“what causes hives all over the body -definition of urticaria”

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.
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].
Chronic cases are much more likely to be related to autoimmune causes than allergies. In the autoimmune form of urticaria and angioedema, a person makes antibodies against a component of their mast cells, triggering the release of histamine and causing symptoms.
The next largest group of chronic hives is those with a physical trigger (cold, scratching, heat, etc.).  The smallest group is the one of most concern. A very small proportion of patient with chronic hives have an under-lying disease that can present as hives. That is why most allergists do a screening lab evaluation for patients with chronic hives. Extensive and expensive evaluation is not necessary.
The cause of Urticarial Vasculitis is not known in 50 per cent of cases. However it can be associated with or triggered by autoimmune/connective tissue diseases like Systemic Lupus Erythematosus (SLE or simply Lupus) Rheumatoid Arthritis, or occur in the context of a systemic vasculitis syndrome, such as Churg Strauss syndrome (Eosinophillic Granulomatosis with Polyangiitis); infections or viruses such as hepatitis; a reaction to certain drugs such as ACE inhibitors; certain types of diuretics; penicillin and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs); cancer; and Glandular problems, such as Graves’ Disease (overactive thyroid).
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 of an auto-injectable epinephrine pen.
Tests are sometimes done when hives go on for long periods or when unusual symptoms are occurring around the same time. This is to exclude other diseases, which may appear as hives first and other conditions later. If hives are associated with high fever, bruising, bleeding into the skin, purple lumps that last for several days or sore joints a doctor’s appointment should be arranged promptly.
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]
Acute urticaria, which is an allergic (IgE-mediated) reaction, is common in both children and adults. This type of urticaria is a self-limiting process that occurs when mast cells in the skin are activated, degranulate, and secrete histamine, leukotrienes, platelet activating factor (PAF), enzymes such as tryptase and chymase, cytokines, and chemotactic cytokines (chemokines). When an allergen (for example, a food) to which the person is allergic arrives via the bloodstream to mast cells in the skin, it binds to the IgE, and the mast cells become activated, and degranulate. Allergens that can result in acute urticaria include foods, drugs (particularly antibiotics such as penicillin), and venoms from bee, wasp, yellow jacket, hornet, or fire ants. Virtually any allergen that can be disseminated throughout the body, and to which there is an IgE response, has the potential to cause generalized urticaria.
Acute urticaria may rarely progress to life-threatening angioedema or anaphylactic shock in a very short period, although anaphylactic shock is usually of rapid onset with no urticaria or angioedema. [5] Prehospital measures may include the following when there is concern for anaphylactic shock:
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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.
Sil A, Tripathi SK, Chaudhuri A, Das NK, Hazra A, Bagchi C, et al. Olopatadine versus levocetirizine in chronic urticaria: an observer-blind, randomized, controlled trial of effectiveness and safety. J Dermatolog Treat. 2012 Nov 19. [Medline].
Hives (the common term for urticaria), are pink or red itchy rashes, that may appear as blotches or raised red lumps (wheals) on the skin. They range from the size of a pinhead to that of a dinner plate. When hives first start to appear, they can be mistaken for mosquito bites. Swellings usually disappear within minutes to hours in one spot, but may come and go for days or weeks at a time, sometimes longer. In most cases hives are not due to allergy and they can be effectively treated with a non-drowsy antihistamine. When hives occur most days for more than 6 weeks this is defined as chronic (ongoing) urticaria, which may require additional medication. 
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.
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]
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.

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FCAAIA Notes: Chronic urticaria (hives lasting 6 weeks or longer) is a frustrating problem for patients and their doctors.  The frustration arises because the majority of cases are “idiopathic”, meaning there is no identifiable trigger. We now know that about 1/3 or more of chronic idiopathic urticaria are not idiopathic at all; in those cases, patients make an autoantibody to a certain molecule on the surface of cells called mast cells.  When mast cells are activated by that autoantibody, they release histamine and other chemicals that cause hives.  Technically then, those hives are not idiopathic.  But, there is still no specific therapy for them and no way to avoid an external trigger.  Idiopathic urticaria are uncomfortable and can be unsightly, but are completely benign.
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.
One study was performed on 45 medical students taking final exams to see if stress negatively affected their resistance to disease. Specifically, these students were studied three to four weeks prior to exams, then again during exams to see how they responded to a hepatitis vaccine. Compared to students who received the vaccine under relaxed conditions, the stressed students showed much weaker immune system responses to the vaccine.
Jump up ^ Kolkhir, P.; Balakirski, G.; Merk, HF.; Olisova, O.; Maurer, M. (December 2015). “Chronic spontaneous urticaria and internal parasites – a systematic review”. Allergy. doi:10.1111/all.12818. PMID 26648083.
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.
The experts disagree when it comes to managing stress to ease allergy symptoms. Grossan tells WebMD that after weeks of sneezing, the body’s immune system is exhausted. “Going to bed and resting can help to restore the body’s resistance and is definitely good stress-relief therapy.”
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]
Self-diagnosis of skin disorders is never an easy task. It’s made more difficult when different conditions have similar symptoms. Hives, for example, come in two types — acute and chronic — and are usually caused by your body releasing histamine in reaction to an allergy. Histamine is an organic compound in your body responsible for triggering the inflammatory process. With hives, the histamine causes fluid to release from the blood vessels and makes the skin swell [source: Rockoff].
Another possible explanation for your stress hives is that due to your weakened immune system, your skin is reacting to irritants that it never had problems with before: cold, heat, soaps, shampoos, lotions, laundry detergents, certain fabrics, sunlight, etc. In fact, there are even doctors that specialize in stress hives, known as psychodermatologists. These specialists work with skin illnesses and stress, and strongly feel that emotions that have not been properly dealt with can induce a rash in patients and that these deep seated emotions are the major cause of chronic hives.
Your doctor may prescribe a cream or antihistamines to help with the itching. Good skin care is essential for prevention of an infection. For isolated or minor infected lesions, an antiseptic e.g. betadine can be applied. However, antibiotics may be necessary for severe or extensive infection.
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]
Steven A Conrad, MD, PhD Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center
Fortunately, it’s easy to find out whether cold is one of your triggers: Your doctor can administer a simple test that involves placing an ice cube on your skin for five minutes to see if a reaction occurs. If it turns out that cold is a trigger for you, your doctor will recommend that you protect your skin from the cold and take your medications as prescribed.
[Guideline] American Academy of Allergy, Asthma & Immunology. Consultation and referral guidelines citing the evidence: how the allergist-immunologist can help. J Allergy Clin Immunol. 2006 Feb. 117(2 Suppl Consultation):S495-523. [Medline].
Occasionally, a person will continue to have hives for many years. These hives, called chronic urticaria, can be one of the most frustrating problems dermatologists see in their patients. This is defined as hives lasting longer than 6 weeks. Patients like this come in miserable and worried with this problem, often having seen multiple specialists. Neither the patient nor the doctor can determine the cause of the hives. Patients will often say, “It has got to be something causing these hives.” The truth is hard to accept for some patients.
Kevin P Connelly, DO Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center
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.
Dr. Li says sweating can also signal a breakout for those prone to hives. The sweat itself doesn’t cause hives, but indicates your body heat rising. For some, excess warmth on the skin, from a workout or other body-heat inducing activity, is enough to produce hives. “Even taking a hot shower makes them break out,” Dr. Li says.
Make a pineapple compress. Bromelain is an enzyme found in pineapples and can help reduce the swelling of hives. Crush some pineapple, either canned or fresh, and place it on a thin cotton towel. Pull the four corners of the towel together and tie them off with a rubber band. Place the damp, pineapple filled towel over the hives.
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)
Urticaria. This is a close-up view of wheals with white-to-light-pink color centrally and peripheral erythema. These are the classic lesions of hives, or urticaria. Some hives are caused by allergies to such things as foods, medications, and insect stings, but the large majority of cases are not allergic, and no specific cause for them is ever found. It is characteristic that they are transient and highly pruritic. The goal of treating most cases of ordinary urticaria is to relieve symptoms while the condition goes away by itself.
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.
Hives can look ugly and are unbelievably itchy, but they are not in themselves dangerous. However, if you have hives and other symptoms such as dizziness, vomiting, diarrhea, difficulty in breathing, difficulty swallowing or faintness, these are signs and symptoms of a much more serous reaction – anaphylaxis. Anaphylaxis is life-threatening! If you experience hives plus one or more of these other symptoms soon after eating or being injected with a substance that you do not usually use, OBTAIN MEDICAL IMMEDIATELY.
The main treatment of all forms of urticaria in adults and in children is with an oral second-generation antihistamine chosen from the list below. If the standard dose (eg 10 mg for cetirizine) is not effective, the dose can be increased up to fourfold (eg 40 mg cetirizine daily). They are stopped when the acute urticaria has settled down. There is not thought to be any benefit from adding a second antihistamine.
The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.
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Q. I was diagnosed with chronic urticaria. What is the reason for this condition? I was diagnosed with chronic urticaria last week after more than two months of urticaria (I have more than twenty 1 dollar coin area no my trunk that are red swollen and itchy). when I was younger I had a similar reaction too a bee sting and I was treated with an adrenalin shoot. Since that one time I never suffered from this kind of symptoms till two months ago. What can be the reason for this condition?

“treatment for chronic idiopathic urticaria -urticaria in pregnancy”

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.
Antihistamines remain the mainstay of treatment. They must be taken on a regular basis, rather than as needed. Newer oral antihistamines often are preferred because of once-daily dosing and because some are less sedating. Appropriate choices include
Like other medications used to treat urticarial vasculitis, antimalarials are believed to exert their effect by their anti-inflammatory properties. Antimalarials reduce neutrophilic chemotaxis. In addition, they increase pH in lysosomes, which may affect antigen presentation. This class of medications usually is effective only in cutaneous disease.
Antihistamines, primarily those that block H1 receptors with low sedating activity, such as fexofenadine, loratadine, desloratadine, cetirizine, and levocetirizine are first-line therapy [6, 7] ; these are preferred over diphenhydramine and hydroxyzine; H2 antihistamines, such as cimetidine, famotidine, and ranitidine, may have a role when used in combination with H1 antihistamines, although the benefit is unclear [8]
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.
Exercise daily. Even if you only have time to take a walk, exercise helps reduce stress hormones that may cause you to feel keyed up. And remember, produces epinephrine, which acts as a natural decongestant, helping you breathe better.
A wide variety of different infections, including hepatitis [26], infectious mononucleosis [27], Helicobacter pylori infection [28], dental infections, sinusitis and urinary tract infections, have all been implicated as causing urticaria. However, in adults seen in the clinic, the overall incidence of infection-related urticaria is low. In contrast, children commonly develop urticaria as a result of viral respiratory infections. This urticaria may be severe and may be associated with episodes of angioedema, but it usually resolves over a few weeks. Worldwide, parasitic infections are a common cause of urticaria and there is nearly always an associated eosinophilia.
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.
If you’re wondering how to get rid of your hives at home, then we can help. We’ve created a special Top 10 Best Ways To Get Rid Of Your Hives list that is going to be exactly what you need to determine what is causing your hives and how to stop them quickly and at home with natural remedies.
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.
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.
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.
In a November 2008 interview with leading Swedish newspaper Dagens Nyheter, Swedish rapper Petter announced that the Hives were working on a new version of his track “Repa skivan” for his upcoming album.[24]
Antihistamines should be avoided where possible in pregnancy. There are no systematic studies of safety in pregnancy, and chlorphenamine is often the first choice if an antihistamine is required in this situation. Loratadine or cetirizine are preferred in women who are breast-feeding.
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.

“pruritic urticarial papules and plaques of pregnancy -common causes of hives”

According to the American Osteopathic College of Dermatology, about half the cases of chronic idiopathic hives are due to immune systems that attack the body’s own tissues (also known as autoimmunity). Thyroid disease is the most commonly reported autoimmune condition in people with chronic hives, followed by rheumatoid arthritis and type 1 diabetes. A study published in September 2013 in the European Journal of Dermatology found that celiac disease is also associated with chronic hives.
; hives intensely itchy skin wheals; arise as hypersensitivity reaction, or on exposure to trigger substances (e.g. in foods, plants, drugs or other agents), or due to uraemia; characteristic of anaphylaxis
Hives are a very itchy rash usually caused by an allergic reaction. Hives look like raised pink spots with pale centers on the skin. The spots range from 1/2 inch to several inches wide (hives often look like mosquito bites). The spots may be different shapes. The spots rapidly and repeatedly change in location, size, and shape. Giant hives are called angioedema. This can cause large swelling beneath the skin, especially of the face.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler’s educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Skin biopsy may be performed to confirm urticarial vasculitis. Microscopic findings of early lesions include a neutrophil leukocytoclastic vasculitis, in which there is damage to small vessels in the middle layers of the skin (dermis). In later lesions, a lymphocytic vasculitis may be seen.
The most common form of mastocytosis, maculopapular cutaneous mastocytosis is also called urticaria pigmentosa. Itchy brown patches or freckles on the skin are due to abnormal collections of mast cells.
Take quercetin. Quercetin can also be effective in reducing inflammation and swelling. It is a flavonoid produced in the body from rutin.[18][19] Eat more fruits and vegetables, such as apples, citrus fruits, onions, sage, parsley, dark cherries, grapes, blueberries, blackberries, and bilberries, to get more quercetin in your diet. You can also drink more tea and red wine or use more olive oil to increase your intake of it. You can take quercetin as a dietary supplement as well.[20]
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.
SOURCES: MedicineNet: “Stress.” American Academy of Allergy Asthma & Immunology (AAAAI): “‘Tis the Season for Allergic Reactions.” AAAAI: “Triggers of Allergic Disease.” CDC: “Workplace Stress.” Murray Grossan, MD, Los Angeles. Gailen D. Marshall, MD, PhD, professor of medicine and pediatrics, University of Mississippi; director, division of clinical immunology and allergy, University of Mississippi Medical Center. William E. Berger, MD, MBA, professor of medicine, University of California; author, Allergies and Asthma for Dummies. WebMD Live Event Transcript: “Signs of Sinusitis.” Marshall G.D. Am Osteopath Assoc, May 2004; vol 104(5 Suppl 5): pp S1-6. Breathe Right Now by Laurence A. Smolley, MD, and Debra Fulghum Bruce PhD. Jabaaij L, vanHattum J, Vingerhoets AJJM, Oostveen FG, et al. Journal of Psychosom. Res. 1996; 41: 129-137.
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].
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
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!
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.
Chronic hives can go on for months and years. They can interfere with sleep, work and other activities. The following precautions may help prevent or soothe the recurring skin reactions of chronic hives:
Pressure or constriction. Delayed pressure urticaria can appear as red swelling six to eight hours after pressure (belts or constrictive clothing, for example) has been applied. Symptoms can also occur in parts of the body under constant pressure, such as the soles of the feet.
Angioedema is a reaction similar to urticaria except there is no redness or itchiness and that it occurs in deeper tissue and is characterised by asymmetrical swelling of tissue. Angioedema is frequently associated with urticaria but the two may occur independently. Itoccurs in around 1 in 3 people with urticaria. Angioedema is not always itchy and can sometimes be painful.
Acute urticaria caused by SIgE against food protein antigens is often identified easily by the patient, particularly as there may be oral symptoms as the food is eaten and as repeated exposure to the foodstuff may lead to progressively more severe reactions, with angioedema and systemic symptoms [2,3]. However, it may be more difficult to identify the causative antigen if this is a contaminant in the food, such as a mould [4] or storage mite [5], or if there is an unexpected ingredient in the foodstuff and a detailed list of ingredients is lacking.
Urticaria may be confused with a variety of other dermatologic diseases that are similar in appearance and are pruritic including atopic dermatitis (eczema), maculopapular drug eruptions, contact dermatitis, insect bites, erythema multiforme, pityriasis rosea, urticarial vasculitis, and others. Usually, however, the experienced clinician is able to distinguish urticaria from its mimickers owing to its distinctive appearance (see the images below), intensely pruritic nature, and complete blanching with pressure. [1]
Each weal usually lasts less than 24 hours. However, as some fade away, others may appear. It can then seem as if the rash is moving around the body. The rash may appear quite dramatic if many areas of skin are suddenly affected.
Cases of urticaria and angioedema can be acute, lasting less than 6 weeks, or chronic, lasting more than 6 weeks. The length of symptoms can often be a clue as to the cause of the symptoms. For example, the most common cause of acute urticaria and angioedema in children is viral infections.
Welts (raised areas surrounded by a red base) from hives can appear anywhere on the surface of the skin. Whether the trigger is allergic or not, a complex release of inflammatory mediators, including histamine from cutaneous mast cells, results in fluid leakage from superficial blood vessels. Welts may be pinpoint in size, or several inches in diameter.
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The rash appears rapidly, usually within a few minutes of sweating, and can last from 30 minutes to an hour or more before fading away. The mean duration is around 80 minutes. Typical signs and symptoms of the rash include:
Information regarding history of previous urticaria and duration of rash and itching is useful for categorizing urticaria as acute, recurrent, or chronic. For chronic or recurrent urticaria, considerations include previous causative factors and the effectiveness of various treatments, as follows [2] :
Physically induced hives and/or swelling share the common property of being induced by environmental factors such as a change in temperature or by direct stimulation of the skin by pressure, stroking, vibration, or light.
Hives usually cause itching, but may also burn or sting. They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to one day before fading. Read more about hives (urticaria and angioedema).

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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.
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.
When a patient has hives, a dermatologist can often make the diagnosis by looking at the skin. Finding the cause of hives, however, can be a challenge. This is especially true for hives that have been around for more than 6 weeks.
Text: “Skin Conditions: Hives (Urticaria and Angioedema)”,- WebMD Medical Reference provided in collaboration with the Cleveland Clinic,”Understanding Hives- Treatment”, – WebMD Medical Reference, “Allergic Reaction”- WebMD Medical Reference from eMedicineHealth
Urticaria is a common skin disease characterised by itching weals or hives that can appear anywhere on the surface of the skin. may be pinpoint in size or several inches in diameter. Most sufferers experience hives continuously or intermittently for less than six weeks, but they may last longer (when they are then called ‘chronic’). Urticaria can also be accompanied by angioedema (swelling of a deeper layer of the skin). There are several varieties of urticaria, but the most common forms are acute urticaria and chronic urticaria. Common causes of acute urticaria are infections and adverse reactions to medications and foods, whereas in chronic urticaria the cause is often unknown. Intense itching is common, and it can lead to disturbed sleep and even depression, having a serious impact on a person’s quality of life. As the face and other exposed body parts can be affected, hives and angioedema can prove embarrassing for the individual.
Urticaria, also known as hives, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly — either as a result of the body’s reaction to certain allergens, or for unknown reasons.
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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.
Chronic hives can be a telltale sign of a larger problem, and extensive blood work may be necessary to pinpoint the underlying issue. Dr. Jaliman says patients with lupus, lymphoma, thyroid disease, hepatitis, or HIV may have hives as a symptom of their illness. Since these people tend to suffer from chronic hives, medications are the most reliable form of relief.
If sunlight triggers your hives, you’ll probably know within just a few minutes of exposure to one of these three types of light: long-wavelength ultraviolet (UVA), short-wavelength ultraviolet (UVB), and sunlight that doesn’t contain ultraviolet rays, such as sunlight through a window covered with a protective film that blocks UVA and UVB light. Hives triggered by sunlight usually disappear within a day, but in the majority of cases, they recur. Fortunately, sunlight is a rare trigger, and it’s easier to test for than other potential triggers.
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.
Gregory J Raugi, MD, PhD, Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle School of Medicine; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle
All songwriting except covers on the band’s albums are credited to “Randy Fitzsimmons”. The band claim Fitzsimmons is an honorary “sixth Hive,” who along with writing their music, discovered and manages the band. Randy Fitzsimmons is a registered pseudonym for Niklas Almqvist [25].
2018 Healthline Media UK Ltd. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.
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61. Shahar E, Bergman R, Guttman-Yassky E, Pollack S. Treatment of severe chronic idiopathic urticaria with oral mycophenolate mofetil in patients not responding to antihistamines and/or corticosteroids. Int J Dermatol. 2006;45:1224–7. [PubMed]
Hormonal causes via endocrine tumors or ovarian pathology are rare. Oral contraceptive use or changes in the menstrual cycle have been reported as a possible cause of urticaria: patients commonly report worsening of hives with the menstrual cycle. This may be hormonally mediated, and the cyclical use of analgesics should also be considered as a possible etiology.
If the bumps are hard or filled with something other than fluid, they may be a sign of an underlying medical condition. Hives that occur along with peeling of the skin or blisters can be a sign of a serious allergic reaction. If you develop a rash or hives after taking a medication, you should consult your doctor immediately.

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Maurer M, Rosén K, Hsieh HJ, Saini S, Grattan C, Gimenéz-Arnau A, Agarwal S, Doyle R, Canvin J, Kaplan A, Casale T. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. 2013 Mar 7;368(10):924-35. doi: 10.1056/NEJMoa1215372.
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.
If the bumps are hard or filled with something other than fluid, they may be a sign of an underlying medical condition. Hives that occur along with peeling of the skin or blisters can be a sign of a serious allergic reaction. If you develop a rash or hives after taking a medication, you should consult your doctor immediately.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Examination of bedding and the children’s play areas for insects may provide a clue to the cause. If insects are found, they must be eliminated by insect repellant or fumigation, and pets should be washed. These bugs are usually not visible to the naked eye. Hanging the bedding in the hot sun may rid these of the bedbugs.
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.
Other measures may be appropriate, such as continuous ECG, blood pressure and pulse oximetry monitoring; administering intravenous crystalloids if the patient is hypotensive; and administering oxygen.
In his book Urticaria No More, Yassin Madwin stresses that hives cannot be caused by stress, confirming this theory. He shows how hives occur when there is a spike in certain hormones; these hormones need serotonin to work properly (serotonin, AKA the happiness hormone). The more you’re stressed, the more your cortisol rises and your serotonin drops. When this happens, a set of pro-inflammatory agents (basophils) are released into the blood stream, which requires histamine intervention.
Interactions between the central nervous system and the immune system are complex and bidirectional, and there is evidence supporting an intimate structural and functional relationship between peripheral nerves and mast cells, as well as for the local secretion of mast cell influencing neuropeptides by nerves, Dr. Howard says. In the subset of patients who are termed stress responders, increased histamine release mediated by neuropeptides can be seen.
Urticarial vasculitis is a form of vasculitis that affects the skin, causing wheals or hives and/or red patches due to swelling of the small blood vessels. It has two forms: One with normal levels of proteins called complements; the other with low levels of complements; it’s called hypocomplementemic vasculitis.
1. Mint juice in small quantity of water without any additives to be taken twice a day. In winter, mint leaves can be boiled, water thereafter can be drunk. 2. 5 Gms of Soda Bicarbonate (cooking soda) dissolved in ordinary water at room temperature, can be applied to affected areas.
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.
If you’re wondering how to get rid of your hives at home, then we can help. We’ve created a special Top 10 Best Ways To Get Rid Of Your Hives list that is going to be exactly what you need to determine what is causing your hives and how to stop them quickly and at home with natural remedies.
The natural history of urticarial vasculitis depends in part upon the blood complement levels. In cases where these are normal, the prognosis is generally good. In cases where the complements are low, the disease may be more severe. When urticarial vasculitis is related to a disease such as lupus or cancer, its prognosis is often governed by the prognosis of the underlying disease
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.
In other words, when a person is stressed, any inflammatory reactions are likely to be more severe in a person who is susceptible to a reaction. In this way, hives, or urticaria, can be linked to stress.
Both Flonase and Nasacort are available without a prescription. These medications contain different steroids but both are meant to treat sinus congestion due to allergies.  Neither should be used in children without talking to your doctor first.  You can substitute Flonase for Nasocort, but you should use it regularly but shouldn’t use more than 1 spray in each nostril twice a day.  If you have diabetes, glaucoma, cataracts or liver disease, ask your doctor before using.
i am Harry Wayn i have been with my girlfriend since June 2011 ..I just found out this past month that she is HIV positive I knew he was on med of all kinds wasn’t exactly positive for what though…I finally sat Her down and talked to her and asked her to please tell me what the pills were for…she finally admitted in 95 she was told she was HIV positive …she was afraid to tell me…she has been in the hospital twice near death …that part I knew just didn’t know the why…I love her with all my heart and can’t leave her..but I am scared we have never practiced safe sex the whole time we have been together…I have been tested twice and am HIV free so far …He appears to me to be in denial of her disease..she takes her med because i give them to her each day…I cant leave her i need her he needs me…we never talk about his disease..how can i make things more in the open with him? He has told me if i discuss this with anyone I will have to leave no if and or buts about it…so I haven’t talked with anyone till now about it…also I know I am going to hear leave her immediately and I cant and won’t do that.. but i.just had a good friendly ear who told me how doctor Okhihie help her cure her HIV virus she gave me the email address okhihiespelltemple@gmail.com i really contacted him he told me to get some items which he will use to prepare the herbal medicine, though i could not found those items over here he said i should send him the little money so that he can help me buy the item and proceed with the herbal medicine i was very happy i gladly send him the little money he prepare the herbal medicine and send it to me i gave it to my love she drank it for just three weeks every thing about her was fully okay then we both went to hospital for check up my love was found negative. so i want to use this great privilege to thank doctor Okhihie for my love because me and my love are living happily today.i will advice any body that is passing through such problem to contact him on his email okhihiespelltemple@gmail.com
Small daily stressors like being late for work typically don’t cause you to break out. Otherwise you’d see a bunch of rash ridden people running around. People generally get stress hives from events like:
Where possible, identify and treat the cause. Nonspecific aggravating factors should be minimised, such as overheating, stress, alcohol, caffeine and medication likely to cause urticaria (eg, non-steroidal anti-inflammatory drugs (NSAIDs) and angiotensin-converting enzyme (ACE) inhibitors). Topical anti-pruritic agents such as calamine lotion or topical menthol 1% in aqueous cream may help ease symptoms.
There are two forms of heat urticaria. The more common form is also called cholinergic urticaria or generalized heat urticaria. In this form, it occurs when the body temperature is raised such as in a hot bath or shower, from a fever or exercise. The outbreak begins with a few small hives and gradually become more widespread. If the reaction is very severe, the wheals will run together, leading to a drop in blood pressure and loss of consciousness. Cholinergic urticaria is helped by antihistamines given regularly in severe cases or intermittently upon exposure to milder cases.
A number of drugs, as aspirin, NSAIDs, opiates, succinylcholine, and certain antibiotics (eg, polymyxin, ciprofloxacin, rifampin, vancomycin, some beta-lactams) can cause urticaria by a nonallergic mechanism rather than by IgE-mediated hypersensitivity.
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According to the American Osteopathic College of Dermatology, about half the cases of chronic idiopathic hives are due to immune systems that attack the body’s own tissues (also known as autoimmunity). Thyroid disease is the most commonly reported autoimmune condition in people with chronic hives, followed by rheumatoid arthritis and type 1 diabetes. A study published in September 2013 in the European Journal of Dermatology found that celiac disease is also associated with chronic hives.
Skin biopsy in patients in whom vasculitis is suspected: the lesions last for more than 24 hours, are painful and usually heal by leaving hyperpigmentation on the area of the lesions in urticarial vasculitis (24).
Initially it is helpful to explain to patients what urticaria is and that very often it is not due to ‘an allergy’. They may be reassured that in nearly all cases there is no serious underlying medical problem causing the rash; that safe, effective treatments are available and that the long-term prognosis is usually good. A patient information leaflet, such as that available from the British Association of Dermatologists [48], is helpful.
Urticaria develops when histamine is released into the small blood vessels (capillaries). The capillaries dilate which causes a welt, and fluid oozes into the surrounding tissue, causing swelling. Histamine also causes intense itching. adam.about.net
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.
Hives, also known as urticaria, affects about 20 percent of people at some time during their lives. It can be triggered by many substances or situations and usually starts as an itchy patch of skin that turns into swollen red welts. The itching may be mild to severe. Scratching, alcoholic beverages, exercise and emotional stress may worsen the itching.
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.
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:
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.

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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.
Medications: Topical ointments can be applied to the skin to relieve the itch. Antihistamines will reduce the itching and swelling. Cortisone drugs used as an ointment or given by mouth may be needed.
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.
An objective trial of a low salicylate diet may be indicated in patients who give a clear history of having developed more severe urticaria, or even angioedema or bronchospasm, after taking aspirin or NSAIDs and, particularly, if the patient also responds to LTRA treatment [57]. It is important to explain to the patient that the diet should not become more troublesome than the urticarial symptoms themselves and it may be simpler for patients to take a regular dose of an anti-histamine, rather than continue on a strict exclusion diet.
Many patients with chronic urticaria derive benefit from a Low Vaso-active Amine Diet.  Histamine contained in foods such as dark fish, fermented cheese and cured meats may act non-specifically as a pseudo-allergen by perpetuating the urticaria.  Avoidance of these foods will help reduce itch and flushing (Berlin Diet).
Cholinergic urticaria (CU) is one of the physical urticaria which is provoked during sweating events such as exercise, bathing, staying in a heated environment, or emotional stress. The hives produced are typically smaller than classic hives and are generally shorter-lasting.[13][14]
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 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].
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Both Flonase and Nasacort are available without a prescription. These medications contain different steroids but both are meant to treat sinus congestion due to allergies.  Neither should be used in children without talking to your doctor first.  You can substitute Flonase for Nasocort, but you should use it regularly but shouldn’t use more than 1 spray in each nostril twice a day.  If you have diabetes, glaucoma, cataracts or liver disease, ask your doctor before using.
Taking care of yourself means giving yourself the tools you need to better manage stress in your life. Take steps to make sure you are eating a healthy diet and getting enough sleep. When you eat unhealthy foods or go through your day on just a few hours of sleep, your ability to deal with stress decreases.
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.
Urticaria is a common skin disease characterised by itching weals or hives that can appear anywhere on the surface of the skin. Weals may be pinpoint in size or several inches in diameter. Most sufferers experience hives continuously or intermittently for less than six weeks, but they may last longer (when they are then called ‘chronic’). Urticaria can also be accompanied by angioedema (swelling of a deeper layer of the skin). There are several varieties of urticaria, but the most common forms are acute urticaria and chronic urticaria. Common causes of acute urticaria are infections and adverse reactions to medications and foods, whereas in chronic urticaria the cause is often unknown. Intense itching is common, and it can lead to disturbed sleep and even depression, having a serious impact on a person’s quality of life. As the face and other exposed body parts can be affected, hives and angioedema can prove embarrassing for the individual.
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.
Like other medications used to treat urticarial vasculitis, antimalarials are believed to exert their effect by their anti-inflammatory properties. Antimalarials reduce neutrophilic chemotaxis. In addition, they increase pH in lysosomes, which may affect antigen presentation. This class of medications usually is effective only in cutaneous disease.
Hives Dermatology A condition characterized by pruritic raised red welts on the skin, associated with allergic reactions and histamine release or defects in the complement or kinin systems Risk factors Prior allergic reactions–eg, hay fever and angioedema Triggers Medications; foods–eg, berries, shellfish, fish, nuts, eggs, milk; pollen; animal dander–especially cats; insect bites; mechanical stimulants–eg, water, sunlight, cold or heat; emotional stress; post-infection; linked to other disease–eg, autoimmune diseases SLE, leukemia, etc; may be partially hereditary, dermographism, cold urticaria, echinococcus infection–dog tapeworm, hereditary angioedema, Henoch-Scho¨nlein purpura, mononucleosis, hepatitis, mastocytosis
Change in temperature. Cold urticaria is caused by exposure to low temperatures followed by re-warming. This can be severe and life-threatening if there is a general body cooling – for example, after a plunge into a swimming pool.
Examination of bedding and the children’s play areas for insects may provide a clue to the cause. If insects are found, they must be eliminated by insect repellant or fumigation, and pets should be washed. These bugs are usually not visible to the naked eye. Hanging the bedding in the hot sun may rid these of the bedbugs.

“cholinergic urticaria treatment _treatment of chronic urticaria”

Most chronic urticaria is idiopathic. The next most common cause is an autoimmune disorder. The causative autoimmune disease is sometimes clinically apparent. Urticarial vasculitis sometimes is associated with connective tissue disorders (particularly SLE or Sjögren syndrome). In urticarial vasculitis, urticaria is accompanied by findings of cutaneous vasculitis; it should be considered when the urticaria is painful rather than pruritic, lasts > 48 h, does not blanch, or is accompanied by vesicles or purpura.
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.
While many of us might be familiar with hives and allergic reactions in generally, many more of us are unfamiliar with exactly what causes them. Hives and angioedema form when histamine, or blood plasma, begins to leak out of the small blood vessels in the skin. Allergic reactions to certain foods, insect bights, medication or even sunlight exposure can all cause a release of histamine, but nonetheless, the root cause for many hive formations is still unknown.
Like other medications used to treat urticarial vasculitis, antimalarials are believed to exert their effect by their anti-inflammatory properties. Antimalarials reduce neutrophilic chemotaxis. In addition, they increase pH in lysosomes, which may affect antigen presentation. This class of medications usually is effective only in cutaneous disease.
Steven A Conrad, MD, PhD Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center
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.
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.
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.
Jump up ^ Kontou-Fili, K.; Borici-Mazi, R.; Kapp, A.; Matjevic, L. J.; Mitchel, F. B. (1997). “Physical urticaria: Classification and diagnostic guidelines”. Allergy. 52 (5): 504–13. doi:10.1111/j.1398-9995.1997.tb02593.x. PMID 9201361.
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.
Exercise-induced anaphylaxis was first described in a series of patients in whom combinations of pruritus, urticaria, angioedema, wheezing, and hypotension occurred as a result of exercise. The hives seen with exercise-induced anaphylaxis are large (10-15 mm), in contrast to the small punctate lesions characteristic of cholinergic urticaria. Subtypes of exercise-induced anaphylaxis have been described that are food-related. In one of these hives is seen only if exercise takes place within 5 hours after eating a food to which the patient is allergic. In a second subtype, hives occurs if exercise is within 5 hours of having eaten but the identity of the food is irrelevant.
After extensive touring, the band retreated Fagersta to record their third album. The result was 2004’s Tyrannosaurus Hives, their first new material in four years. The album includes the hit singles “Walk Idiot Walk,” which debuted at No. 13 on the UK singles charts, “Two-Timing Touch and Broken Bones,” another top 50 hit, and “A Little More for Little You.” The tracks “B is for Brutus” and “No Pun Intended” were also featured in the games Gran Turismo 4 and SSX on Tour, respectively. In 2006, their song “Diabolic Scheme” was used in the vampire film Frostbiten, marking the first time a Hives song was used in a major motion picture. (“Hate to say I told you so” featured in the 2002 ‘Spider-man’ movie starring Tobey Maguire)
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 natural history of urticarial vasculitis depends in part upon the blood complement levels. In cases where these are normal, the prognosis is generally good. In cases where the complements are low, the disease may be more severe. When urticarial vasculitis is related to a disease such as lupus or cancer, its prognosis is often governed by the prognosis of the underlying disease
If you want to remove stress hives from your life forever, then all you need to do is remove all the stress and anxiety form your life. If only it were that easy, right? As I discovered from my dermatologist, the only treatment that will make your stress bumps go away for good is OxyHives. It takes 1-2 hours, but it works for me each and every time. With 2 small kids, I may not be able to remove all the stress form my life, but at least I can remove the rash and hives that appear when I get stressed out. Learn more about OxyHives and how to get rid of your hives fast at http://www.hives.org/how-to-get-rid-o…
This very rare form of angioedema develops in response to contact with vibration. In vibratory angioedema, symptoms develop within two to five minutes after contact with a vibrating object, and abate after about an hour. Patients with this disorder do not suffer from dermographism or pressure urticaria. Vibratory angioedema is diagnosed by holding a vibrating device such as a laboratory vortex machine against the forearm for four minutes. Speedy swelling of the whole forearm extending into the upper arm is also noted later. The principal treatment is avoidance of vibratory stimulants. Antihistamines have also been proven helpful.[citation needed]
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).
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.
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The skin reaction usually becomes evident soon after the scratching, and disappears within 30 minutes. Dermatographism is the most common form of a subset of chronic hives, acknowledged as “physical hives”.[citation needed]
Cholinergic urticaria (CU) is one of the physical urticaria which is provoked during sweating events such as exercise, bathing, staying in a heated environment, or emotional stress. The hives produced are typically smaller than classic hives and are generally shorter-lasting.[13][14]
Sandalwood essential oil is effective in calming the skin and reducing itching. It cools the skin down and decreases the pain as well. Apply sandalwood oil to the rash every three to four hours for speedy results.

“autoimmune hives +dermatographic urticaria”

If you have chronic hives, it’s important to try to identify your triggers, if possible, and take steps to avoid them so you can lower the risk of an exacerbation. While you may already be aware of common triggers, such as allergies to pollen, pet dander, and shellfish, here are some lesser-known triggers of chronic hives:
Urticaria predominantly affects adult females and up to 20% of the population sometime in their life.  It presents as a diffusely raised itchy wheal and flare reaction which migrates over the skin surface. All forms of Urticaria may occur in association with deeper skin swelling or angioedema and equally, angioedema may occur in isolation with no apparent urticaria (when Hereditary Angioedema (HAE) due to a deficiency of the C1 Esterase inhibitor enzyme should be suspected).
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.
Angioedema is a related condition (also from allergic and nonallergic causes), though fluid leakage is from much deeper blood vessels in the subcutaneous or submucosal layers. Individual hives that are painful, last more than 24 hours, or leave a bruise as they heal are more likely to be a more serious condition called urticarial vasculitis. Hives caused by stroking the skin (often linear in appearance) are due to a benign condition called dermatographic urticaria.
Each weal usually lasts less than 24 hours. However, as some fade away, others may appear. It can then seem as if the rash is moving around the body. The rash may appear quite dramatic many areas of skin are suddenly affected.
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]
An allergy skin test helps identify triggers for one’s allergic reactions. Small amounts of allergy-provoking substances (allergens) are scratched into the skin. Redness and swelling develop if one is allergic to the substance. A positive allergy skin test implies that the person has an IgE antibody response to that substance. The test is rapid, simple, and relatively safe.
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.
Usually no tests are needed. The rash is very typical and is easily recognised as hives by doctors. In many cases you will know what caused the rash from the events leading up to it. (For example if you have just been put on a new medicine, or if your skin came into contact with a nettle, or if you were stung by a bee.) In some cases it may be helpful to have some allergy tests such as skin prick tests to help determine the specific cause. Sometimes blood tests for allergies can be helpful. Occasionally, if urticarial vasculitis is suspected, a sample of the skin may be taken (a skin biopsy) for further analysis.
Wong JT, Nagy CS, Krinzman SJ, Maclean JA, Bloch KJ. Rapid oral challenge-desensitization for patients with aspirin-related urticaria-angioedema. J Allergy Clin Immunol. 2000 May. 105(5):997-1001. [Medline].
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. 
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.
Jump up ^ Uguz, Faruk; Engin, Burhan; Yilmaz, Ertan (2008). “Axis I and Axis II diagnoses in patients with chronic idiopathic urticaria”. Journal of Psychosomatic Research. 64 (2): 225–9. doi:10.1016/j.jpsychores.2007.08.006. PMID 18222137.
Solar urticaria is a rare disorder in which urticaria develops on areas of the body which are exposed to sunlight. Itching and urticaria may develop within a few minutes and may progress to angioedema. The symptoms usually resolve in a few hours. (Polymorphic light eruption may also cause an itchy rash on sun-exposed skin, but this rash is papular or eczematous; usually starts 6–8 h after sun exposure and lasts for several days.) Very rarely, patients may develop ‘aquagenic’ urticaria where their skin has been in contact with water (irrespective of its temperature) or urticaria in response to vibration.
Hives can be caused by an allergic reaction to foods, drugs, insect bites, infections or substances which can cause other allergic reactions. However not all cases are caused by allergy; frequently they are caused by viruses. It can sometimes be extremely difficult to find the cause. Triggers include medications, food, viruses, latex, heat, cold and direct exposure to sun. If the cause is known, the trigger should be avoided.
Urticaria is characterised by weals (hives) or angioedema (swellings, in 10%) or both (in 40%). There are several types of urticaria. The name urticaria is derived from the common European stinging nettle ‘Urtica dioica’.
Angioedema is a reaction similar to urticaria except there is no redness or itchiness and that it occurs in deeper tissue and is characterised by asymmetrical swelling of tissue. Angioedema is frequently associated with urticaria but the two may occur independently. Itoccurs in around 1 in 3 people with urticaria. Angioedema is not always itchy and can sometimes be painful.
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]
In 50% of patients with acute urticaria, a specific etiology can be identified. Brief episodes of urticaria can be associated with identifiable causes, and the method of exposure (ie, direct contact, oral or intravenous routes) is usually known. Urticaria is often associated with a recent infection.

“allergy welts +allergic reaction welts”

Jump up ^ Kolkhir, P.; Balakirski, G.; Merk, HF.; Olisova, O.; Maurer, M. (December 2015). “Chronic spontaneous urticaria and internal parasites – a systematic review”. Allergy. doi:10.1111/all.12818. PMID 26648083.
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.
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.
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.
[Guideline] American Academy of Allergy, Asthma & Immunology. Consultation and referral guidelines citing the evidence: how the allergist-immunologist can help. J Allergy Clin Immunol. 2006 Feb. 117(2 Suppl Consultation):S495-523. [Medline].
Your doctor will need to ask many questions in an attempt to find the possible cause of hives or angiodema. Since there are no specific tests for hives — or the associated swelling of angioedema — testing will depend on your medical history and a thorough exam by your primary care doctor or dermatologist.
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]
William E. Berger, HIVES: The Road to Diagnosis and Treatment of Urticaria, Annals of Allergy, Asthma & Immunology, Volume 92, Issue 5, May 2004, Page 582, ISSN 1081-1206, 10.1016/S1081-1206(10)61771-1.
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.
A much rarer type of urticaria, known as urticaria vasculitis, can cause blood vessels inside the skin to become inflamed. In these cases, the weals last longer than 24 hours, are more painful, and can leave a bruise.
San Francisco — Although the expression “I was so stressed I broke out in hives” is quite common, it can be a challenge for dermatologists to identify the psychosocial precipitants of chronic urticaria, according to Josie Howard, M.D., a psychiatrist in private practice, and clinical instructor departments of psychiatry and dermatology, University of California, San Francisco. But that is beginning to change, she says.
[Guideline] Magerl M, Borzova E, Giménez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of and cholinergic urticarias–EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy. 2009 Dec. 64(12):1715-21. [Medline].
Swellings, known as wheals, appear as a rash on the skin. They are usually pink or red, with an oval or round shape. They can range from a few millimeters to several inches across. They can be extremely itchy, and they have a red flare around them.
The presence of systemic symptoms could mean the urticarial rash is not ordinary urticaria,” he said, suggesting that vasculitis, Schitzler’s syndrome, adult-onset Still’s disease, an autoinflammatory syndrome, or urticarial dermatitis could be at play.
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