“itchy hives _treatment for cholinergic urticaria”

Try deep breathing techniques. Deep breathing techniques have been shown to help reduce stress. Start by lying flat on your back. Use pillows under your knees and neck to make sure you are comfortable. Put your hands, palm down, on your stomach right below the rib cage. Place the fingers of your hands together so you can feel them separate and know you are doing the exercise correctly. Take a long, slow deep breath by expanding your belly, breathing like a baby breathes, meaning from the diaphragm. Your fingers should separate as they lie on your belly.
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.
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.
Cholinergic urticaria is a common physical urticaria that is caused by sweating. It is sometimes referred to as heat bumps, as the rash appears as very small (1-4mm) weals surrounded by bright red flares.
Oral steroids (prednisone, [Medrol]) can help severe cases of hives in the short term, but their usefulness is limited by the fact that many cases of hives last too long for steroid use to be continued safely. Other treatments have been used for urticaria as well, including montelukast (Singulair), ultraviolet radiation, antifungal antibiotics, agents that suppress the immune system, and tricyclic antidepressants (amitriptyline [Elavil, Endep], nortriptyline [Pamelor, Aventyl], doxepin [Sinequan, Adapin]). Evidence to support the benefit of such treatments is sparse. In ordinary cases, they are rarely needed. A new treatment now indicated for chronic urticaria is the monthly subcutaneous injection of a monoclonal antibody, omalizumab (Xolair), directed against the IgE receptor on human mast cells.
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.
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.
An allergic skin condition featuring itchy, raised, pink areas surrounded by pale skin. These patches persist for periods of half an hour to several days and then resolve. Urticaria may result from sunlight, cold, food or drug allergy, insect bites, scabies, jelly fish stings or contact with plants. Treatment is with antihistamine drugs or corticosteroids. Also known popularly as nettle rash or hives.
4. Rockwell WJ. Reactions to molds in foods. In: Chiaramonte LT, Schneider AT, Lifshitz F, editors. Food allergy: a practical approach to diagnosis and management. New York: Marcel Dekker; 1988. pp. 153–70.
Since hives can come and go so swiftly, a very significant percentage of cases are never accurately diagnosed. The hives can appear and disappear without any explanation of what caused them or cured them. Skin testing may be used in finding the source of infrequent hives; a detailed history is usually more rewarding. The patient can record everything that was ingested or touched for the 24 hours prior to the outbreak and bring this to the physician.
Antihistamines that require a prescription include cyproheptadine (Periactin), which tends to cause drowsiness. A prescription antihistamine that causes little sedation is levocetirizine (Xyzal). Sometimes physicians combine these with other types of antihistamines called H2 blockers, such as ranitidine (Zantac) and cimetidine (Tagamet). This antihistamine list is not exhaustive. Physicians individualize treatment plans to suit specific patients and modify them depending on the clinical response.
Practice positive affirmations. Positive affirmations are phrases you say to yourself to help reduce your stress and bring up your mood. When saying these, use the present tense and repeat as often as you can. Examples of positive affirmations are:
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.
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.
For those with chronic hives from heat-induced or illness-induced activities, Dr. Li suggests visiting a doctor to pinpoint the symptoms and receive an antihistamine prescription. “The solutions are individualized and many times may involve just taking a little more medication,” she says.
Frequently, more than one type of physical urticaria may occur in a patient and it may be difficult for the individual to avoid the triggering stimulus/stimuli. The physical urticarias may, therefore, be difficult to treat and may be long-lasting.
If your reaction involves swelling of your tongue or lips, or you have trouble breathing, your allergist may prescribe an epinephrine (adrenaline) auto-injector for you to keep on hand at all times. These can be early symptoms of anaphylaxis, a potentially fatal allergic reaction that impairs breathing and can the body into shock. The only treatment for anaphylaxis is epinephrine. If you develop hives and your injector is not nearby – or if using the auto-injector doesn’t cause the symptoms to immediately improve – go to an emergency room immediately. You should also go to the emergency room after using an auto-injector.
Can stress cause hives? The answer is definitely “yes.” Hives and stress can go hand-in-hand. When you experience excessive short or long term stress, it takes a toll on body’s immune system. Since the stress is throwing off your immune system, your body responds by internally sending out histamine to fend off your current health problem, which in this case is stress. Histamine release doesn’t make stress go away, but it can cause hives to start popping up in various places. Basically, this is an allergic reaction to stress and your body is sending out visible signals (hives) to let you know that it’s time to chill out. (18)
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.
An eruption of itching wheals, colloquially called hives, usually of systemic origin; may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (heat, cold, light, friction), or psychic stimuli.
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.

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