The term “hives” (nettle fever) unites a group of diseases with similar clinical presentation: itchy skin rash type blisters-like trace from being stung by nettles. Localization of the rash can be limited to any one part of the body, or totally spread over the entire surface. If the rash disappears completely over a period of time not exceeding 6 weeks, then we talk about acute urticaria.
In more rare cases, urticaria persists for years not wanting to leave chosen areas. In such cases, this conduct of chronic urticaria.
The content of the article
Symptoms and types of urticaria
The symptoms of urticaria (photo)the Main clinical manifestations of hives — rash boldyrevsky, some of which can have size from a couple millimeters to a dozen centimeters in diameter. Skin rashes fade over time and disappear, but in their place, and often in completely previously untouched parts of the body there are new blisters that causes is quite noticeable itching and a burning desire to scratch.
In most cases, urticaria is a temporary phenomenon: suddenly springing, she increases the intensity of its presence in 8-12 hours, and then after 24-48 hours, gradually fading away.
Another thing — chronic urticaria, the manifestations of which sometimes are unpredictable. As a rule, the clinical picture of this form of hives can be represented in the form of a sine wave and is characterized by 6-12-week bouts of exacerbation followed by periods of remission. The exacerbation may be associated with exposure to certain triggers, which will be discussed below. Approximately 10% of patients with chronic urticaria remain in power unpleasant symptoms during the entire time that the disease lasts. Clinical signs of chronic hives tend to be worse in the evening, that can cause some trouble falling asleep.
Infrequently, but nevertheless, it happens that urticaria affects the shallow blood vessels in the skin and causes inflammation. In this case we talk about urticarial vasculitis (aninite): it lasts more than 24 hours, and the main markers of the disease — blisters — quite painful to the touch and can leave behind small scars. Urticarial vasculitis requires treatment not only to an allergist, but a dermatologist.
Causes of urticaria
Urticaria is called massive local (subcutaneous) release of histamine and other mediators of inflammation, cutaneous catalyzing corresponding reactions.
Causes of acute urticaria
Factors that trigger chain reactions, causing acute urticaria, about half of the cases remain outstanding. In General, these may be:
- food allergies, such as peanuts, shrimp, eggs or cheese;
- allergies to environmental factors (pollen, dust mites or chemicals);
- allergic to latex, characteristic of health workers;
- infection: from the banal SARS to HIV;
- insect bites;
- emotional stress;
- side effects from taking certain medicines, including antibiotics, NSAIDs, and antihistamines;
- physical factors such as mechanical or thermal effect on the skin, sunlight or water.
Causes of chronic urticaria
Chronic urticaria many experts associated with autoimmune disorders in which the immune system begins to attack its own tissues, leading to release of large quantities of histamine, thereby triggering skin reactions.
However, the true causes of chronic urticaria is not yet established. It is known that it can develop in combination with other autoimmune disorders such as rheumatoid arthritis and erythematosus (“lupus”).
Chronic urticaria, as, indeed, and severe, often starts under the influence of any trigger factors, among which the same stress, alcohol, caffeine, heat, compression of the skin (e.g. tight clothing), some food additives (salicylates, etc.).
Acute urticaria Treatment Krapivnitskaya
In most cases, hives do not require any special treatment, because her symptoms are relatively mild and go away within a few days.
Urticaria in a child (photo)If the situation is not so optimistic and signs of acute urticaria are more serious and don’t want to go, it’s time to call for help of antihistamine drugs, blocking the effects of histamine, relieve itching and eliminate the rash. Here are just a few representatives of this group of drugs: cetirizine (allertec, zyrtec, cethrin), Fexofenadine (Telfast, Rapido, fexomat, dinoks), loratadine (sucking, lomilan, allegation, erius).
Modern antihistamines — this is not the relic diphenhydramine, causing drowsiness and lethargy, while in lightly-irresponsible “cocktail” of alcohol even ultra-modern antihistamines may cause dizziness up to loss. If in connection with the symptoms of urticaria in a patient includes problems with sleep, in this case, you can kill two birds with one stone by appointing an antihistamine that promote sleep: tavegil or atarax.
But not by antihistamines alone… In the case of heavy course of the disease symptoms can be controlled with short-term (3-5 days) receiving glucocorticoids, for example, this role can be the same time-tested prednisone. These drugs suppress the immune system, and, therefore, alleviate the symptoms of urticaria. Long-term use of glucocorticoids can cause the plume side effects like high blood pressure, glaucoma, cataracts and diabetes (or of worsening the past).
Treatment of chronic urticaria
As for the treatment of chronic urticaria, the situation is somewhat more complicated. You can use the same glucocorticoids or antihistamines, taking them regularly and progressively increasing the dosage under medical supervision until the moment when the symptoms will begin to fade. A new antihistamine, as the Spanish rupatadine (Ruppin), well established in the treatment of severe urticaria.
In the treatment of chronic urticaria and used a method known as narrowband phototherapy. It is based on the impact on the patient’s skin to high-intensity UV irradiation. This requires a few (2 to 5) times a week to visit a special office for that procedure. Just to improve the clinical picture may require about 20 such sessions.
Antagonists of leukotriene receptors (mantelar, singulair, Attalus, adalat) can help to relieve the redness and swelling of the skin. In the long run they can be a good alternative to glucocorticoids, as they do not cause such unpleasant side effects.
Powerful drug cyclosporine (panimun bioral, ekoral) has proven effective in the treatment of urticaria in 2/3 of the cases. Its principle of operation is similar to that of corticosteroids: cyclosporine eliminates the negative effects of the immune system. It should be noted that, as confirmed by the results of clinical trials, the longer it is used cyclosporine, the less its effectiveness. Therefore, you should not use this medicine for more than 5 months, after which its efficiency is only 25%.
And, of course, if you know the triggers that cause exacerbation of urticaria in a particular patient, it would be good to get out from under their destructive influence. Factors provocateurs, like alcohol and caffeine can be easily removed from life. With stress is more complicated, nevertheless, you must try to tear myself from his clutches, making another step towards getting rid of hives. In some cases, good trigger of relaxation techniques such as meditation or hypnosis, which can relieve stress and alleviate the symptoms of the disease.