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This chronic condition can also make your skin red and itchy. Although it’s most common in children, it can occur at any age. It generally starts as small, raised bumps. These bumps may leak fluid if scratched. The rash can form thickened areas of skin over a larger area, called plaques.
A prospective study published in 2004 found that chronic urticaria lasted longer in patients who had associated angioedema; severe urticaria; a positive ASST; or positive thyroid autoantibodies [69]. In this study chronic urticaria lasted for > 1 year in more than 70% of patients and for 5 years (the end of the study period) in 14% of patients. A retrospective study [70] found that 44% of patients seen in a dermatology clinic with either acute or chronic urticaria had a good response to H1 anti-histamine treatment. Patients with physical urticaria responded less well than patients with other types of urticaria and had a more prolonged clinical course.
There are two types of hives – short-lived (acute) and long-term (chronic). Neither is typically life-threatening, though any swelling in the throat or any other symptom that restricts breathing requires immediate emergency care.
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]
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.
Hives are red and sometimes itchy bumps on your skin. 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.
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.
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.
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.
If you have a bad allergic reaction, like shortness of breath, talk to your doctor about a prescription medicine called an “auto-injector.” This medicine stops the allergic reaction when you inject it into your thigh. Follow your doctor’s advice on how to use this medicine.
Challenge testing for physical urticarias may be appropriate [14]. For example, cold urticaria may be induced by applying ice to the forearm for a few minutes and then allowing the skin to re-warm, and dermographism may be induced by scratching the skin lightly. A skin biopsy should be taken, ideally from a ‘new’ lesion, if urticarial vasculitis is suspected (see below). The ASST is not performed routinely. It is less sensitive and specific than in vitro basophil histamine release assays [47] for the detection of histamine-releasing autoantibodies, but again these are not available routinely.
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.
People who don’t respond to the maximum dose of H1 antihistamines may benefit from increasing the dose, then to switching to another non-sedating antihistamine, then to adding a leukotriene antagonist, then to using an older antihistamine, then to using systemic steroids and finally to using ciclosporin or omalizumab.[39]
This page contains information about urticaria (hives) and other skin conditions such as angioedema. You can also find information about symptoms and treatment for urticaria and angioedema on our downloadable Factsheet area.
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.”
If the disease is very severe large doses of Methylprednisolone or Plasmapheresis (plasma exchange) may also be given. When the disease becomes quiet less toxic drugs are used to keep control and these include: Azathioprine, Methotrexate and Mycophenolate Mofetil usually in combination with low dose prednisolone.
73. 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;49:S283–5. Suppl. [PubMed]
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.
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

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As noted above, many cases of ordinary hives are “idiopathic,” meaning no cause is known. Others may be triggered by viral infections. A few may be caused by medications, usually when they have been taken for the first time a few weeks before. (It is less likely for drugs taken continuously for long periods to cause hives but certainly not impossible.) a medication is implicated as a cause of hives, the drug must be stopped, since testing is rarely available to confirm the cause. In most cases, drug-induced hives will go away in a few days. If a drug is stopped and the hives do not go away, this is a strong indication that the medication was not the cause of the hives.
Hives can also cause deeper swellings in the skin and mucosa called angioedema. These swellings are often bigger, last longer, may itch less, sometimes hurt or burn and respond less well to antihistamines. Large swellings over joints, for example, can cause pain that feels like arthritis even if the joint is not involved. Angioedema most frequently affects the face and lips. Although hives and facial swelling can be uncomfortable and cosmetically embarrassing, they are not usually dangerous.  Information on angioedema is available on the ASCIA website www.allergy.org.au/patients/skin-allergy
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.
Hive-like rashes commonly accompany viral illnesses, such as the common cold. They usually appear three to five days after the cold has started, and may even appear a few days after the cold has resolved.
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.
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.
Recognize the symptoms. The symptoms and appearance of hives can be very short-lived, lasting only minutes, to very long term. The symptoms and appearance of hives can last for months and years. Hives can also appear on any area of the body, though the most common are the raised, itchy bumps that appear in the same area that was exposed to the allergen.
In acute forms of urticaria and angioedema, a history of the events surrounding the outbreak is the most important information that can be obtained. Here are three common questions your allergist may inquire about:
Physical urticaria: Hives caused by direct physical stimulation of the skin — for example, cold, heat, sun exposure, vibration, pressure, sweating, and exercise. The hives usually occur right where the skin was stimulated and rarely appear elsewhere. Most of the hives appear within one hour after exposure.
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.
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.
Idiopathic cold urticaria is characterized by the rapid onset of pruritus, erythema, and swelling after exposure to a cold stimulus. The location of the swelling is confined to those parts of the body that have been exposed. When suspected, an ice-cube test can be performed in which an ice cube is placed on the subject’s forearm for 4-5 minutes. A positive reaction leads to formation of a hive in the shape of the ice cube within 10 minutes after the stimulus is removed (click for picture). The time course of this reaction (i.e., cold challenge followed by hive formation as the area returns to body temperature) demonstrates that a two-step reaction has occurred in which exposure to cold is a prerequisite, but hive formation actually occurs as the temperature increases.
Urticaria and angioedema are commonly classified by duration. Lesions of less than six weeks’ duration are considered acute; episodes that persist beyond six weeks are designated chronic. The causes and mechanisms of hive formation are different in each instance, as are the prognosis and approaches to treatment.
Using methods such as deep breathing, yoga, meditation and mindfulness techniques can increase your ability to deal with stressful situations as well as lower your body’s reaction when stress does appear.
Angioedema is swelling of the deeper tissue that sometimes occurs with hives. Like hives, angioedema can occur on any part of the body. When it occurs around the mouth or throat, the symptoms can be severe, including airway blockage.
If Aspirin & Salicylate intolerance is suspected then all forms of Salicylate including toothpaste, muscle rubs and peppermints should also be avoided. Aspirin sensitive individuals tolerate the newer Cyclo-oxygenase-2 selective inhibitors or COX-2 anti-inflammatory (NSAI) medications such as Celecoxib and Meloxicam.
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.
Lancey RA, Schaefer OP, McCormick MJ. Coronary artery bypass grafting and aortic valve replacement with cold cardioplegia in a patient with cold-induced urticaria. Ann Allergy Asthma Immunol. 2004 Feb. 92(2):273-5. [Medline].
Later in the lesion’s course, infiltrate may become a mixture of lymphocytes and neutrophils. Consider performing direct immunofluorescence on the skin biopsy, which may show deposition of complement and fibrin in the blood vessels and, occasionally, immunoglobulin M, immunoglobulin G, and immunoglobulin A along the basement membrane zone of the skin.
The information on Health24 is for educational purposes only, and is not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health advice, please consult a healthcare professional. See additional information.
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.”
Everyone reacts to stress differently. You might experience only a few of these signs or you might notice that more signs develop, especially when you don’t address your stress. Paying attention to your body’s reaction to stress can help you address it immediately, instead of waiting for stress cause you to break out in hives.
All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional.

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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
Urticarial vasculitis is a condition characterized by inflammation of the small blood vessels in the skin. Signs and symptoms include an itching and burning sensation in the affected skin. Lesions (wheals) caused by urticarial vasculitis may also leave behind a bruise.
^ Jump up to: a b Zuberbier, T (January 2012). “A Summary of the New International EAACI/GA2LEN/EDF/WAO Guidelines in Urticaria”. The World Allergy Organization journal. 5 Suppl 1: S1–5. doi:10.1097/WOX.0b013e3181f13432. PMID 23282889.
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.
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]
Disclosure: Genentech Consulting fee Consulting; American Health Insurance Plans Consulting fee Consulting; Johns Hopkins School of Public Health Consulting fee Consulting; Array BioPharma Consulting fee Consulting
Complement-mediated urticarias include 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 may be IgE-mediated or due to mast cell degranulation, and there may be significant cross-reactivity among the nonsteroidal anti-inflammatory drugs (NSAIDs) in causing urticaria and anaphylaxis. [16]
In addition, the mission of AAFA’s Web site is to provide online access to AAFA’s reliable, validated asthma and allergy information and tools to families, patients, parents, healthcare providers, policymakers and others.
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]
Aloe vera gel can also be applied over the affected area to reduce inflammation. Aloe vera gel is to have a cooling effect and this will help provide relief, especially if you have the urge to scratch the inflamed area.
Some medications, like morphine, codeine, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen [Advil]), cause the body to release histamine and produce urticaria through nonallergic mechanisms. People with urticaria should avoid these medications.
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.
Once a diagnosis of urticarial vasculitis is made, follow-up care depends on the patient’s complement levels. If complement level findings are normal, follow patients for symptoms and response to treatment. If complement level findings are low, follow patients for attendant complications related to the cause of their hypocomplementemia (see History).
The cause of most cases of urticarial vasculitis is unknown. It may be associated with a number of diseases, especially systemic lupus erythematosus, rheumatoid arthritis and Sjögren’s syndrome. Some cancers, including leukemias, colon and pancreatic, and infections like Hepatitis B and C can cause this form of vasculitis. So can some drugs, including antibiotics, ACE inhibitors used for treating high blood pressure, and certain diuretics.
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.
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.
Immunosuppressants used for CU include cyclosporine, tacrolimus, sirolimus, and mycophenolate. Calcineurin inhibitors, such as cyclosporine and tacrolimus, inhibit cell responsiveness to mast cell products and inhibit T cell activity. They are preferred by some experts to treat severe symptoms.[46] Sirolimus and mycophenolate have less evidence for their use in the treatment of chronic hives but reports have shown them to be efficacious.[47][48] Immunosuppressants are generally reserved as the last line of therapy for severe cases due to their potential for serious adverse effects.
Unfortunately there are no known specific therapies for HUV. The regime of prescription steroids and other immunosuppressive drugs aims to dampen the body’s production of anti-C1q antibodies.[3] However, this again renders the individual immunocompromised.

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Some people react to anything that makes them hot or sweaty with hives. This can be sunlight, exercise, hot baths, blushing or anger. These are tiny intensely itchy hives with a big red blotch around them and are called cholinergic urticarial.
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.
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: 
Practice positive affirmations. Positive affirmations are phrases you say to yourself to help reduce your stress and bring up mood. When saying these, use the present tense and repeat as often as you can. Examples of positive affirmations are:
A highly effective (but expensive) treatment now recommended by the American FDA and British NICE guidelines for use as the preferred third line add-on treatment of Chronic Urticaria unresponsive to high dose antihistamines, includes subcutaneous injections of 300mg Omalizumab (Xolair) once a month for 6 months.  Recent studies on this monoclonal antibody (previously only used in asthma) show that once initial control is gained (after one month), the dose may be halved to maintain control for the 6 month induction period which can result in total remission of the Urticaria. However at least 40% will relapse after withdrawal of Omalizumab.  (Zuberbier et al, EAACI Guidelines urticaria, Allergy 69(7) 2014)
Chronic hives don’t put you at any sudden risk of a serious allergic reaction (anaphylaxis). If you do experience hives as part of a serious allergic reaction, seek emergency care. Signs and symptoms of anaphylaxis include dizziness, trouble breathing, and swelling of your lips, eyelids and tongue.
Urticaria may be classified on the basis of underlying aetiology (see Table 1) or by a clinical classification. In most cases of chronic urticaria it will not be possible to identify the underlying cause, i.e. the rash is idiopathic; however, when seeing a patient, it is helpful to use a clinical classification, as this guides history-taking and ensures that in any one individual all possible triggers for the urticaria are identified. In some patients several factors may cause/worsen the rash.
The symptoms of hives include itching in most cases, swelling of the area, red welts that look much like a mosquito bite. If you have any of these symptoms, you may have hives. Most doctors when presented with hives, will try to test to find out the allergen that is responsible for the case. If the allergen simply cannot be found, such as in cold hives, only the symptoms are treated. Many doctors will give antihistamines because histamines are released into the system and this is what causes hives to form, but these commonly given antihistamines and corticosteroids only treat symptoms, not the causes. If you or your child has a life threatening case that causes constricted breathing, epinephrine is commonly given on the spot.
Chronic stress that persists for weeks or even months produces cortisol, the body’s main stress-induced hormone. When cortisol becomes elevated and remains so for awhile, it affects the cells that comprise your immune system. The immune system can’t keep infections or diseases at bay as it would do normally. Viruses or bacteria proliferate to the point where they can infect many cells, leading to symptoms and increased chance of illness.
Urticarial vasculitis is a condition characterized by inflammation of the small blood vessels in the skin. Signs and symptoms include an itching and burning sensation in the affected skin. Lesions (wheals) caused by urticarial vasculitis may also leave behind a bruise.
Sometimes hives go away on their own without treatment. Otherwise, hives can generally be treated at home. The most common treatment for hives is an over-the-counter (OTC) antihistamine. Antihistamines can relieve symptoms like itching. You can find a great selection of OTC antihistamines here.
If you have persistent urticaria, you may be referred to a skin specialist (dermatologist). Treatment usually involves medication to relieve the symptoms, while identifying and avoiding potential triggers.
Mallory Shiver, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Arkansas Foundation for Skin Cancer, Christian Medical and Dental Associations
Azathioprine may be used as a steroid-sparing agent once other therapeutic options have been exhausted. Measurement of thiopurine methyltransferase can help ensure safe and optimal treatment with azathioprine.
This type of urticaria is also termed rare, and occurs upon contact with water. The response is not temperature-dependent and the skin appears similar to cholinergic form of the disease. The appearance of hives is within one to 15 minutes of contact with the water, and can last from 10 minutes to two hours. This kind of hives do not seem to be stimulated by histamine discharge like the other physical hives. Most researchers believe this condition is actually skin sensitivity to additives in the water, such as chlorine. Water urticaria is diagnosed by dabbing tap water and distilled water to the skin and observing the gradual response. Aquagenic urticaria is treated with capsaicin (Zostrix) administered to the chafed skin. This is the same treatment used for shingles. Antihistamines are of questionable benefit in this instance, since histamine is not the causative factor.[citation needed]
Eczema is a general term for many types dermatitis (skin inflammation). Atopic dermatitis is the most common of the many types of eczema. Other types of eczema include: contact eczema, allergic contact eczema, seborrheic eczema, nummular eczema, stasis dermatitis, and. dyshidrotic eczema.
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]
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.
Simply put, external stressors plus cognitive, behavioral and social stressors have been shown to play a significant role in the intensity of itch, often providing an ever greater correlation than the actual dermatologic disease severity, according to Dr. Howard.
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 cause 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.
Urticaria and angioedema often occur at different times or together in the same person. They occur in about 15 per cent of the population at some time or other in their lives, with women more commonly affected  than men.
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.
Your dermatologist may call this type of hives fixed, which means not moving. Fixed hives may happen when a person takes a certain medicine (fixed drug eruption) or gets too much sunlight (fixed solar urticaria).
Once a diagnosis of urticarial vasculitis is made, follow-up care depends on the patient’s complement levels. If complement level findings are normal, follow patients for symptoms and response to treatment. If complement level findings are low, follow patients for attendant complications related to the cause of their hypocomplementemia (see History).
Clinical Context:  Indomethacin is the only NSAID reported effective in urticarial vasculitis. It is rapidly absorbed; metabolism occurs in the liver by demethylation, deacetylation, and glucuronide conjugation. Indomethacin inhibits prostaglandin synthesis.
Acute and chronic urticaria can result in severely impaired quality of life from pruritus and associated sleeplessness, as well as anxiety and depression. The depression can be severe enough to lead to suicide in rare cases. Additionally, many of the diseases associated with chronic urticaria may cause significant morbidity and mortality.
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
Previous studies varied in their definitions of the condition. However, when a study in the United Kingdom used consistent criteria restricted to patients diagnosed with vasculitis by biopsy and with urticarial lesions of more than 3 months duration, 2.1% of 1310 patients with urticaria were found to have urticarial vasculitis.
Later in the lesion’s course, infiltrate may become a mixture of lymphocytes and neutrophils. Consider performing direct immunofluorescence on the skin biopsy, which may show deposition of complement and fibrin in the blood vessels and, occasionally, immunoglobulin M, immunoglobulin G, and immunoglobulin A along the basement membrane zone of the skin.
In every medical reference, you would see them listing stress as one of the potential causes that can trigger hives or angioedema. Studies of groups of people suffering with different levels of urticaria have proven that stress can worsen hives and that it’s possible to get urticaria induced by stress.
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Jump up ^ Champion, R. H.; Roberts, S. O. B.; Carpenter, R. G.; Roger, J. H. (1969). “Urticaria and Angio-Oedema”. British Journal of Dermatology. 81 (8): 588–97. doi:10.1111/j.1365-2133.1969.tb16041.x. PMID 5801331.
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.

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If you have hives, you to know what causes them so you can eliminate that trigger and free yourself from the itching. The following lists are not exhaustive but do give the main known hives causes. While most cases of hives are idiopathic, see if you can eliminate any obvious causes of your hives. Just remember that it’s best to talk to your healthcare provider before eliminating all possible hive triggers. If you suspect a medication is causing your hives, contact your healthcare provider immediately.
Chronic hives don’t put you at any sudden risk of a serious allergic reaction (anaphylaxis). But if you do experience hives as part of a serious allergic reaction, seek emergency care. Signs and symptoms of anaphylaxis include dizziness, trouble breathing, and swelling of your lips, eyelids and tongue.
The most common symptoms are hives that cause itching, pain and a burning feeling. Skin patches often are red-rimmed with white centers, and unlike common hives may have petechia, or bleeding under the skin. The patches can be present for days and result in skin discoloration as they heal. Some patients may also have fevers, joint and abdominal pain, shortness of breath and swollen lymph glands. Sometimes urticarial vasculitis even causes injury to vital organs including the gut, lungs and kidneys.
Pityriasis rosea typically fades without treatment in six to eight weeks. During this time, you can use an OTC anti-itch medication, like diphenhydramine (Benadryl) or cetirizine (Zyrtec) to ease your symptoms.
Azathioprine may be used as a steroid-sparing agent once other therapeutic options have been exhausted. Measurement of thiopurine methyltransferase can help ensure safe and optimal treatment with azathioprine.
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]
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.
In so many words, stress hives are caused by excessive stress. When you’re stressed out, your immune system is thrown off a little bit. In an effort to try to “fix” the problem (stress), your immune system sends out histamine. It’s as if your body becomes allergic to stress.Since histamine can’t cure stress, it causes your body to develop hives instead.
In some people hives are caused by physical triggers, including cold (such as cold air, water or ice), heat, sunlight (solar), vibration, rubbing or scratching of the skin (dermatographism) and delayed pressure (such as after carrying heavy bags.  In other people, exercise (sweating), stress, alcohol, spicy food or coffee may cause symptoms.
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.

“articurial -full body hives”

Mastocytosis is a disease in which there is mast cell hyperplasia affecting the skin, gastrointestinal tract, bone marrow, liver, spleen and lymph nodes. Clinical features include urticaria, pruritus, flushing, nausea, vomiting, abdominal pain, diarrhoea and headache. Patients may be prone to severe anaphylactoid reactions after exposure to certain medications [79] and severe anaphylactic reactions after exposure to antigens to which they are sensitized, such as insect venom [80], because of the increased tissue load of mast cells. Mastocytosis is classified into cutaneous and systemic variants and urticaria pigmentosa is the most common form of cutaneous mastocytosis, occurring in approximately 85% of children and 95% of adults in whom mastocytosis is limited to the skin. Systemic mastocytosis varies from an indolent condition, where there is no associated haematological disease, to an aggressive mast cell leukaemia. The lesions of urticaria pigmentosa are variable in colour, macular or maculopapular and are usually symmetrical in distribution, with sparing of the extremities and face. The diagnosis of urticaria pigmentosa is made by skin biopsy, which shows a significant increase in dermal mast cells [81]. Patients have symptoms of pruritus and dermographism and pressure on affected skin causes erythema and urtication –‘Darier’s sign’. Children usually present before the age of 2 years and urticaria pigmentosa may be present at birth. They tend to have fewer, larger skin lesions than adults and they may also develop bullae, which do not occur in adults. Treatment is with H1 and H2 anti-histamines and ketotifen [82] (an anti-histamine with mast cell-stabilizing properties), methoxsalen with long-wave ultraviolet radiation (psoralen plus ultraviolet A,) [83] and topical steroids [84] may all be used to alleviate urticaria and pruritus. It is rare for children to develop systemic mastocytosis and urticaria pigmentosa resolves completely in about 50% of children. In contrast, urticaria pigmentosa in adults usually persists and about 50% of patients may go on to develop systemic mastocytosis. The prognosis in adults is, therefore, highly variable.
Fueyo-Casado A, Campos-Muñoz L, González-Guerra E, Pedraz-Muñoz J, Cortés-Toro JA, López-Bran E. Effectiveness of omalizumab in a case of urticarial vasculitis. Clin Exp Dermatol. 2017 Mar 1. [View Abstract]
Acute urticaria can result from “non-specific” stimulation of mast cells, when there is degranulation of mast cells in the absence of a defined allergen. An example is exposure to certain radiocontrast media which changes the osmolality of the environment in which the mast cell resides and can result in degranulation. Patients who develop acute urticarial eruptions can have other accompanying manifestations of a systemic anaphylactic reaction such as wheezing, laryngeal edema, cramps, diarrhea, and hypotension.
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)
Other common causes are food, medication, chemicals such as acetone, a polymer such as latex, an viral, fungal, or bacterial infection, pet hair or dander, plants, and physical stimuli such as pressure, temperature, and sun exposure.[5]
Treatment depends on the extent of symptoms and organ involvement. When levels of complement are normal and there is no internal organ involvement or underlying disease, the symptoms may improve on their own or with minimal treatment. In this case, antihistamines or nonsteroidal drugs such as ibuprofen or naproxen may be helpful. For more severe cases, other drugs which affect the immune system may be needed, such as corticosteroids (prednisone, others), hydroxychloroquine, colchicine, dapsone; and chemotherapies like azathioprine or cyclophosphamide. Treatment may be intermittent, although it is not uncommon for patients to need treatment for several years.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The cold type of urticaria is caused by exposure of the skin to extreme cold, damp and windy conditions; it occurs in two forms. The rare form is hereditary and becomes evident as hives all over the body 9 to 18 hours after cold exposure. The common form of cold urticaria demonstrates itself with the rapid onset of hives on the face, neck, or hands after exposure to cold. Cold urticaria is common and lasts for an average of five to six years. The population most affected is young adults, between 18 and 25 years old. Many people with the condition also suffer from dermographism and cholinergic hives.[citation needed]
Idiopathic cold urticaria is characterized by the rapid onset of pruritus, erythema, and swelling after exposure to a cold stimulus. The location of the swelling is confined to those parts of the body that have been exposed. When suspected, an ice-cube test can be performed in which an ice cube is placed on the subject’s forearm for 4-5 minutes. A positive reaction leads to formation of a hive in the shape of the ice cube within 10 minutes after the stimulus is removed (click for picture). The time course of this reaction (i.e., cold challenge followed by hive formation as the area returns to body temperature) demonstrates that a two-step reaction has occurred in which exposure to cold is a prerequisite, but hive formation actually occurs as the temperature increases.
There are some researches that link post-traumatic stress disorder (PTSD), a classic stress-mediated syndrome with urticaria (the medical term for hives or nettle-rash), clearing the possible co-morbidity.

“idiopathic urticaria -urticaria pictures”

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.
Management of urticaria is focused on treating the symptoms and typically is not altered by underlying etiology. The mainstay is avoidance of further exposure to the antigen causing urticaria. Pharmacologic treatment options include the following:
If any features of anaphylaxis (eg, hypotension, respiratory distress, stridor, gastrointestinal distress, swallowing problems, joint swelling, joint pain) are present, immediate medical intervention should occur. (See Physical Examination.)
The “chronic” in CIU means that symptoms last six weeks or more. CIU is an unpredictable form of chronic hives that can appear at any time with no identifiable cause. These hives may not go away for many months—or even years. CIU can be difficult to diagnose.
Jump up ^ Phan, NQ; Bernhard, JD; Luger, TA; Ständer, S (October 2010). “Antipruritic treatment with systemic μ-opioid receptor antagonists: a review”. Journal of the American Academy of Dermatology. 63 (4): 680–8. doi:10.1016/j.jaad.2009.08.052. PMID 20462660.
If you are experiencing hives, don’t know the cause and they have lasted at least six weeks or more, talk to a specialist to see if you have chronic idiopathic urticaria. There may be medicines they can prescribe to help you manage your condition.
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. 
Get medical help. In rare cases, hives can cause swelling in the throat and can cause an emergency situation that requires epinephrine. Epinephrine can also be used as an EpiPen in those who are severely allergic to a particular substance and require epinephrine to avoid anaphylaxis, which is a severe allergic reaction that may occur with or without the appearance of hives. The symptoms of an anaphylactic reaction include:
An allergic reaction can cause hives, as can temperature extremes, stress, infections, or illnesses. In some cases, hives are accompanied by angioedema, a condition that can cause swelling around the eyes, lips, hands, feet, or throat. Very rarely, hives and angioedema are associated with an allergic reaction that involves the whole body or anaphylactic shock.
Seek urgent medical attention for yourself or your child if hives are severe and/or cover a large area of your body, or if you have other symptoms, such as difficulty breathing or a fever. Chronic urticaria or chronic hives should be evaluated by an allergist or immunologist to determine proper hives treatment.
In most cases of chronic urticaria and angioedema, symptoms last less than a few months to a few years. Some people may experience symptoms for many years, and those who do should be seen by an allergist for an appropriate diagnosis and treatment plan. 
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.  
The complement pathway is composed of several subset pathways: the lectin/mannose pathway, alternative pathway and the classical pathway. All pathways culminate in the production of a C3 convertase, which catalyses C3 into its constitutive parts (better detailed here – classical complement pathway).[5]
Chronic infections such as viral hepatitis, sinus infections (sinusitis), and urinary tract infections can cause chronic hives. An infection with Helicobacter pylori, a bacteria commonly connected with stomach ulcers, is also associated with chronic hives. 
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.
Urticaria, commonly referred to as hives, is the most frequent dermatologic disorder seen in the emergency department (ED). It appears as raised, well-circumscribed areas of erythema and edema involving the dermis and epidermis that are very pruritic. Urticaria may be acute (lasting <6 wk) or chronic (lasting >6 wk). A large variety of urticaria variants exist, including acute immunoglobulin E (IgE)–mediated urticaria, chemical-induced urticaria (non-IgE-mediated), autoimmune urticaria, cholinergic urticaria, cold urticaria, mastocytosis, periodic fever syndromes including Muckle-Wells syndrome, and many others. [2, 10] While acute urticaria is generally related to an exogenous allergen or acute infection, chronic urticaria is more likely to be associated with autoimmunity. [8, 11, 12]
Question on Papular Urticaria: Is Urticaria & Papuller Urticaria the same? My 15 yr old sis is suffering from Papullar Urticaria since 2 yrs. We tried all medication including Allopathic (also Steroids), homeopathy. But no improvement. Pls suggest a remed
Theoretically, almost any drug can cause an allergic reaction (see the images below); thus, allergic reactions to a wide variety of drugs can occur. Antibiotics, such as penicillin, have been implicated most frequently. [11] Urticarial reactions to penicillin can occur as long as 14 days after a course of treatment has stopped. In this situation, serum sickness may be present.
There is a lot that we still do not understand about urticaria causes although do know that there are certain triggers and certain reactions that could cause the symptoms associated with utricaria to flare up. The absence of any well defined or clear cause of urticaria does to a large extent limit our ability to deal with the problem. The point to note is that urticaria is not always caused through or because of an allergy and there is no definitive urticaria cure. Non–allergic causes are connected to auto- immunity, to hormone interplay to stress factors, and more. These are some of the more common urticaria causes or triggers:
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.
I went in some hay and got the hives on the back of my legs so close together it looked like one big red/pink spot on the back of my legs so i took 2 cold rags and put them on the back of my legs for about 8-10 minutes and TOTALLY relieved itching.
The very best way to get rid of stress hives is to remove as much stress from your life as possible. There are so many effective ways to reduce stress on a daily basis. Find what works best for you and make it a part of your routine. Exercise is always one of my stress boosters. Other great ideas for stress hives treatment, and hives treatment in general, include yoga, massage, journaling and prayer.
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.
The type I allergic immunoglobulin (Ig) E response is initiated by antigen-mediated IgE immune complexes that bind and cross-link Fc receptors on the surface of mast cells and basophils, thus causing degranulation with histamine release.

“aortic area +hives triggers”

The symptoms of urticaria are often very obvious and this often has a negative impact on one’s social life. This in turn can cause a great deal of distress and anxiety which would only serve to aggravate the condition. You can consult your doctor for detailed advice on how to cure urticaria symptoms such as itching and inflammation. There are also several home remedies for hives that can be used to treat the condition as well as reduce the severity of the symptoms. While there is little supporting research to back up most of these home treatments, some of them are extremely effective. Treatment results could vary greatly however, and in some cases certain remedies may be ineffective. Exercise caution when using any of these home treatments. These are some of the most effective home remedies for urticaria:
Urticaria, commonly referred to as hives, appears as raised, well-circumscribed areas of erythema and edema involving the dermis and epidermis that are very pruritic (see the image below). It may be acute (<6 wk) or chronic (>6 wk). Urticaria may be confused with a variety of other dermatologic diseases that are similar in appearance and are also pruritic; usually, however, it can be distinguished from these diseases by an experienced clinician. [1]
Allergic reactions, chemicals in foods, insect stings, sunlight, and medicines can make your body release a chemical called histamine. Histamine sometimes makes blood plasma leak out of small blood vessels in the skin, causing hives or angioedema.
Angioedema is a reaction similar to hives that affects deeper layers of your skin. It most commonly appears around your eyes, cheeks or lips. Angioedema and hives can occur separately or at the same time.
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.
Urticarial vasculitis is a condition characterized by inflammation of the small blood vessels in the skin. Signs and symptoms include an itching and burning sensation in the affected skin. Lesions (wheals) caused by urticarial vasculitis may also leave behind a bruise.
Urticarial vasculitis can be treated similarly but other agents (that are typically less effective for CSU) may be tried, such as dapsone, hyroxychloroquine, or colchicine. Hydroxychloroquine can be particularly helpful for the treatment of the hypocomplementaemic urticarial vasculitis syndrome. The various types of urticarial vasculitis account for less than 1% of all chronic urticarias.
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.
Irinyi B, Szeles G, Gyimesi E, Tumpek J, Heredi E, Dimitrios G, et al. Clinical and laboratory examinations in the subgroups of chronic urticaria. Int Arch Allergy Immunol. 2007. 144(3):217-25. [Medline].
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.
Clinical Context:  Dapsone is the preferred sulfone. Other sulfones must be metabolized to dapsone for their effect. The mechanism of action is similar to that of sulfonamides in which competitive antagonists of PABA prevent the formation of folic acid, inhibiting bacterial growth.
a vascular reaction of the skin marked by transient appearance of slightly elevated patches (wheals) that are redder or paler than the surrounding skin and often attended by severe itching; the cause may be certain foods, infection, or emotional stress. (See Atlas 2, Plate D.) Called also hives. adj., adj urtica´rial.
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.
The medical term for hives is urticaria (ur-tih-CARE-ee-uh). When large welts occur deeper under the skin, the medical term is angioedema (an-gee-oh-eh-dee-ma). This can occur with hives, and often causes the eyelids and lips to swell.
What you should really take care of is your wellbeing that is independent from others. You should have a rock solid self-esteem; embrace yourself! If you see that you need a change, do it for yourself (not for them, for you) because you deserve it. When people are just minutes closer to challenging their atheism, you only regret that you didn’t live happily enough or that you didn’t make the choices you wanted for yourself.
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.
Making a paste of baking soda and water can help to calm hives and also prevent new ones from popping up. Baking soda is known as nahcolite, which is part of the natural mineral natron. Natron contains large amounts of sodium bicarbonate. It has been used since ancient times as a soother and cleanser. Mix a teaspoon of baking soda with some cold water to create a paste and then rub it on the affected area. Let it dry completely before washing it off. You can do this a few times a day, if needed. Relief is typically immediate from this easy hives treatment.
Individual lesions of acute urticaria can appear at different locations and fade without scarring, often in a matter of hours. The development of urticaria can be an isolated event without systemic reaction or it can be a prelude to the development of an anaphylactic reaction. Although urticaria results from transient extravasation of plasma into the dermis, angioedema is the subcutaneous extension of urticaria that results in deep swelling within subcutaneous/submucosal tissues and is associated with pain.
Psychological stress exacerbates chronic urticaria through a variety of mechanisms, including heightened basophil response to corticotrophin releasing factor and adrenocorticotropic hormone (ACTH) and a derangement of the hypothalamic-pituitary-adrenal (HPA) axis (Dyke SM, Carey BS, Kaminski ER. Clin Exp Allergy. 2008;38(1):86-92).
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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
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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.
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.
13. Gellert GA, Ralls J, Brown C, Huston J, Merryman R. Scombroid fish poisoning underreporting and prevention among non-commercial recreational fishers. West J Med. 1992;157:645–7. [PMC free article] [PubMed]
We all experience stress at some time in our lives. In small amounts, stress can help you. For example, stress might keep you alert when studying for a test, or give you a boost of adrenaline when faced with a deadline. But stress is also a warning sign that something is wrong. It can set off a number of physical, cognitive and emotional symptoms that make it more difficult to deal with a situation. When you ignore the signs of stress, it may in some cases, grow stronger and can cause you to break out in hives.
It’s important that you talk to your doctor about your experience with CIU, sharing details about your symptoms. Think about your condition and write down what you are going through. In close partnership, you and your doctor can manage your disease together.

“causes of welts urticarial reaction”

Acute urticaria is most often a benign, self-limited skin disease. It usually occurs independently, but it may contribute to the more serious clinical manifestations of anaphylaxis: angioedema and anaphylactic shock. The etiologies of both acute and chronic urticaria are numerous (see Causes in Presentation). The etiologic agent is more likely to be identified in acute urticaria (40-60%) than in chronic urticaria (10-20%). The lesions of IgE-mediated urticaria usually last less than 24 hours and are often migratory, leaving no residual skin abnormalities. The lesions of urticarial vasculitis usually last longer, classically, but not always, longer than 24 hours. [8] They are both painful and pruritic and often leave purpuric and hyperpigmented lesions. [9] Unlike simple urticaria, urticarial vasculitis demonstrates leukocytoclastic vasculitis on histology. Like urticaria, it may occur with or without angioedema. It may be associated with systemic symptoms such as arthralgias and GI symptoms, which are more common in patients with low complement levels. Although it is most often idiopathic, it is more often associated with autoimmune diseases such as lupus and Sjögren syndrome, as well as viral infections, medications, and malignancy, when compared with classic urticaria. [13] If urticarial vasculitis is suspected, an autoimmune screen, including complement levels, should be included in the workup. Initial treatment options include antihistamines and NSAIDs.
Urticaria that develops after exposure to high ambient temperatures (e.g., after exercise, a warm shower or bath, or during a fever). The hives that develop are typically small (1 to 3 mm) and are often surrounded by erythema. Synonym: generalized heat urticaria
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Get away from the allergens. The first step in treating hives is to ensure you are away from the source of the allergic response. If you know what it is, which is how most cases of hives are, remove the substance that is causing the allergic reaction from your skin or environment. Common allergens that are easy to determine are poison ivy, poison oak, insect bites, wool clothing, a cat, or a dog. Avoid these or any other known allergen as much as possible.
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!
[Guideline] American Academy of Allergy, Asthma & Immunology. Consultation and referral guidelines citing the evidence: how the allergist-immunologist can help. J Allergy Clin Immunol. Feb. 117(2 Suppl Consultation):S495-523. [Medline].
Diagnosis is by skin biopsy, taken ideally from a ‘new’ lesion (within 12 h of appearance), which shows a small vessel leucocytoclastic vasculitis involving post-capillary venules, with endothelial cell swelling, a neutrophil cell infiltrate, extravasation of red blood cells and fibrinoid deposits in and around blood vessels [75]. The condition is thought to be mediated via a type III/immune complex hypersensitivity reaction, in which antigen/antibody complexes deposit in vessel walls. This results in complement activation, neutrophil chemotaxis and infiltration and the release of proteolytic neutrophil enzymes, such as collagenases and elastases, which cause tissue damage. Immunofluorescence shows deposition of immunoglobulin and complement.
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Seek urgent medical attention for yourself or your child if hives are severe and/or cover a large area of your body, or if you have other symptoms, such as difficulty breathing or a fever. Chronic urticaria or chronic hives should be evaluated by an allergist or immunologist to determine proper hives treatment.
Acute hives can be related to other infections such as strep throat, athlete’s foot, mononucleosis, and coxsackie viruses. Though they’re not viral infections, both intestinal worms and malaria can also cause urticaria.
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.
Understanding the mechanisms of allergy is recent — just over the past 35 to 40 years, says Marshall, who is director of the division of clinical immunology and allergy at the University of Mississippi Medical Center. While allergic diseases have both genetic and environmental components there’s still so much about allergy we don’t know.

“multivariable -urticaria es contagiosa”

Foods that are fermented such as cheese, vinegar and alcoholic beverages also produce histamine and should be cut out of your daily diet. Some people may be allergic to additives and artificial colorings so over-processed and junk foods need to be avoided as well.
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.
She’ll also ask about the foods you eat and if you have pets, to see if an allergy is to blame. She may check for other illnesses or conditions that could be causing the hives, like an overactive or underactive thyroid.
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]
Stress hives develop due to chronic stress or tension in your life, and appear as red, raised and swollen areas on the skin that seem to suddenly appear. Stress hives, which are also known as a stress rash or as stress bumps, are often incredibly itchy, and some people report having a burning or stinging sensation wherever they appear. Stress induced hives will go away by themselves when you have successfully released ALL the stress from your body or taken the hives treamtment OxyHives, which will eliminate your symptoms.
Making a paste of baking soda and water can help to calm hives and also prevent new ones from popping up. Baking soda is known as nahcolite, which is part of the natural mineral natron. Natron contains large amounts of sodium bicarbonate. It has been used since ancient times as a soother and cleanser. Mix a teaspoon of baking soda with some cold water to create a paste and then rub it on the affected area. Let it dry completely before washing it off. You can do this a few times a day, if needed. Relief is typically immediate from this easy hives treatment.
Antihistamines are also prescribed to treat chronic (lasting longer than 6 weeks) hives. When prescribed for chronic hives, you take this medicine every day to prevent hives from forming. There are many antihistamines on the market. Some make you drowsy, and some do not.
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 than 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.
Histamine and other proinflammatory substances are released from mast cells in the skin and tissues in response to the binding of allergen-bound IgE antibodies to high-affinity cell surface receptors. Basophils and other inflammatory cells are also seen to release histamine and other mediators, and are thought to play an important role, especially in chronic urticarial diseases.
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.
Also, if you have chronic hives, you may want to ask your doctor about getting tested for the antigen Heliobacter pylori, which is associated with chronic hives. In a study published in February 2015 in the journal Advances in Dermatology and Allergology, a third of chronic hives patients were also infected with H. pylori. What’s more, about 92 percent of those with both hives and H. pylori experienced a reduction in hive-related symptoms after their infection was treated.
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 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.  
Robert A Schwartz, MD, MPH Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School
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.
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.