J, Vingerhoets AJJM, Oostveen FG, et al. Journal of Psychosom. Res. 1996; 41: 129-137.
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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. 
For some cases of urticaria, especially chronic urticaria, no cause can be found, despite exhaustive efforts. This is known as idiopathic urticaria, [2] although most of these are chronic autoimmune urticaria as defined by a positive autologous serum skin test (ASST). [9]
If you want to remove stress hives from your life forever, then all you need to do is remove all the stress and anxiety form your life. If only it were that easy, right? As I discovered from my dermatologist, the only treatment that will make your stress bumps go away for good is OxyHives. It takes 1-2 hours, but it works for me each and every time. With 2 small kids, I may not be able to remove all the stress form my life, but at least I can remove the rash and hives that appear when I get stressed out. Learn more about OxyHives and how to get rid of your hives fast at http://www.hives.org/how-to-get-rid-o…
In addition, it appears that a large percentage of people without an obvious trigger for chronic hives may actually have an autoimmune disease. With these conditions, the immune system attacks healthy tissue, including the skin. Juvenile rheumatoid arthritis, lupus, and dermatitis herpetiformis (associated with celiac disease) are among those that may cause hives.
Urticaria (or ‘hives’ or ‘nettle rash’) consists of blancheable, erythematous, oedematous papules or ‘weals’ (Fig. 1). These weals vary in size from 1 mm to many centimetres –‘giant urticaria’, and are usually intensely itchy. They are caused by vasoactive mediators, predominantly histamine, released from mast cells. In the vast majority of cases the weals are transient, lasting for only a few hours in any one place, but with new weals appearing in other places. This means that most urticarial rashes ‘move’ around the body – a useful pointer from the clinical history that the rash is urticarial. Urticaria is to be distinguished from ‘angioedema’, which is well-demarcated swelling, occurring within deep skin structures or in subcutaneous tissue (Fig. 2) and caused mainly by bradykinin production. Angioedema is not itchy, but may be painful. In about 50% of patients urticaria occurs alone; in about 40% of patients urticaria occurs with angioedema and in about 10% of patients angioedema occurs alone [1]. The aetiology of isolated angioedema is very often different from that of urticaria or urticaria with angioedema. The topic of isolated angioedema is to be reviewed in a further article in this series.
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.
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: 
This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review.  Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. Development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
Where possible, identify and treat the cause. Nonspecific aggravating factors should be minimised, such as overheating, stress, alcohol, caffeine and medication likely to cause urticaria (eg, non-steroidal anti-inflammatory drugs (NSAIDs) and angiotensin-converting enzyme (ACE) inhibitors). Topical anti-pruritic agents such as calamine lotion or topical menthol 1% in aqueous cream may help ease symptoms.

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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.
25. Cornejo-Garcia JA, Mayorga C, Torres MJ, et al. Anti-oxidant enzyme activities and expression and oxidative damage in patients with non-immediate reactions to drugs. Clin Exp Immunol. 2006;145:287–95. [PMC free article] [PubMed]
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.
Stress hives symptoms include red bumps and swollen areas on your skin that seem to appear almost out of nowhere. They are typically quite itchy and have been known to a prickly or burning sensation – especially if touched. Stress hives can appear on any part of your body (face, hands, feet, arms, etc.) and can vary in size from as small as the eraser on a pencil to as large as a dinner plate. Stress hives, like a typical hives rash, have been known to spread from place to place, and smaller areas of hives can blend together to create larger areas known as plaques. These stress hives symptoms can easily be treated with the right over the counter medication.
Up to 20% of people will develop hives at some time during their life.  In most cases, hives are not due to allergy. Underneath the lining of the skin and other body organs (including the stomach, lungs, nose and eyes) are mast cells. Mast cells contain chemicals including histamine. When these are released into the skin they irritate nerve endings to cause local itch and irritation and make local blood vessels expand and leak fluid, triggering redness and swelling.
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.
The British guideline refers to chronic urticaria/angio-oedema; it also lists angio-oedema without weals as a subtype and refers to urticarial vasculitis as a differential diagnosis. Urticarial vasculitis is vasculitis of the skin characterised by inflammation of the small blood vessels rather than urticaria[5]. Causes include infection (hepatitis B/C, glandular fever or streptococcal infection), medication (penicillins, fluoxetine, thiazides, allopurinol, quinolones or carbamazepine), autoimmune disease, paraproteinaemia and malignancy.
Urticaria is characterised by weals (hives) or angioedema (swellings, in 10%) or both (in 40%). There are several types of urticaria. The name urticaria is derived from the common European stinging nettle ‘Urtica dioica’.
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.
Key to the prevention of hives is avoiding known triggers. Take note of when hives appears – is it after you eat certain foods? In times of stress? After playing with your dog or cat (animal dander is a common allergen)? You may need to keep a food diary to identify possible allergens in your diet. 
Many parents wait to give the antihistamine until new hives have appeared. This means your child will become itchy again. The purpose of the medicine is to keep your child comfortable until the hives go away. Therefore, give the medicine regularly until you are sure the hives are completely gone.
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].
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).
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Clinical examination may reveal urticaria, dermographism or angioedema or signs of a connective tissue disease or urticarial vasculitis, but it is often normal. Similarly, investigations are very often normal, particularly if there is a long history of urticaria, with no obvious triggering factors and if the patient is clinically well. Recent guidelines from the British Association of Dermatologists [44] and the British Society of Allergy and Clinical Immunology [45] suggest that investigations are not needed in all patients; however, individual patients may be reassured by a series of normal results. Depending on the clinical history, tests may include: full blood count (FBC) and differential, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), routine biochemistry, glucose, thyroid function, thyroid autoantibodies, anti-nuclear antibody (ANA), immunoglobulins and protein electrophoresis, complement C3 and C4, cryoglobulins, SIgE tests, serology for infections, stool sample for ova, cysts and parasites and urine analysis (for evidence of infection or renal vasculitis). Further investigations may, of course, be required if the initial screening tests are abnormal. For example, the presence of a normochromic, normocytic anaemia, lymphopaenia and strongly positive ANA would prompt further investigations for SLE.
Chronic hives can lead to severe discomfort, distress, and possibly depression. Stress, too, can aggravate hives, creating a vicious cycle. Patients who experience symptoms of depression should speak to a doctor.

“cold urticaria underlying causes -stress hives”

Clinical Context:  Azathioprine is a purine precursor that affects the formation of adenine and guanine. This results in impaired DNA synthesis in immunocompetent cells such as lymphocytes, which are dividing rapidly during an inflammatory process. Azathioprine has a slow onset of action; it is rarely used as monotherapy.
Some people find it relaxing to engage in a hobby, others find spending time with a pet, drawing, painting or writing is helpful. Experiment with different activities, paying attention to how you feel after participating. Then, make sure to include time each day for those activities that make you feel more relaxed.
Stress hives are indeed caused by too much stress, tension or anxiety in your life. When you expose your body to excessive stress, whether it be over a short period of time or a long period of time, your body’s immune system starts to falter. When your immune system is off kilter, it starts sending histamine into the body to fight off what is ailing you – stress. In essence, your body forms an allergic reaction to stress. Unfortunately, stress can not be eliminated with histamine, so instead, the histamine just causes hives to appear on your face, neck, chest and other parts of your body.
Bluestein HM, Hoover TA, Banerji AS, Camargo CA Jr, Reshef A, Herscu P. Angiotensin-converting enzyme inhibitor-induced angioedema in a community hospital emergency department. Ann Allergy Asthma Immunol. 2009 Dec. 103(6):502-7. [Medline].
How long do hives last? Mild hives can appear suddenly and be completely gone a few minutes later. Other times, hives can last for hours and even several weeks to months. Acute episodes of urticaria last for six weeks or less. Hives that last for six weeks or less are acute hives. Those that remain for more than six weeks are chronic hives. It’s nice to know that the majority of hives cases don’t last longer than 24 hours. (4)
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.
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.
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 histamine leaked by mast cells. The main side effect of antihistamines is drowsiness.
Urticaria also may be accompanied by angioedema, which results from mast cell and basophil activation in the deeper dermis and subcutaneous tissues and manifests as edema of the face and lips, extremities, or genitals. Angioedema can occur in the bowel and present as colicky abdominal pain. Angioedema can be life-threatening if airway obstruction occurs because of laryngeal edema or tongue swelling.
Urticaria that is caused by an allergy is usually due to an allergy to foods, spices, food additives or preservatives, insect stings or drugs. The most common foods that cause urticaria are seafood, berries, nuts, eggs and chocolates (but almost every food has been implicated), and the most common additives are preservatives, nitrates and colourants such as tartrazine. Drugs commonly implicated are over-the-counter medications, antibiotics, aspirin, medicines containing tartrazine, birth control pills and medication for colds. Insect bites, worm infestation and infections also commonly result in urticaria. Contact with dogs, cats, pollens, plants, and blood transfusions may also cause urticaria. Auto immune mechanisms may also be involved (this is where the body becomes ‘allergic’ to itself!)
Javed Sheikh, MD Assistant Professor of Medicine, Harvard Medical School; Clinical Director, Division of Allergy and Inflammation, Clinical Director, Center for Eosinophilic Disorders, Beth Israel Deaconess Medical Center
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.
Pressure or constriction. Delayed pressure urticaria can appear as red swelling six to eight hours after pressure (belts or constrictive clothing, for example) has been applied. Symptoms can also occur in parts of the body under constant pressure, such as the soles of the feet.
The prognosis in acute urticaria is excellent, with most cases resolving within days. Acute urticaria usually can be controlled using only symptomatic treatment with antihistamines. If a known triggering factor is present, avoidance is the most effective therapy. Acute urticaria causes discomfort, but it does not cause mortality, unless it is associated with angioedema involving the upper airways. [25, 26, 27] If a patient continues to be exposed to a known trigger, the condition may become chronic.
Saigal K, Valencia IC, Cohen J, Kerdel FA. Hypocomplementemic urticarial vasculitis with angioedema, a rare presentation of systemic lupus erythematosus: rapid response to rituximab. J Am Acad Dermatol. 2003 Nov. 49(5 Suppl):S283-5. [View Abstract]
Urticaria is a common skin disease characterised by itching weals or hives that can appear anywhere on the surface of the skin. Weals may be pinpoint in size or several inches in diameter. Most sufferers experience hives continuously or intermittently for less than six weeks, but they may last longer (when they are then called ‘chronic’). Urticaria can also be accompanied by angioedema (swelling of a deeper layer of the skin). There are several varieties of urticaria, but the most common forms are acute urticaria and chronic urticaria. Common causes of acute urticaria are infections and adverse reactions to medications and foods, whereas in chronic urticaria the cause is often unknown. Intense itching is common, and it can lead to disturbed sleep and even depression, having a serious impact on a person’s quality of life. As the face and other exposed body parts can be affected, hives and angioedema can prove embarrassing for the individual.
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.
The common symptoms include a raised, bumpy red rash, with the bumps often looking more like normal skin colour, that is often quite itchy. The raised areas of skin are known as weals, which often fade after a few hours but can sometimes reappear elsewhere on the body.
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.
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.
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.
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] :
Ordinary hives flare up suddenly and usually for no specific reason. Welts appear, often in several places. They flare, itch, swell, and go away in a matter of minutes to hours, only to appear elsewhere. This sequence may go on from days to weeks. Most episodes of hives last less than six weeks. Although that cutoff point is arbitrary, cases of hives that last more than six weeks are often called “chronic.”

“physical urticaria -hiv hives”

Nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk are all so of the most delicious foods that this natural world of ours can provide us with. Not only are they delicious (matter of taste), but they also provide our bodies with the countless nutrients, vitamins and minerals that our bodies need to reach and maintain peak levels of performance. Unfortunately, not every person is created the same, and what might be enjoyable and beneficial for one person and their body can be harmful and potentially fatal to another.
Hives are itchy red or white bumps on the skin. This itchy rash is also known as urticaria, or as nettle rash. The rash may be acute (if it comes on suddenly and does not last for long) or chronic (if the rash has lasted for six weeks or more).
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.
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.
Chronic Urticaria is thought to affect up to 1% of the population at any given time and, of these cases, two thirds are thought to be spontaneous (CSU) where the exact trigger for symptoms is unknown(1).
Family and personal medical history of angioedema – Characteristics of angioedema [1] include vasodilation and exudation of plasma into the deeper tissues more so than with simple urticaria; angioedema can occur with and without the wheals of simple urticaria and presents clinically as subcutaneous swelling that is generally nonpitting and nonpruritic; it can affect the mouth as well as  the mucosal surfaces of the respiratory and GI tracts, manifesting as hoarseness and GI upset; it can be a feature of anaphylaxis if the throat is involved, leading to airway compromise
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)
The Asthma and Allergy Foundation of America (AAFA), a not-for-profit organization founded in 1953, is the leading patient organization for people with asthma and allergies, and the oldest asthma and allergy patient group in the world.
Skin biopsy in patients in whom vasculitis is suspected: the lesions last for more than 24 hours, are painful and usually heal by leaving hyperpigmentation on the area of the lesions in urticarial vasculitis (24).
In chronic cases, a physician may check various blood and urine tests, and other procedures such as X-rays to look for other causes. If a physical urticaria is suspected, special tests to mimic the physical stimulus may be performed, such as placing an ice cube on the skin to cause a hive to form in people with cold urticaria.
Mortureux P, Léauté-Labrèze C, Legrain-Lifermann V, Lamireau T, Sarlangue J, Taïeb A. Acute urticaria in infancy and early childhood: a prospective study. Arch Dermatol. 1998 Mar. 134(3):319-23. [Medline].
If you have chronic hives, it’s important to try to identify your triggers, if possible, 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:
Urticaria occurs when certain substances such as histamine are released from specific cells in the skin. This process is usually triggered by various immunologic mechanisms, most commonly involving the presence of circulating “IgE” antibodies, although other pathways may also be involved.
Acute urticaria is said to affect 10%-20% of the population at some time during life. It is not uncommon in childhood, but the greatest incidence appears to be in young adults (15%). Chronic urticaria occurs more frequently in mid-life, especially in women.
If you have chronic hives, or urticaria, you probably already know that when you are under stress, your symptoms either appear or worsen. Doctors have increasingly looked to study the relationship between emotional stress and skin conditions. One study, which appeared in Dermatology Times, examined the relationship between stress and chronic hives. Josie Howard, M.D., a psychiatrist in private practice and clinical instructor of psychiatry and dermatology at the University of California, stated that, “external stressors plus cognitive, behavioral and social stressors have been shown to play a significant role in the intensity of itch.” She also explains that it is not unusual for hives to appear after a major life stressor and that those with chronic hives have “limited stress management skills.”
There are many causes of urticaria; allergic and non-allergic. In about 90% of people with chronic urticaria, no cause is found even after exhaustive investigations. In acute urticaria the chances of determining the cause are higher. For example, many cases of acute urticaria in children may be associated with a viral, bacterial or parasitic infection. Stress can certainly make established symptoms worse, but is very rarely the direct cause of urticaria.
Food allergies that cause hives can include anything that you’re allergic to. The most common suspects are milk, nuts, peanuts, and shellfish. Less common allergies such as cheese, chocolate, eggs, garlic, melons, pork, spices, strawberries, and tomatoes may also be responsible.
Despite the reputation of hives being an “allergic” condition, there is often no obvious connection to any provoking substance. In this situation, random allergy testing is not usually helpful. If you know what is causing your hives, then avoiding the cause, if most popular treatment for relief from hives is an over-the-counter medication that contains antihistamine. These drugs help fight against an attack of hives and counter the release of histamine from the skin cells that causes the rash. However, antihistamines tend to have side effects such as drowsiness, especially in children. If you prefer an alternative hives treatment, there are several home remedies for hives that are not only effective but safe as well. Do keep in mind that not all home remedies are subjected to scientific testing and results can therefore vary considerably. Some popular methods of home treatment for relief include:
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:
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An eruption of itching wheals, usually of systemic origin; it may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (e.g., exercise, heat, cold, light, friction), or psychic stimuli.
Researchers have identified many – but not all – of the factors that can cause hives. These include food and other substances you take, such as medications. Some people develop hives just by touching certain items. Some illnesses also cause hives. Here are a few of the most common causes:

“cure for hives +what do hives come from”

The overall prognosis in Urticarial Vasculitis depends on the severity of the disease and the amount of damage that has been done to organs, especially the lungs. The main risk to patients appears be Chronic Obstructive Pulmonary Disease (COPD).
Angiodema is what occurs when a swelling deep in the skin accompanies hives. This swelling does not last long but its presence is quite dramatic when it occurs. Angiodema can attack the extremities as well as the eyes or lips.
Family and personal medical history of angioedema – Characteristics of angioedema [1] include vasodilation and exudation of plasma into the deeper tissues more so than with simple urticaria; angioedema can occur with and without the wheals of simple urticaria and presents clinically as subcutaneous swelling that is generally nonpitting and nonpruritic; it can affect the mouth as well as  the mucosal surfaces of the respiratory and GI tracts, manifesting as hoarseness and GI upset; it can be a feature of anaphylaxis if the throat is involved, leading to airway compromise
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.  
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).
This article needs attention from an expert in Molecular and Cellular Biology. Please add a reason or a talk parameter to this template to explain the issue with the article. WikiProject Molecular and Cellular Biology may be able to help recruit an expert. (October 2011)
Hives are a common skin condition and rarely require serious medical intervention. Hives have a tendency to resolve on their own, but cause discomfort and pain during an attack. In very rare cases, hives may lead to a marked drop in blood pressure and shock. This is referred to as ‘anaphylactic shock’ and requires immediate medical treatment. Hives are generally caused by an allergic reaction to certain foods, medication or insect bites. There are also some cases of hives where no specific cause is determined. In such situations, changes to diet and lifestyle may help in preventing the condition. Contrary to popular belief, hives are not caused by stress or anxiety.
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]
Beyond allergic reactions, some medications are also associated with chronic hives. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most notable, so your reaction could be due to something as common as aspirin. Antibiotics, codeine, morphine, and radiocontrast dye are also known to be triggers.
Unusual, recurrent, or persistent cases warrant further evaluation. Referral for allergy skin testing should be done, and routine laboratory tests should consist of CBC, blood chemistries, liver function tests, and thyroid-stimulating hormone (TSH). Further testing should be guided by symptoms and signs (eg, of autoimmune disorders) and any abnormalities on the screening tests (eg, hepatitis serologies and ultrasonography for abnormal liver function tests; ova and parasites for eosinophilia; cryoglobulin titer for elevated liver function tests or elevated creatinine; thyroid autoantibodies for abnormal TSH).
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.
Chronic spontaneous urticaria and angioedema is diagnosed when hives and swelling are present for more than six weeks and when it has been determined that an apparent protracted episode of urticaria is not the result of recurrent episodes of acute urticaria.
Definitely! A stress rash can occur anytime you are feeling over stressed and anxious. Too much stress in your life will adversely affect your immune system which will cause it to start sending histamine to fight what is ailing you. Unfortunately, stress isn’t something that the immune system can “fight off”, so the end result is that you get stress induced hives. In essence, those itchy bumps all over your face, neck, chest, arms, legs and pretty much your whole body sometimes, are caused by stress. Learn what causes hives at http://www.hives.org/hives-causes.php
Individual lesions are typically transient. They come and go within a few minutes to hours and precise questioning may be needed to establish this. If there is uncertainty about how long each lesion lasts, a line drawn around one lesion will demonstrate any change when inspected the following day. Individual weals may join to form large patches.
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.
Avoid anything you think might have caused the hives. For hives triggered by pollen or animal contact, take a cool shower or bath. For localized hives, wash the allergic substance of the skin with soap and water. Localized hives usually disappear in a few hours and don’t need Benadryl. Avoid heat or rubbing, which makes hives worse.

“xolair urticaria -alcohol hives”

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.)
Here’s an additional reason to brush, floss, and see your dentist regularly: In a study published in April 2013 in the journal Advances in Dermatology and Allergology, researchers found that tooth decay and several other infections can play a significant role in the development of chronic hives. Bacterial infections (such as urinary tract infections and strep throat) and viral infections (such as hepatitis and norovirus, a common cause of stomach “flu”) were also found to be triggers of chronic hives.
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.
Jump up ^ Chung, Man Cheung; Symons, Gilliam, Jane; Kaminski, Edward R. (2010). “Stress, psychiatric co-morbidity and coping in patients with chronic idiopathic urticaria”. Psychology & Health. 25 (4): 477–90. doi:10.1080/08870440802530780. PMID 20204926.
As with adults, any potential triggering factors should be identified and, if possible, avoided. Non-sedating H1 anti-histamines are the first-line medical treatment. All these drugs are licensed for children over 12. Age restrictions and dosage vary for the different drugs in younger children. Cetirizine, desloratidine, levocetirizine and loratidine are all available as syrups, with desloratidine being licensed for the youngest age group (1–5 years). In children under 1 year, only the sedating H1 anti-histamines chlorphenamine and hydroxyzine are licensed. High-dose treatment, or a combination of two different non-sedating H1 anti-histamines, or a combination of a non-sedating H1 anti-histamine in the morning, with a sedating H1 anti-histamine at night may be needed. If symptoms are still not well controlled, an H2 receptor antagonist and/or a LTRA may be tried. Montelukast is licensed for prophylaxis of asthma in children from 6 months of age and is available as granules and as a chewable tablet for younger children as well as in a standard tablet format. Zafirlukast is licensed for prophylaxis of asthma in children from 12 years of age and is available only in a standard tablet format. Finally, if high-dose H1 anti-histamines, H2 receptor antagonists and LTRA are ineffective, oral steroids may be needed; however, even oral steroids may be ineffective if the child has severe physical urticaria. Referral to a specialist centre is suggested if the child has very severe symptoms.
Michael A Kaliner, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Allergy, Asthma and Immunology, American Society for Clinical Investigation, American Thoracic Society, Association of American Physicians
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.
Jump up ^ Langan, EA; Nie, Z; Rhodes, LE (Sep 2010). “Melanotropic peptides: more than just ‘Barbie drugs’ and ‘sun-tan jabs’?”. The British Journal of Dermatology. 163 (3): 451–5. doi:10.1111/j.1365-2133.2010.09891.x. PMID 20545686.
When an allergic reaction occurs, the body releases a protein called histamine. When histamine is released, the tiny blood vessels known as capillaries leak fluid. The fluid accumulates in the skin and causes a rash.
Rosacea is another common skin condition. Depending on the type, it often causes small, red, sometimes pus-filled bumps to form on the skin. The skin can thicken in these areas. The rash typically covers the cheeks, nose, and forehead. But it can involve other areas of the face. These bumps may appear for weeks to months before disappearing and appearing again at a later time.
72. Davis MD, Daoud MS, Kirby B, Gibson LE, Rogers RS., III Clinicopathologic correlation of hypocomplementemic and normocomplementemic urticarial vasculitis. J Am Acad Dermatol. 1998;38:899–905. [PubMed]
The skin lesions of urticarial disease are caused by an inflammatory reaction in the skin, causing leakage of capillaries in the dermis, and resulting in an edema which persists until the interstitial fluid is absorbed into the surrounding cells.[citation needed]
Solar urticaria is a rare disorder in which brief exposure to light causes the development of urticaria within 1-3 minutes. Typically, pruritus occurs first, in about 30 seconds, followed by edema confined to the light-exposed area and surrounded by a prominent erythematous zone caused by an axon reflex. The lesions usually disappear within 1-3 hours.
“When people run, they can breathe better because epinephrine pours throughout the body,” says Berger, past president of the American College of Allergy and Immunology and author of Allergies and Asthma for Dummies.”Epinephrine is also triggered during stressful moments, which should add to better breathing — not worse!”
If hives become a chronic or long-term problem, you should ask your physician for a referral to a specialist. An allergist can test you in order to determine, if possible, the cause of your allergic reaction. These allergy tests will cover foods, plants, chemicals, insects, and insect bites.
Consultation with or referral to a dermatologist, allergist, immunologist, or rheumatologist may be appropriate in selected cases, particularly in cases of complicated, recurrent, refractory, severe, or chronic urticaria. Dermatology referral is mandatory if urticarial vasculitis is suspected.
Your allergist may want to conduct skin tests, blood tests and urine tests to identify the cause of your hives. If a specific food is the suspected trigger, your allergist may do a skin-prick test or a blood test to confirm the diagnosis; once the trigger is identified, you’ll likely be advised to avoid that food and products made from it. In rare instances, the allergist may recommend an oral food challenge – a carefully monitored test in which you’ll eat a measured amount of the suspected trigger to see if hives develop. If a medication is suspected as the trigger, your allergist can conduct similar tests, and a cautious drug challenge – similar to an oral food challenge, but with medications – may also be needed to confirm the diagnosis. Because of the possibility of anaphylaxis, a life-threatening allergic reaction, these challenge tests should be done only under strict medical supervision, with emergency medication and equipment at hand.
; hives intensely itchy skin wheals; arise as hypersensitivity reaction, or on exposure to trigger substances (e.g. in foods, plants, drugs or other agents), or due to uraemia; characteristic of anaphylaxis
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.
If you have chronic hives, or urticaria, you probably already know that when you are under stress, your symptoms either appear or worsen. Doctors have increasingly looked to study the relationship between emotional stress and skin conditions. One study, which appeared in Dermatology Times, examined the relationship between stress and chronic hives. Josie Howard, M.D., a psychiatrist in private practice and clinical instructor of psychiatry and dermatology at the University of California, stated that, “external stressors plus cognitive, behavioral and social stressors have been shown to play a significant role in the intensity of itch.” She also explains that it is not unusual for hives to appear after a major life stressor and that those with chronic hives have “limited stress management skills.”
Angioedema is different. The swelling happens under the skin, not on the surface. It’s marked by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours. It’s rare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.

“pictures of urticaria -urticarial dermatitis”

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.
Urticarial lesions itch, have a central white wheal that is elevated, and are surrounded by an erythematous halo. The lesions are typically rounded and circumscribed. Characteristically, hives should blanch with pressure; they generally resolve within 24 hours, leaving no residual change to the skin. The redness, which is augmented by local neural reflexes, is due to dilated blood vessels in superficial layers of the skin; the wheal is due to leakage of these vessels as fluid extravasates and compresses the vessels beneath it so that the central area appears clear.
Seeing red raised spots on your child’s skin can be scary, especially if you don’t know what caused them. Often, though, these spots are a case of the hives — a common skin reaction to something like an allergen (a substance that causes allergies). Most will clear up and go away
Mix a baking soda paste. Baking soda can be used to help relieve the itching of your hives. Mix 1 tbsp of baking soda with enough water to make a paste. Try a few drops at first and stir, adding more as needed. Using your fingers or soft spatula, spread the paste over the hives. Use as often as needed and rinse off with cool water.
If your GP thinks that it’s caused by an allergic reaction, you may be referred to an allergy clinic for an allergy test. However, if you’ve had urticaria most days for more than 6 weeks, it’s unlikely to be the result of an allergy.
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).
Non-sedating antihistamines that block the histamine H1 receptors are the first line of therapy. First generation antihistamines such as diphenhydramine or hydroxyzine block both central and peripheral H1 receptors and can be sedating. Second generation antihistamines such as loratadine, cetirizine, or desloratadine selectively antagonize the peripheral H1 receptors and are less sedating, less anticholinergic, and generally preferred over the first generation antihistamines.[39][40]
Apart from avoiding certain histamine producing foods, you should also increase your intake food items that are high in vitamin C. Vitamin C can provide relief from symptoms of hives by reducing the production of histamine. Though there is no conclusive evidence that proves this, many people benefit from an increased vitamin C intake as it also boosts the immunity and helps fight an infection.
The patients’ age, gender, use of medications, and duration of the disease were recorded, and a dermatologist also examined them to determine the possible causes of urticaria, such as drugs, food, insect bites, or other causative factors.
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.
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.
An alternative second-line treatment to H2 anti-histamines in patients who still have severe urticaria despite high-dose H1 anti-histamine treatment, is an LTRA such as montelukast or zafirlukast. LTRA treatment may be particularly effective if the patient is sensitive to aspirin or has a positive ASST [54]; however, urticaria does not always improve with LTRA and, very occasionally, patients notice worsening of the rash [55]– in which case they should stop the treatment. LTRA alone are not used for urticaria.
Jump up ^ Langan, EA; Nie, Z; Rhodes, LE (Sep 2010). “Melanotropic peptides: more than just ‘Barbie drugs’ and ‘sun-tan jabs’?”. The British Journal of Dermatology. 163 (3): 451–5. doi:10.1111/j.1365-2133.2010.09891.x. PMID 20545686.
Chronic urticaria and/or angioedema are hives or swelling that lasts more 6 weeks. The cause is usually harder to find than in acute cases. The causes can be similar to those of acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.
Symptoms of chronic urticaria usually resolve, although this can take months or several years. Most people with chronic urticaria manage with appropriate doses of non-drowsy antihistamines. People with severe symptoms interfering with quality of life may be referred to a clinical immunology/allergy specialist or dermatologist for assessment and consideration of additional medications.
Other natural remedies for hives include applying aloe vera gel on the affected skin or making a paste with oatmeal and cornstarch and coating the rash with it. Keep this paste on for thirty minutes before washing it off with water. Lotions containing aloe vera as an ingredient are also effective.
Image Source: Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology Klaus Wolff, Richard Allen Johnson, Dick Suurmond Copyright 2005, 2001, 1997, 1993 by The McGraw-Hill Companies. All Rights reserved.

“hives on legs -urticaria types”

The presence of systemic symptoms could mean the urticarial rash is not ordinary urticaria,” he said, suggesting that vasculitis, Schitzler’s syndrome, adult-onset Still’s disease, an autoinflammatory syndrome, or urticarial dermatitis could be at play.
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 taken recently. If you have been keeping a food diary, show it to your allergist.
Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Biogen/IDEC (Discussion of Drug reactions in relationship to an agent for Multiple Sclerosis)
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Received honoraria from UpToDate for author/editor; Received honoraria from JAMA Dermatology for associate editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for i inherited these trust accounts; for: Celgene; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble; Amgen.
Further investigation may find associated diseases. Laboratory studies may include renal function and immunological status. Chest x-ray should be performed in patients with hypocomplementaemia and breathing problems.
Clinical Context:  Azathioprine is a purine precursor that affects the formation of adenine and guanine. This results in impaired DNA synthesis in immunocompetent cells such as lymphocytes, which are dividing rapidly during an inflammatory process. Azathioprine has a slow onset of action; it is rarely used as monotherapy.
Another common form of physically induced hives is called cholinergic urticaria. This produces hundreds of small, itchy bumps. These occur within 15 minutes of exercise or physical exertion and are usually gone before a doctor can examine them. This form of hives happens more often in young people.
Pressure hives produces deep and painful local swelling. The swelling can occur immediately or several hours later. This type of urticaria can be triggered by prolonged sitting. It is also triggered but the wearing of tight clothing and consequently is seen in areas such as the waist/belt line, under elastic bands such as panties, socks or wristbands. Choosing appropriate clothing and/or taking regular breaks from sitting, usually controls pressure urticaria. If medication is needed, steroids are usually administered for a short time.
a pruritic skin eruption characterized by transient wheals of varying shapes and sizes with well-defined erythematous margins and pale centers. It is caused by capillary dilation in the dermis that results from the release of vasoactive mediators, including histamine, kinin, and the slow reactive substance of anaphylaxis associated with antigen-antibody reaction. It may be a reaction to drugs, food, insect bites, inhalants, emotional stress, exposure to heat or cold, or exercise. Treatment includes antihistamines and removal of the stimulus or allergen. Also called hives. See also angioedema, cholinergic urticaria. urticarial, adj.
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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
Angioedema is a reaction similar to urticaria except there is no redness or itchiness and that it occurs in deeper tissue and is characterised by asymmetrical swelling of tissue. Angioedema is frequently associated with urticaria but the two may occur independently. Itoccurs in around 1 in 3 people with urticaria. Angioedema is not always itchy and can sometimes be painful.