“urticaria que es +cold urticaria pictures”

What do bed bug bites look like? See spider bite pictures and learn how to identify bug bites from mosquitos, bees, bed bugs, wasps, and more. See what their bites & stings look like and how to treat bug bites.
Kai AC, Flohr C, Grattan CE. Improvement in quality of life impairment followed by relapse with 6-monthly periodic administration of omalizumab for severe treatment-refractory chronic urticaria and urticarial vasculitis. Clin Exp Dermatol. 2014 Apr 23. [Medline].
Urticaria is characterized by itchy bumps or areas of raised skin that are light red in color and cause intense itching. This condition is commonly known as hives and while it is most commonly caused by an allergic reaction it can also have non-allergic causes. Urticaria is classified as either acute or chronic and this is dependant on how long the outbreak lasts. Outbreaks that last for less than 6 weeks are referred to as acute urticaria cases while those that last for longer periods are termed as chronic. Acute urticaria is generally the result of an allergic reaction while chronic urticaria often has autoimmune causes. An acute viral infection can also be a cause of acute urticaria. Hives are also known to be caused by local pressure, friction, extremes of temperature, and sunlight.
If you are constantly worried about what causes hives then you should understand that when you expose your body to excessive stress either for a small amount of time or perhaps a long period of time your own body’s immune system sets out to falter and it starts sending histamine for the body to handle what is causing problem.
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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
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.
In children, urticaria is more often acute than chronic. Acute urticaria is caused frequently by IgE-mediated allergic reactions to foods or by acute infections, usually viral respiratory tract infections. ‘Papular urticaria’ occurs more often in children than in adults, and is due usually to insect bites. There is an immediate IgE-mediated weal and flare reaction, but lesions can develop into intensely itchy, indurated papules which may take several weeks to resolve.
Patients who have angioedema involving the oropharynx or any involvement of the airway should receive epinephrine 0.3 mL of 1:1000 solution sc and be admitted to the hospital. On discharge, patients should be supplied with and trained in the use of an auto-injectable epinephrine pen.
“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.”
Urticaria, otherwise known as hives, 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.
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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 open up. This often results in pinkness or redness, as well as extra fluid in the tissues, which causes swelling and itching. (7)
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].
If your symptoms worsen or last longer than a couple of days, see your doctor. They can identify the cause and provide you with medication to help relieve your symptoms. Understanding what caused the hives is key to preventing future outbreaks.
Hives can also develop as a result of sun or cold exposure, infections, excessive perspiration, and emotional stress. The reason why stress seems to precipitate an outbreak of hives in many people is not completely understood but is likely related to the known effects of stress on the immune system. In many cases, the cause of hives in a given individual cannot be identified.
I 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.
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Hives are red and sometimes itchy bumps on your skin. An allergic reaction to a drug or food usually causes them. Allergic reactions cause your body to release chemicals that can make your skin swell up in hives. People who have other allergies are more likely to get hives than other people. Other causes include infections and stress.
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“urtica urens why do i have hives”

Allergies to foods and soaps or detergents are often the first things that come to mind. While many people try to avoid these suspected triggers, they frequently find that it doesn’t help. You might be surprised to know that while allergies may be the problem, other causes are more common.
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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 Vasculitis Foundation is pleased to announce its Dream Big! campaign. The aim of this year-long campaign is to fast track the advances about which every person impacted by vasculitis is dreaming: faster diagnosis; better, less invasive treatments; and, ultimately, a cure for all forms of the disease. Click here to learn more!
Some patients can have both urticaria and angioedema, occurring simultaneously or separately. Approximately 50% of patients have both urticaria and angioedema, whereas 40% have urticaria alone, and 10% have angioedema alone. [24] Hereditary angioedema (C1 inhibitor deficiency) accounts for only 0.4% of cases of angioedema but is associated with a high mortality rate.
When we’re exposed to a stressful situation, our bodies prepare for confrontation. This “fight or flight” response is controlled by our hormones and nervous system and dates back to prehistory, as we prepared to fight or flee our stressor.
These red areas will usually appear small, but can easily multiply and singular welts join together forming rashes. The area affected will be slightly elevated with a blanched center, especially when you press down your finger on the area of the rash. It is estimated that 20% of people will experience urticaria at some point in their lives. While it is common for the appearance of welts to form on the skin during an allergic reaction, it is also important to note that they can occur internally, which is why it is so important to speak to a doctor immediately, especially if you are unaware as to the cause of the reaction.
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]
Chronic urticaria and angioedema can affect other internal organs such as the lungs, muscles, and gastrointestinal tract. Symptoms include muscle soreness, shortness of breath, vomiting, and diarrhea.
There are no routine diagnostic tests in chronic spontaneous urticaria apart from blood count and C-reactive protein (CBC, CRP), but investigations may be undertaken if an underlying disorder is suspected.
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.
A food allergy attack can last for quite a while as the allergen remains within your system and this increases the severity of the reaction. Drink plenty of fluids such as fresh fruit and vegetable juices as this will help to get rid of the allergen and reduce the recovery period.
Hives are welts on the skin that often itch. These welts can appear on any part of the skin. Hives vary in size from as small as a pen tip to as large as a dinner plate. They may connect to form even larger welts.
Hives, also called urticaria, are itchy, red bumps on the skin. They typically appear as an allergic reaction to food or medication, but can also be caused from emotional stress and environmental factors. Treatment for hives includes antihistamine medication, topical lotion and lifestyle change. Roughly 15 to 20 percent of all adults will be affected by hives during their lifetime, according to healthy-skin-guide.com.
Unfortunately, stress and allergies go hand in hand, says Los Angeles-based ear, nose, and throat doctor, Murray Grossan, MD. Once the allergy season is full-blown, the combination of miserable allergy symptoms, nights of fitful sleep, and fatigue, definitely leave you in need of stress relief.
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.
Chizzola maculae is a very specific skin lesion due to fluoride exposure. The size of a coin, these lesions may resemble small blue bruises or be wholly pink. Doctors George Waldbott and V. A. Cecilioni named the lesions after a town in Italy, where they were common in young women and children.[17] According to Waldbott, chizzola maculae are early symptoms of fluoride intoxication.[18][19]
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.
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.
Patients with urticaria make up a large proportion of the referrals to allergy clinics. There are many causes of urticaria and it is the clinical history which is most important when attempting to identify potential causes; however, urticaria is very often idiopathic. In a small minority of patients urticaria may be a symptom of a serious underlying medical illness or the allergic symptoms may progress to cause systemic reactions, and it is important to identify these patients and to remember that severe urticaria is a distressing and disabling condition. This review will discuss classification, investigation and treatment of urticaria and will consider some of the more unusual types of urticaria that may be encountered in the out-patient clinic.
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.
Disorders such as cold urticaria, cholinergic (generalised heat) urticaria, and dermatographism can be treated with antihistamines such as fexofenadine, cetirizine or loratidine. If so severe that responsiveness to these is insufficient, higher normal doses can be used (example fexofenadine 180 mg twice daily; cetirizine 10 mg up to 4 times a day). The next step is higher concentrations of antihistamines such as hydroxyzine or diphenydramine at 25-50 mg four times a day. In some instances, when severe, a particular drug is tried, eg, cyproheptadine 4-8 mg, 3-4 times a day, to treat cold urticaria or hydroxyzine 50 mg four times a day for cholinergic urticaria. Solar urticaria (light-induced urticaria) is treated with antihistamines and sun-screens, if sensitivity is to u.v. wavelengths. Sensitivity to visible light wavelengths is particularly difficult since symptoms can occur indoors as well as outdoors. Delayed pressure urticaria is an exception where symptoms more closely resemble CSU (with which it is commonly associated) and responds poorly to antihistamines.  It can be treated with cyclosporine or, perhaps, omalizumab.  It does respond to corticosteroid.

“cold urticaria natural treatment +yurtici”

^ Jump up to: a b c Griffiths, Christopher; Barker, Jonathan; Bleiker, Tanya; Chalmers, Robert; Creamer, Daniel (2016). Rook’s Textbook of Dermatology, 4 Volume Set (9 ed.). John Wiley & Sons. p. Chapter 42.3. ISBN 9781118441176.
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.
Urticaria is caused by vasodilation and increased permeability of capillaries of the skin due to the release by mast cells of vasoactive mediators. The mast cell degranulation is due to an immunoglobulin E–mediated reaction to allergens (e.g., foods, drugs, or drug additives), heat, cold, and, rarely, infections or emotions. Urticaria is a primary sign of local and systemic anaphylactic reactions. It affects people of all ages but is most common between the ages 20 and 40. Angioedema is frequently associated with urticaria.
If your child has chronic hives, the doctor may ask you to keep a daily record of activities, such as what your child eats, drinks, and where the hives tend to show up on the body. Diagnostic tests — such as blood tests, allergy tests, and tests to rule out underlying conditions such as thyroid disease or hepatitis — might be done to find the exact cause of the hives.
The clinical history should indicate if a vasculitic process is likely, with the lesions lasting for several days, instead of hours, and being painful or burning, instead of itchy. Patients should be asked about drug treatment and joint, gastrointestinal and pulmonary symptoms. Examination may show purpura or hyperpigmentation at the sites of earlier lesions and, possibly, signs of an associated underlying disease such as SLE. Investigations which may be relevant include skin biopsy to confirm the diagnosis; FBC and ESR; renal and liver function tests; urine analysis; complement C3 and C4 levels and anti-C1q antibodies; ANA and extractable nuclear antigens (ENA) (often positive for Ro/SS-A and La/SS-B if the patient has Sjögren’s syndrome); hepatitis, Borrelia or Epstein–Barr virus serology; immunoglobulins and protein electrophoresis and cryoglobulins and chest X-ray (CXR) and pulmonary function tests if symptoms suggest lung involvement. [Anti-neutrophil cytoplasmic antibodies (ANCA) are rarely found in urticarial vasculitis and if ANCA testing is positive an alternative diagnosis such as Wegener’s granulomatosis or microscopic polyangiitis should be considered.]
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.
Urticaria is a skin condition commonly known as hives. It produces an itchy rash that tends to come and go and can last for a variable period of time. The condition can be acute (lasting less than 6 weeks) or chronic (lasting longer than 6 weeks). Most cases of urticaria have no known cause.
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.
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].
The diseases listed above are rare causes of hives, with the exception of thyroid disease. People with chronic urticaria have a higher incidence of thyroid problems compared to the general population.
Check CH50, C3, C4, Clq, and antibodies to Clq in urticarial vasculitis patients. If these test results are positive, evaluate renal function and urinalysis to check for the effects of vasculitis on the kidneys.
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Angioedema, similar to hives, is an allergic skin reaction that manifests as a swelling beneath the skin rather than on the surface. This typically occurs near the eyes and lips. Like hives, angiodema is usually harmless but can be life-threatening if it causes the throat or tongue to swell, which may block the airway.
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.
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.
No. Seriously, stress is a mental state. And we treat mental problems with mind treatment, not with supplements. This advice, unfortunately, fails to find and explain the real cause of your stress problem.
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.
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.
History of present illness should include a detailed account of the individual episodes of urticaria, including distribution, size, and appearance of lesions; frequency of occurrence; duration of individual lesions; and any prior episodes. Activities and exposures during, immediately before, and within the past 24 h of the appearance of urticaria should be noted. Clinicians specifically should ask about recent exercise; exposure to potential allergens (see Table: Some Causes of Urticaria), insects, or animals; new laundry detergent or soaps; new foods; recent infections; or recent stressful life events. The patient should be asked about the duration between any suspected trigger and the appearance of urticaria and which particular triggers are suspected. Important associated symptoms include pruritus, rhinorrhea, swelling of the face and tongue, and dyspnea.
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Localized cold urticaria, in which only certain areas of the body urticate with cold contact, has been reported after predisposing conditions such as cold injury; it has also been reported at sites of intracutaneous allergen injections, ragweed immunotherapy, or insect bites.
46. Williams P, Sewell WAC, Bunn C, Pumphrey R, Read G, Jolles S. Clinical Immunology Review Series: an approach to the use of the immunology laboratory in the diagnosis of clinical allergy. Clin Exp Immunol. 2008;153:10–18. [PMC free article] [PubMed]
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.
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.
A complete patient history is the basis for treatment. In the history, ask for time of onset of the lesions; duration of the lesions (eg, >24 h); whether lesions are painful or burning, rather than pruritic; and the history of resolution with purpura or hyperpigmentation. Inquire about the patient’s medications, fever, arthralgia, dyspnea, abdominal pain, and symptoms of angioedema. Omalizumab has produced mixed results.[18, 19]
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.
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 in children _chronic idiopathic urticaria diet”

When a cause for hives can be found, it’s most likely an infection. Viral upper respiratory infections cause about 40% of hives rashes. Fortunately, these hives outbreaks resolve as the infection resolves. A chronic bacterial infection, especially sinusitis, may be the culprit if a case of hives is lingering.
An easy natural cure for hives is to soak a ball of cotton wool in milk of magnesia and apply the lotion all over the rash. Milk of magnesia has alkaline properties that help in soothing the skin and reducing the pain as well. In place of milk of magnesia, you can apply vitamin E oil for the same results. Repeat this process at least twice to three times a day.
Stress rash often takes the form of hives, or welts. Hives can appear anywhere on the body. Areas affected by hives are generally red, raised, and swollen. These blotchy areas can be as small as a pencil tip or as large as a dinner plate.
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.
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The actual cause of Acute Urticaria is relatively easy to identify as the trigger is usually immediately apparent and is reproducible on re-exposure.  Examples include: Shellfish, Peanut, Penicillin, Bee or Latex allergy.  In children generalised Acute Urticaria is often triggered by a streptococcal or viral infection (hepatitis, herpes etc).
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Urticaria affects almost 20 percent of the population but the majority of the time, the cause is unknown (idiopathic). Even so, it is a good idea to try to find the trigger so you can possibly avoid it in the future.
Rubbing or scratching (simple dermographism). This is the most frequent cause of physical urticaria. Symptoms appear within a few minutes in the place that was rubbed or scratched and typically last less than an hour.
Clinical Context:  Hydroxychloroquine is the preferred antimalarial agent because of its low toxicity and high effectiveness profile. It is usually well tolerated if carefully monitored by the prescribing physician. Therapy is required for 4-8 weeks before evaluating effectiveness.
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.
Uticaria usually includes redness of the skin, itchiness, and mild to moderate swelling because of leakage of fluid into the tissues. Hives are generally not an emergency, but when they appear suddenly, spread rapidly and are accompanied by a swollen throat, tightness of the chest, wheezing or difficulty breathing, this indicates a severe allergic reaction that requires immediate medical attention.
Lasting for minutes, days or months, hives (also called wheals, welts or urticaria) are large, itchy red bumps on the skin, and generally are worsened by scratching.Hives lasting for a period of 6 weeks or longer is referred to as chronic urticaria.
Your doctor will likely recommend you treat your symptoms with home remedies, such as over-the-counter antihistamines. If self-care steps don’t help, talk with your doctor about finding the prescription medication or combination of drugs that works best for you. Usually, an effective treatment can be found.
Cold-induced Urticaria is a disorder in which hives occur within minutes of being exposed to the cold or appear as a result of the effects of warming. Total body exposure to cold, such as swimming in frigid water can result in a drop in blood pressure, fainting, shock and drowning.
Angioedema is similar to hives, but the swelling occurs beneath the skin instead of on the surface. Angioedema is characterized 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.
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.
Acute urticaria is defined as the presence of evanescent wheals which completely resolve within six weeks.[31] Acute urticaria becomes evident a few minutes after the person has been exposed to an allergen. The outbreak may last several weeks, but usually the hives are gone in six weeks. Typically, the hives are a reaction to food, but in about half the cases, the trigger is unknown. Common foods may be the cause, as well as bee or wasp stings, or skin contact with certain fragrances. Acute viral infection is another common cause of acute urticaria (viral exanthem). Less common causes of hives include friction, pressure, temperature extremes, exercise, and sunlight.
We classify Urticaria into Acute Urticaria when the rash duration is under 6 weeks and Chronic Urticaria when it persists for over 6 weeks. Physical Urticaria is due to an external physical trigger such as heat, cold, pressure or exercise (also called Inducible Urticaria). While Urticarial Vasculitis is a rare condition associated with underlying auto-immune connective tissue diseases which requires specialist referral.
Angioedema is a condition in which small blood vessels leak fluid into the tissues, causing swelling. There is no known cure, but it may be possible to prevent the swelling with medications or occasionally diet. Allergy is a very rare cause of angioedema.
The initial medical treatment for urticaria is a standard dose of a second-generation H1 anti-histamine. These drugs penetrate the blood–brain barrier to only a slight extent and so cause fewer central nervous system side effects than the older first-generation anti-histamines, although symptoms such as sedation and psychomotor impairment may still occur. Seven such anti-histamines are licensed for use in the United Kingdom: Cetirizine, desloratidine, fexofenadine, levocetirizine, loratidine and mizolastine, which are all given once a day, and acrivastine which is given three times a day, and may therefore be less effective and convenient to use. Cetirizine and levocetirizine [49] and loratidine [50] may have clinically useful ‘anti-inflammatory’ properties at therapeutic doses. Cetirizine may cause drowsiness in some patients and mizolastine is contra-indicated in patients with cardiac disease; prolonged Q-T interval; or severe liver disease. Dose reductions may be needed if there is renal impairment. Clinical response and tolerability may be better with one second-generation H1 anti-histamine than another, so if symptoms are not well controlled or the patient notices side with the first drug chosen, a second drug should be tried. Often, symptom control is improved if the dose of anti-histamine is increased to twice daily. This is above the licensed recommended dose; however, ‘off-label’ dosages are recommended widely [44,45,51]. A night-time dose of one of the older first-generation, sedating H1 anti-histamines, such as chlorphenamine or hydroxyzine, may help patients to sleep. Empirically, anti-histamine treatment is usually prescribed for 3–6 months (or longer if the patient has angioedema associated with the urticaria) and is tailed off gradually. Episodic urticaria may be treated with stat doses of anti-histamines as required.
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.  

“cold induced urticaria -hives with fever”

The most common stressful events that were related to the occurrence of hives included the death of a family member, family conflicts, financial problems, sexual dysfunction, illness of a family member, problems in the workplace, and extramarital affairs. Even forms of good stress—such as getting married or engaged, and going on a vacation—can cause hives. The authors propose that the treatment of stress through relaxation techniques and stress management programs may be useful for the treatment of hives caused or worsened by stress.
Keep taking your allergy medications. While that may not sound like a stress-relief strategy, it might surprise you. Stress may cause anxiety and depression, says Marshall, and depressed individuals are less compliant with their medications. So stay on track!
Patients who have angioedema involving the oropharynx or any involvement of the airway should receive epinephrine 0.3 mL of 1:1000 solution sc and be admitted to the hospital. On discharge, patients should be supplied with and trained in the use of an auto-injectable epinephrine pen.
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.
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.
Severe reactions can be seen with exposure to cold water; swimming in cold water is the most common cause of a severe reaction. This can cause a massive discharge of histamine, resulting in low blood pressure, fainting, shock and even loss of life. Cold urticaria is diagnosed by dabbing an ice cube against the skin of the forearm for 1 to 5 minutes. A distinct hive should develop if a patient suffers cold urticaria. This is different from the normal redness that can be seen in people without cold urticaria. Patients with cold urticaria need to learn to protect themselves from a hasty drop in body temperature. Regular antihistamines are not generally efficacious. One particular antihistamine, cyproheptadine (Periactin), has been found to be useful. The tricyclic antidepressant doxepin has also been found to be an effective blocking agent of histamine discharge. Finally, a medication named ketotifen, which keeps mast cells from discharging histamine, has also been employed with widespread success.[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.
Chronic urticaria and angioedema can affect other internal organs such as the lungs, muscles, and gastrointestinal tract. Symptoms include muscle soreness, shortness of breath, vomiting, and diarrhea.
Patients with urticaria make up a large proportion of the referrals to allergy clinics. There are many causes of urticaria and it is the clinical history which is most important when attempting to identify potential causes; however, urticaria is very often idiopathic. In a small minority of patients urticaria may be a symptom a serious underlying medical illness or the allergic symptoms may progress to cause systemic reactions, and it is important to identify these patients and to remember that severe urticaria is a distressing and disabling condition. This review will discuss classification, investigation and treatment of urticaria and will consider some of the more unusual types of urticaria that may be encountered in the out-patient clinic.
On 2 July 2010, the band released an EP titled Tarred and Feathered, which covered “Civilization’s Dying” by Zero Boys, “Nasty Secretary” by Joy Rider & Avis Davis and “Early Morning Wake Up Call” by Flash and the Pan.[12][13] “Nasty Secretary” is also a song on the US release of the Gran Turismo 5 soundtrack. On 9 January 2011, Nicholaus Arson wrote another short diary entry on the band’s website saying that they had recorded some new songs before Christmas, and were planning to continue recording throughout January.[14]
Codeine and other opiate-derived medications can cause degranulation of mast cells by stimulation of opiate receptors. Urticaria and angioedema can result from agents that alter the metabolism of arachidonic acid, such as aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). These responses to NSAIDs have the potential to be fulminant with generalized hives and swelling. Angiotensin-converting enzyme inhibitors (ACEIs), drugs used to treat hypertension, (eg, Captopril) can cause recurrent episodes of angioedema, but urticarial skin lesions are not observed. Because ACE normally inactivates bradykinin, the angioedema is thought to be due to elevated bradykinin levels causing dilation and leaking of vessels in deep layers of the skin. This is the most common cause of angioedema seen in emergency rooms. Tongue, throat and laryngeal swelling can be extremely severe and intubation may be necessary. The swelling resembles that seen in hereditary or acquired C1 inhibitor deficiency where bradykinin is also the mediator of swelling.
46. Williams P, Sewell WAC, Bunn C, Pumphrey R, Read G, Jolles S. Clinical Immunology Review Series: an approach to the use of the immunology laboratory in the diagnosis of clinical allergy. Clin Exp Immunol. 2008;153:10–18. [PMC free article] [PubMed]
If your child has chronic hives, the doctor may ask you to keep a daily record of activities, such as what your child eats, drinks, and where the hives tend to show up on the body. Diagnostic tests — such as blood tests, allergy tests, and tests to rule out underlying conditions such as thyroid disease or hepatitis — might be done to find the exact cause of the hives.
Hives, also called urticaria, are itchy, red bumps on the skin. They typically appear as an allergic reaction to food or medication, but can also be caused from emotional stress and environmental factors. Treatment for hives includes antihistamine medication, topical lotion and lifestyle change. Roughly 15 to 20 percent of all adults will be affected by hives during their lifetime, according to healthy-skin-guide.com.
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.
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.
Ongoing hives lasting days at a time are almost never allergic in origin, with the exception of some cases of allergy to medicines. Stress is a very rarely the cause of hives but may make the symptoms worse. 
Jump up ^ Yang, Hsiao-Yu; Sun, Chee-Ching; Wu, Yin-Chang; Wang, Jung-Der (2005). “Stress, Insomnia, and Chronic Idiopathic Urticaria – a Case-Control Study”. Journal of the Formosan Medical Association. 104 (4): 254–63. PMID 15909063. Archived from the original on 2017-09-08.
Darius Mehregan, MD, Associate Professor, Hermann Pinkus Chairman of Dermatology, Department of Dermatology, Wayne State University School of Medicine; Clinical Associate Professor of Pathology, University of Toledo College of Medicine; Dermatopathologist, Pinkus Dermatopathology Laboratory; Consulting Staff, Department of Dermatology, J Dingell Veterans Affairs Medical Center
Some people with chronic (lasting more than 6 weeks) hives, see the hives go away on their own — often within a year. For many people with a chronic case, however, the hives come and go for months or years.
Mast cells are the cells in the skin and mucous membranes that contain histamine. Release of histamine causes the allergic symptoms of hives and angioedema (swelling of large areas of the body). Itching is a common symptom when histamine is released. Anti-histamines are often prescribed to help control this symptom.
A hive often goes away in 24 hours or less. New hives may appear as old ones fade, so hives may last for a few days or longer. A bout of hives usually lasts less than 6 weeks. These hives are called acute hives. If hives last more than 6 weeks, they are called chronic hives.
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.
Hives are red, swollen, itchy bumps on the skin. Some people get them as part of an allergic reaction to food, medicine, or an insect sting. Others notice hives popping up on their skin on a more regular basis.
If you experience swelling of the lips or face, trouble breathing, or wheezing, you should seek immediate medical attention. These can be life-threatening complications, and you will likely need a shot of epinephrine for treatment.
Urticarial Vasculitis is a form of cutaneous vasculitis characterised by inflammation of the small blood vessels. Urticarial Vasculitis can be classified into three subtypes. All are defined by a measure of the “complement” levels in the blood. The complement system is a set of proteins that contribute to and amplify immune responses. They play a role in some, but not all, autoimmune disorders including some forms of Urticarial Vasculitis.
Early lesions show a perivascular neutrophilic infiltrate involving postcapillary venules. Leukocytoclasis is present, expansion of the vessel wall occurs, and the endothelium is intact. Eosinophils may be noted early. Fibrin deposition and extravasation of red blood cells ensue.
Antihistamines are the first line medication for acute or chronic urticaria. Some of these are over-the-counter preparations. The newer anti-histamines are less sedating and therefore can be used in the daytime as well. Most of them are long-acting and can be taken once-a-day only. Normal prescribed dosages may not be of benefit and your doctor may often prescribe larger doses or the addition of a second medication. Sometimes a specific anti-ulcer treatment which also has some effect on blocking urticaria may be used. If no relief is obtained a doctor should be consulted.
It has been suggested that natural salicylates in foods and food additives (‘E’ numbers), including colourings (azo and non-azo dyes), preservatives (sulphites, nitrates and nitrites), anti-oxidants [butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT)] and aspartame (an artificial sweetener), may cause urticaria [9,10], particularly in patients who develop acute allergic symptoms after taking aspirin (acetylsalicylic acid) or non-steroidal anti-inflammatory drugs (NSAIDs); however, randomized controlled trials are lacking [11]. Skin prick testing and SIgE tests to the foods are negative, as the reaction is not IgE-mediated.

“hives treatment _multivariable regression”

The pathophysiology of urticarial vasculitis is similar to other forms of cutaneous small vessel leukocytoclastic vasculitis. Urticarial vasculitis is a type III hypersensitivity reaction in which antigen-antibody complexes are deposited in the vascular lumina. This reaction results in complement activation and chemotaxis of neutrophils. These cells release various proteolytic enzymes, such as collagenase and elastase, resulting in damage to the vascular lumina. Some authors have speculated that eosinophils may be involved in the early stages of the vasculitic lesions. Patients with hypocomplementemic urticarial vasculitis are more likely to show autoantibodies to C1q and vascular endothelial cells.[6, 7] The presence of antineutrophilic cytoplasmic antibodies is rare. Many patients ultimately prove to have SLE. Other etiologies include drug reactions and parasitic infections.[8]
When you have an allergic reaction to a substance, your body releases histamine and other chemicals into the blood. This causes itching, swelling, and other symptoms. Hives are a common reaction. People with other allergies, such as hay fever, often get hives.
CU can occur in response to drugs, physical stimuli, as part of inflammatory or inherited diseases, or can be idiopathic in nature. Acetylsalicylic acid (ASA) or nonsteroidal anti-inflammatory drug (NSAID) intolerant CU is hypothesized to occur due to inhibition of the cyclooxygenase pathway, which causes enhanced production of leukotrienes. The physical urticarias (classically divided into heat, cold, solar, vibration, delayed-pressure, dermatographism, aquagenic and cholinergic induced urticaria) occur in response to external stimuli. Urticarial vasculitis involves the appearance of urticarial lesions lasting greater than 24 hours in the hisopathological setting of vasculitis. Inherited syndromes with CU include the spectrum of cryopyrinopathies, such as Familial Cold Autoinflammatory syndrome, Muckle-Wells syndrome, and Neonatal-Onset Multisystem Inflammatory Disease/Chronic Infantile Neurologic Cutaneous Articular syndrome (NOMID/CINCA). Urticaria presents as a feature of many inflammatory disorders, such Schnitzler syndrome, Still’s disease, and Gleich’s syndrome. Chronic idiopathic urticaria, unlike the physical urticarias and ASA or NSAID intolerant variants, has no discernable external cause.
Jump up ^ Nakamizo, S.; Egawa, G.; Miyachi, Y.; Kabashima, K. (2012). “Cholinergic urticaria: Pathogenesis-based categorization and its treatment options”. Journal of the European Academy of Dermatology and Venereology. 26 (1): 114–6. doi:10.1111/j.1468-3083.2011.04017.x. PMID 21371134.
In patients with chronic idiopathic urticaria, approximately 35% will experience episodes of angioedema and 25% are positive for dermatographism. Like many autoimmune diseases, chronic idiopathic urticaria has a higher incidence in women than men, with the reported ratio of females to males ranging from 2:1 to 4:1. Numerous autoimmune conditions have been associated with chronic idiopathic urticaria, including thyroid disease, celiac disease, and rheumatoid arthritis (RA).
Leukotrienes are released from mast cells along with histamine. The medications, montelukast and zafirlukast block leukotriene receptors and can be used as add on treatment or in isolation for patients with CU. It is important to note that these medications may be more beneficial for patients with NSAID induced CU.[42][43]
Once you know what triggers your outbreaks, limiting your exposure to these will reduce your risk of developing hives. Keep in mind though that sometimes hives appears to be spontaneous with no known trigger. 
Urticaria is the medical name for hives. These are welts; pink swellings that come up on any part of the skin. They itch and each individual hive lasts a few hours before fading away, leaving no trace. New hives appear as old areas fade. They can be pea sized or join to cover broad areas of the body. While the itch can be intense, the skin usually not scabbed or broken. In some people the hives burn or sting.
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.
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.
Kai AC, Flohr C, Grattan CE. Improvement in quality of life impairment followed by relapse with 6-monthly periodic administration of omalizumab for severe treatment-refractory chronic urticaria and urticarial vasculitis. Clin Exp Dermatol. 2014 Apr 23. [Medline].
A single hive generally fades in about 24 hours. But new hives may form as old hives disappear. If you have multiple hives, you may experience these symptoms for about 6 weeks. This is considered a bout of acute hives.
Omalizumab was approved by the FDA in 2014 for patients 12 years old and above with chronic hives. It is a monoclonal antibody directed against IgE. Significant improvement in pruritus and quality of life was observed in a phase III, multicenter, randomized control trial.[45]
I am from New York. I was in trouble when doctor told me that I have been diagnosed with Genital Herpes… I though about my Family, I know my Family will face a serious problem when I’m gone, I lost hope and I wept all day, but one day I was surfing the internet I found Dr. Atiti contact number. I called him and he guided me. I asked him for solutions and he started the remedies for my health. Thank God, now everything is fine, I’m cured by Dr. Atiti herbal medicine, I’m very thankful to Dr. Atiti and very happy with my hubby and family. email him on atitilovespell@gmail.com OR contact his number:+2349051208634.
Applying a cold compress to the affected areas of skin can offer some relief from pain and itching. Cooling the skin can decrease the swelling and reduce the histamine content in the bloodstream. Avoid hot baths and showers during an attack of hives as this dilates blood vessels and increases the skin flare up. Stay away from direct sunlight as well as this can aggravate a hives attack.
If you have chronic stress or are experiencing symptoms that interfere with your life, or are causing frequent outbreaks of hives, it might be beneficial to talk to your doctor about medical treatments for stress. There are also a number of lifestyle changes you can make to help reduce overall stress.
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.
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What do bed bug bites look like? See spider bite pictures and learn how to identify bug bites from mosquitos, bees, bed bugs, wasps, and more. See what their bites & stings look like and how to treat bug bites.
If your child has chronic hives, the doctor may ask you to keep a daily record of activities, such as what your child eats, drinks, and where the hives tend to show up on the body. Diagnostic tests — such as blood tests, allergy tests, and tests to rule out underlying conditions such as thyroid disease or hepatitis — might be done to find the exact cause of the hives.
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.
Stress hives suck, but they’re not the end of the world. If you have chronic urticaria, it’s a good sign that stress is really eating away at you and having a negative effect on your life. My goal with TSM is to help you manage stress and live a more enjoyable life. Don’t let stress control your life.
Jump up ^ “Warner Bros. Interactive Entertainment & MTV Games Announce LEGO Rock Band Full Track List” (Press release). Harmonix. 12 October 2009. Archived from the original on 18 August 2011. Retrieved 18 August 2011.
Since urticarial vasculitis may be chronic, educate patients about its course. For patient education resources, see the Allergy Center and Skin, Hair, and Nails Center, as well as Hives and Angioedema.
As the demand for dermatologic services continues to grow, so does the use of non-physician clinicians in dermatology. Are you currently employing mid-level providers, or do you have plans to? Please tell us in this quick poll.
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].
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Lasting for minutes, days or months, hives (also called wheals, welts or urticaria) are large, itchy red bumps on the skin, and generally are worsened by scratching.Hives lasting for a period of 6 weeks or longer is referred to as chronic urticaria.
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
Allergic reactions, particularly to foods and medications, are another common cause of acute hives. Allergies only cause about 5 percent to 10 percent of chronic hives cases. Pet allergies are usually to blame; pollen, mold, and dust mite allergies cause chronic hives only in rare instances.
42. Sabroe RA, Grattan CE, Francis DM, Barr RM, Kobza BA, Greaves MW. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol. 1999;140:446–52. [PubMed]
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.
The diagnosis is usually made clinically and on history – particularly in acute ordinary urticaria – and no investigations are needed. It can be established once it has been shown that individual lesions only last a few hours. A detailed history may point to a trigger in some cases.
Food allergy should be considered in acute urticaria and urticaria in children. Such foods as tree nuts, peanuts, eggs, shellfish, and tomatoes should be considered (the involvement of food additives or preservatives is controversial). [10] ) Please visit our main article to learn more about food allergies.

“chronic urticaria treatment natural -non itchy hives”

In acute (short-lived) hives, the weals may come and go for a few days or weeks. Rarely, they persist for more than six weeks. Chronic hives is much less common. The weals come and go for months or even years. 
Chronic spontaneous urticaria is mainly idiopathic (cause unknown). An autoimmune cause is likely. About half of investigated patients carry functional IgG autoantibodies to immunoglobulin IgE or high-affinity receptor FcεRIα.
Because blood and allergy tests exist to confirm hives at the doctor’s office, and antihistamines are readily available over the counter, determining the diagnosis and appropriate treatment might seem easy. However, since many of these disorders show the same symptoms and have different treatment methods, it’s important to be aware of the similarities and differences between them. So, read on to learn about five common skin disorders that may look and feel a lot like hives.
In persons with autoimmune hives, the IgG autoantibody that binds to the Fc-receptor tricks the mast cell into believing that the IgE on its surface has encountered an allergen. When this happens, hives or tissue swelling can result. (The diagram above shows a Mast cell with purple histamine granules. The “patient IgG” is the autoantibody that binds to the Fc-receptor.)
The median age of urticarial vasculitis involvement is 43 years, with a range of 15-90 years. While urticarial vasculitis is primarily a disease of middle-aged adults, it can be seen in persons of any age.
I have had urticaria for 7 years, and in that time I’ve made some discoveries. First, upon the first sensations of an itch, DO NOT SCRATCH IT; slap it instead. If that doesn’t work, I’ve found that a bath in the hottest water possible really helps to releive my discomfort/itch, then put on a long-sleeved cotton shirt that is relatively form-fitting (but not constrictive) and cotton yoga pants. I’ve noticed a link between my consumption of peanuts/peanut butter, coffee, and, yes, even chocolate to uriticaria outbreaks. Since I’ve eliminated peanuts/peanut butter from my diet entirely, I almost never get outbreaks (except the rare days that I have a cup of coffee as a special treat–then I know what I’m in for). Try experimenting with your diet, but I know the above mentioned foods are known to be common allergy-producing foods, so this could be a good starting (and perhaps ending) point… Good luck!
Urticaria is characterized by itchy bumps or areas of raised skin that are light red in color and cause intense itching. This condition is commonly known as hives and while it is most commonly caused by an allergic reaction it can also have non-allergic causes. Urticaria is classified as either acute or chronic and this is dependant on how long the outbreak lasts. Outbreaks that last for less than 6 weeks are referred to as acute urticaria cases while those that last for longer periods are termed as chronic. Acute urticaria is generally the result of an allergic reaction while chronic urticaria often has autoimmune causes. An acute viral infection can also be a cause of acute urticaria. Hives are also known to be caused by local pressure, friction, extremes of temperature, and sunlight.
Henry K Wong, MD, PhD is a member of the following medical societies: American Academy of Dermatology, International Society for Cutaneous Lymphomas, Medical Dermatology Society, Society for Investigative Dermatology
Sulfone antibiotics are used for infectious diseases (eg, leprosy); however, sulfones are effective in inflammatory diseases. The mechanism of action may involve inhibiting free radical formation by neutrophils. In most case reports, these medications are effective only in purely cutaneous forms of urticarial vasculitis.
Past medical history should include a detailed allergy history, including known atopic conditions (eg, allergies, asthma, eczema) and known possible causes (eg, autoimmune disorders, cancer). All drug use should be reviewed, including OTC drugs and herbal products, specifically any agents particularly associated with urticaria (see Table: Some Causes of Urticaria). Family history should elicit any history of rheumatoid disease, autoimmune disorders, or cancer. Social history should cover any recent travel and any risk factors for transmission of infectious disease (eg, hepatitis, HIV).
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].
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.
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]
Clinical Context:  Hydroxychloroquine is the preferred antimalarial agent because of its low toxicity and high effectiveness profile. It is usually well tolerated if carefully monitored by the prescribing physician. Therapy is required for 4-8 weeks before evaluating effectiveness.
It occurs mainly on the “bathing-costume area” – the thighs, buttocks and lower torso. However, the distribution depends largely on the insect responsible; in some cases the forearms, arms and face are affected. Fleas may cause papular urticaria where two to three lesions are seen in a row.
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.
If non-sedating antihistamines are not effective, a 4 to 5-day course of oral prednisone (prednisolone) may be warranted in severe acute urticaria, particularly if there is angioedema. Systemic steroids do not speed up resolution of symptoms.
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.
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.
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. urticaria is defined as urticaria with recurrent episodes lasting longer than 6 weeks).

“pictures of urticarial vasculitis |wheals hives”

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA
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
Cold urticaria is usually idiopathic, but it may occur in patients with cold-dependent antibodies, such as cryoglobulins or cold agglutinins [15] and there is a very rare familial form of cold-induced urticaria which is dominantly inherited [16]. Patients develop itching, erythema and urticaria affecting that part of the body which has been exposed to cold. Symptoms may worsen as the exposed area is warmed. Total immersion in cold water can cause severe symptoms with hypotension and patients should be warned that swimming in cold water can be dangerous. Local heat-induced urticaria is rare [17]. Some unfortunate patients may develop urticaria on exposure to both heat and cold [18]. Generalized heat-induced urticaria or ‘cholinergic’ urticaria is caused by exercise, sweating and hot showers or baths. The term ‘cholinergic’ is used because sweat glands are innervated by cholinergic nerve fibres. The urticarial lesions are often small and intensely itchy. Very severe cholinergic urticaria may cause hypotension and therefore there may be some overlap with the clinical syndrome of exercise-induced anaphylaxis [19,20].
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.
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)
Urticaria results from the release of histamine, bradykinin, leukotriene C4, prostaglandin D2, and other vasoactive substances from mast cells and basophils in the dermis. [2] These substances cause extravasation of plasma into the dermis, leading to the urticarial lesion. The intense pruritus of urticaria is a result of histamine released into the dermis. One study showed that D-dimer levels correlate with the severity of acute urticaria and may serve as a marker of disease severity. [75]  
The intense itching can become unbearable to the point where the individual may inadvertently cause damage to the skin by scratching at the affected areas. The condition can be disturbing to parents who have never experienced it themselves, but observe it in their children. Although you may find yourself exasperated as your child continues to scratch at the skin, despite your warnings against doing so, you need to keep your calm. The intense itching can be unbearable, and even adults find it near impossible to restrain themselves. Instead of admonishing your child, , make sure that you take steps to minimize the discomfort and try to distract a child with hives so that they do not scratch the rash. In severe cases, the individual may also have a fever and may suffer from digestive distress. In most cases, the rash subsides for a couple of hours or even days before it returns. Other severe urticaria symptoms include periodic flushing, headaches, dizziness, respiratory problems, fluid retention, tongue or facial swelling and hypotension. Medical attention is essential, as if neglected, severe cases of utricaria can even cause asphyxiation, resulting in death. There are several ongoing research programs to understand the exact causes of this condition in order to increase the effectiveness of existing treatment methods.
You can usually treat mild cases of hives or angioedema at home. See your doctor if your symptoms continue for more than a few days. Seek emergency care if you feel your throat is swelling or if you’re having trouble breathing.
A viral infection such as a cold or flu can trigger an urticarial rash in some people. (You react to the virus.) A mild viral infection which causes few other symptoms is probably a common trigger of an urticarial rash that develops without an apparent cause.
Dermographism literally means skin writing. Scratching the skin will produce a raised mark and redden the surrounding skin. It is easy to test. Simply use a moderately sharp object, such as a fingernail or a key, and run it over the skin. If a recognizable patter is used in testing, such as a name or the game of X’s and O’s, it is a form of physical urticaria which is easily identified.
Urticaria is a skin condition commonly known as hives. It produces an itchy rash that tends to come and go and can last for a variable period of time. The condition can be acute (lasting less than 6 weeks) or chronic (lasting longer than 6 weeks). Most cases of urticaria have no known cause.
Weals are due to release of chemical mediators from tissue mast cells and circulating basophils. These chemical mediators include histamine, platelet-activating factor and cytokines. The mediators activate sensory nerves and cause dilation of blood vessels and leakage of fluid into surrounding tissues. Bradykinin release causes angioedema.
Urticaria occurs when a trigger causes high levels of histamine and other chemical messengers to be released in the skin.These substances cause the blood vessels in the affected area of skin to open up (often resulting in redness or pinkness) and become leaky. This extra fluid in the tissues causes swelling and itchiness.
Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Angiotensin converting enzyme inhibitors (ACE inhibitor) anti-hypertensives release Bradykinin and are a common trigger for angioedema and urticaria, especially Lisinopril, Perindopril and Enalapril.  ACE inhibitors may trigger angioedema even after many years of use.  The Angiotensin-II receptor anatagonists (ACE 2) such as Valsartan and Candesartan are less likely to induce angioedema and urticaria.
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.
Chronic hives may be treated with antihistamines or a combination of medications. When antihistamines don’t provide relief, oral corticosteroids may be prescribed. A biologic drug, omalizumab (Xolair), is also approved to treat chronic hives in those at least 12 years of age.
Chronic urticaria and/or angioedema are hives or swelling that lasts more than 6 weeks. The cause is usually harder to find than in acute cases. The causes can be similar to those acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.
If you aren’t certain what is causing your hives and are bothered by the symptoms, talking to your can help you identify potential allergic triggers. He or she can also order blood or skin tests for allergies if necessary.
History of present illness should include a detailed account of the individual episodes of urticaria, including distribution, size, and appearance of lesions; frequency of occurrence; duration of individual lesions; and any prior episodes. Activities and exposures during, immediately before, and within the past 24 h of the appearance of urticaria should be noted. Clinicians specifically should ask about recent exercise; exposure to potential allergens (see Table: Some Causes of Urticaria), insects, or animals; new laundry detergent or soaps; new foods; recent infections; or recent stressful life events. The patient should be asked about the duration between any suspected trigger and the appearance of urticaria and which particular triggers are suspected. Important associated symptoms include pruritus, rhinorrhea, swelling of the face and tongue, and dyspnea.
Drugs that block histamine-1 (H1) receptors (antihistamines) are the primary treatment for urticaria. The use of both H1 and H2 receptor blockers has been recommended but has not been proven more effective. Patients should avoid identified allergens. Doxepin, calcium channel blockers, or immunosuppresive drugs may be needed for symptoms that are not well controlled with antihistamines. Known triggers of urticaria should be avoided.
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.
“There is a growing appreciation of the link between the mind, the immune system, and the skin,” Dr. Howard says. “The skin and the nervous system are derived from the same embryologic layer, and we are only just beginning to appreciate the implications of this link.”
Jump up ^ Tebbe, Beate; Geilen, Christoph C.; Schulzke, Jörg-Dieter; Bojarski, Christian; Radenhausen, Michael; Orfanos, Constantin E. (1996). “Helicobacter pylori infection and chronic urticaria”. Journal of the American Academy of Dermatology. 34 (4): 685–6. doi:10.1016/S0190-9622(96)80086-7. PMID 8601663.
If non-sedating antihistamines are not effective, a 4 to 5-day course of oral prednisone (prednisolone) may be warranted in severe acute urticaria, particularly if there is angioedema. Systemic steroids do not speed up resolution of symptoms.
Widespread hives usually are a reaction to a viral infection. Less commonly they are an allergic reaction to a food, medicine or bee sting. Often the cause is not found (more than 30%). Hives on just one part of the body (localized) are usually due to skin contact with plants, pollen, food, or pet saliva. Localized hives are not an allergy and not caused by drugs, infections, or swallowed foods. Hives are not contagious.
Chronic urticaria is estimated to affect between 0·1–3% of children in the United Kingdom [1]. Physical factors, such as pressure and cold, are the most common identifiable trigger and children with chronic urticaria usually also have angioedema. Approximately 30% of children with chronic urticaria have a positive ASST [39] and approximately 4% have positive thyroid peroxidase antibodies. It is suggested that thyroid function be monitored in children with chronic urticaria and positive thyroid autoantibodies, even though it has not been well established that treatment of clinical thyroid disease, if it develops, will improve the urticaria [65]. It has also been reported that children with severe chronic urticaria have a higher incidence of coeliac disease than controls [66].

“autoimmune chronic idiopathic urticaria _urticaria causes”

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.
When you’re all stressed out, your body releases hormones and other chemicals, including histamine, the powerful chemical that leads to allergy symptoms. While stress doesn’t actually cause allergies, it can make an allergic reaction worse by increasing the histamine in your bloodstream.
Significant amounts of most anti-histamines are secreted in breast milk, but cetirizine and loratidine are secreted at lower levels and therefore these drugs are recommended if anti-histamine treatment is necessary in a woman who is breast feeding. The lowest possible cumulative dose should be used. Chlorphenamine has been reported to cause poor feeding and drowsiness and should be avoided.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Individual hives can last anywhere from a few hours to a week (sometimes longer), and new ones might replace those that fade. Hives that stay for 6 weeks or less are called acute hives; those that go on longer than 6 weeks are chronic hives.
Updated by: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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.
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]
A rare autoimmune disease characterized by recurrent urticaria (nettle rash), first described in the 1970s. There is no defined paradigm for the syndrome aetiology and severity in progression. Diagnosis is confirmed with the identification of at least two conditions from: venulitis on skin biopsy, arthritis, ocular inflammation, abdominal pain or positive C1q antibodies to immune complexes.[3] It is this last category, anti-C1q antibodies, that all HUV patients test positive for.[4] In vitro experiments and mouse models of the disease have not thoroughly determined the link between these antibodies and the disease, even though the link is so pronounced.
Insect bites are localised, often clustered in groups of 3–5 lesions, and they appear in crops. Bites persist for days. Close inspection reveals a central punctum. Chronic hypersensitivity to insect bites is often called papular urticaria.
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.
The older oral antihistamines (eg, hydroxyzine, diphenhydramine) are sedating and can cause confusion, urinary retention, and delirium. They should be used cautiously to treat urticaria in elderly patients.
The Hives are a Swedish rock band that rose to prominence in the early 2000s during the garage rock revival. Their mainstream success came with the release of the album Veni Vidi Vicious, containing the anthem “Hate to Say I Told You So”. The band have been acclaimed by music critics as one of the best live rock bands in current music.[1][2]
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.
68. Diav-Citrin O, Shechtman S, Aharonovich A, et al. Pregnancy outcome after gestational exposure to loratadine or antihistamines: a prospective controlled cohort study. J Allergy Clin Imunol. 2003;111:1239–43. [PubMed]
The actual cause of Acute Urticaria is relatively easy to identify as the trigger is usually immediately apparent and is reproducible on re-exposure.  Examples include: Shellfish, Peanut, Penicillin, Bee or Latex allergy.  In children generalised Acute Urticaria is often triggered by a streptococcal or viral infection (hepatitis, herpes etc).
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.
“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.”
Winter is not exactly the most popular season, and with good reason for those who live with chronic hives: The cold can trigger a flare-up in some. Besides the weather, other cold-related triggers include chilly foods and swimming pools. For people who are allergic to the cold, full-body immersion in a swimming pool, in particular, can trigger a severe reaction that involves not just hives but allergic shock (anaphylaxis) and loss of consciousness.
In a very small number of patients, severe, debilitating urticaria, associated possibly with airway angioedema, bronchospasm and hypotension, persists despite treatment with high-dose H1 anti-histamines; H2 anti-histamines and/or LTRA; corticosteroids; and, perhaps, dietary interventions. These patients usually have autoimmune urticaria and cyclosporin treatment has proved effective in about 65% of such patients in a randomized double-blind study [58]. Longer courses of cyclosporin may give a lengthier clinical response [59]; however, the optimum dose and length of treatment have not yet been established. Tacrolimus [60] and mycophenolate mofetil [61] have also been effective in open-label studies. Results of intravenous treatment in small numbers of patients have been variable [62,63]. The current recommendation from the clinical guidelines for the use of intravenous immunoglobulin [64] is that intravenous immunoglobulin should not be used unless all other therapies have failed. If patients require immunomodulating therapies, referral to a specialist centre is recommended.
Skin examination should note the presence and distribution of urticarial lesions as well as any cutaneous ulceration, hyperpigmentation, small papules, or jaundice. Urticarial lesions usually appear as well-demarcated transient swellings involving the dermis. These swellings are typically red and vary in size from pinprick to covering wide areas. Some lesions can be very large. In other cases, smaller urticarial lesions may become confluent. However, skin lesions also may be absent at the time of the visit. Maneuvers to evoke physical urticaria can be done during the examination, including exposure to vibration (tuning fork), warmth (tuning fork held under warm water), cold (stethoscope or chilled tuning fork), water, or pressure (lightly scratching an unaffected area with a fingernail).
Evidence of systemic autoimmune disease, including hypothyroidism or hyperthyroidism (autoimmune thyroiditis); hepatitis, renal failure, and polyarthritis (cryoglobulinemia); malar rash, serositis, and polyarthritis (SLE); dry eyes and dry mouth (Sjögren syndrome); cutaneous ulcers or hypopigmented lesions after resolution of urticaria (urticarial vasculitis)

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In children, an objective trial of a low E numbers diet may be helpful, especially if the clinical history suggests that episodes of urticaria may be related to ingestion of foods which are high in E numbers.
Yet another consideration is if you have an allergy to latex because a number of foods are known to produce a cross-reaction. Foods on this list include avocado, bananas, chestnuts, kiwi, and passion fruit.
Stress can wreak havoc on your physical and emotional health. You may feel overwhelmed or anxious about the source of your stress. If you’re experiencing physical symptoms like a rash, stress may be amplified.
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.
If your hives are uncomfortable or disrupting your life, consider seeing an allergist or physician to determine the underlying cause, especially if you have never had hives before. In many cases, a doctor can prescribe or recommend an over-the-counter medication that can help relieve your symptoms or calm down your hives as they occur.
Clinical Context:  Hydroxychloroquine is the preferred antimalarial agent because of its low toxicity and high effectiveness profile. It is usually well tolerated if carefully monitored by the prescribing physician. Therapy is required for 4-8 weeks before evaluating effectiveness.
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].
TREATMENT FOR CHRONIC URTICARIA: I HAVE CHRONIC URTICARIA FOR 11 YEARS,I HAVE BEEN TO SEE EVERYONE AND NOTHING SEEMS TO WORK .THE ONLY TIME I WENT IS WHEN I WAS IN INTENSIVE CARE BUT I CANT SLEEP FOREVER! ANY SUGGESTIONS, YOURS ITCHINGLY LEE GILLOTT
Previous studies have sought to determine the different types of stress that worsened symptoms in people with chronic hives. One study found that 16 percent of the people studied experienced a stressful event within one year before the onset or worsening of their hives.
Antihistamines are the first line medication for acute or chronic urticaria. Some of these are over-the-counter preparations. The newer anti-histamines are less sedating and therefore can be used in the daytime as well. Most of them are long-acting and can be taken once-a-day only. Normal prescribed dosages may not be of benefit and your doctor may often prescribe larger doses or the addition of a second medication. Sometimes a specific anti-ulcer treatment which also has some effect on blocking urticaria may be used. If no relief is a doctor should be consulted.
The most important part of the investigation of a patient with urticaria is to take a detailed history [43]. This should include structured questions about the many possible clinical causes of urticaria (see above); the frequency, timing and duration of attacks; whether the patient has developed more severe allergic symptoms such as angioedema or wheezing in association with the urticaria; and whether there are any symptoms suggestive of an underlying medical condition such as a connective tissue disease and/or urticarial vasculitis. Photographs may be helpful in confirming the diagnosis and patients may have compiled a symptom diary, which is sometimes useful when trying to identify possible triggers for the rash.
This is variable. Most cases of idiopathic urticaria resolve over a period of six months but a minority can persist for many years. Some remit and then relapse. 50% of cases of chronic urticaria have resolved within 3-5 years. At least 20% of chronic urticaria patients requiring referral to secondary care are still symptomatic 10 years after first presentation. Factors associated with lasting duration include severe symptoms, associated angio-oedema and positive antithyroid antibodies.
Localized cold urticaria, in which only certain areas of the body urticate with cold contact, has been reported after predisposing conditions such as cold injury; it has also been reported at sites of intracutaneous allergen injections, ragweed immunotherapy, or insect bites.
For example, dermatologists insist that masturbation has nothing to do with acne, but trust me – masturbate 3 times a day for 4 hours. The next day, I guarantee that you’ll have a huge pimple on your cheek. Hormonal imbalance can make matters worse. It’s a proven fact.