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Urticaria

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Urticaria is the medical term for chronic hives. Generally, these hives will appear either red, white, or even purplish welts that are raised from the skin causing bumps. When scratched, some hives will bleed while others will ooze a clear or white material. Hives are not necessarily constant, although they may be, and often disappear as quickly as their onset.

URTICARIA SIGNS AND SYMPTOMS

It is not unusual for hives to appear become a nuisance for a few weeks, and then to disappear again for a few weeks. Some patients can actually predict when their hives will appear, as they come with nearly clock-like precision. Others can predict when their hives will appear based on the events of their life, such as right before and during their menstrual cycle, before any type of nerve racking event, and when they are becoming ill. Others have no idea when or why their hives appear, they only know that they will.

URTICARIA CAUSES

For most patients that suffer from urticaria, there is never an identified cause. There are obvious triggers in many cases, but an actual cause remains unfounded. Some patients experience hives as an indicator of other diseases. Thyroid diseases, lupus, and many other autoimmune problems are linked to the onset of hives. Treating the disease often assists with the hives, but it may not necessarily alleviate them.

Hives can also indicate an allergic reaction. A patient who is allergic to shell fish, for example, may only experience hives after eating shrimp or crab. In these cases, urticaria becomes very easy to treat.

Symptoms of hives vary nearly as much as the sufferer’s cause. Hives generally tend to appear red, or white, swollen, and are almost always in the form of distinctive round wheals. Some hives are large while others are quite small. Some hives appear in the form of large itchy reddened patches instead of perfect little circles. It is not uncommon for the hives to alter shape during their span. One hive will generally last between 4 to 36 hours. As the hive disappears, there is usually another one forming or already formed to take its place.
urticaria
Image: Urticaria


Just under half of the population that suffers from urticaria also suffers from angioedema. Angioedema is similar to hives and usually accompanies a break out. Swelling and tender redness swells along the face, near the eyes or lips, throughout the genitals, on the hands or the feet, and sometimes within the trachea. A breakout of angioedema can be life threatening if the swelling causes the airway to close. By definition, the cause of hives is contributed to the skin’s natural tendency to release histamine and other chemical combinations into the blood stream by specific skin cells known as the mast cells.

The skin reacts by swelling and reddening. The small blood vessels leading into the skin then leak minutely. This is the most that medical science understands of chronic hives. Why some people are prone to the actual hive when other simply absorbs the excretions is not understood. With the exception of being able to identify about 10% of the cases of urticaria (foods, medicines, and specific allergens) over 85% of the cases remain a mystery to the physician and the patient for life.

URTICARIA RISK FACTOR

There are several risk factors associated with urticaria, including family history of either hives, chronic hives, or angioedema, gender (women are more susceptible than men,) a history of allergic reactions that appear in other forms, have had hives once before, age (older adults are more likely to develop urticaria than younger adults or teens,) or the presence of diseases that facilitate hives including but not limited to lupus, thyroid conditions, and lymphoma.

URTICARIA DIAGNOSIS

Diagnosing urticaria often involves journaling daily activities and symptoms over the course of three to four weeks. This journaling should indicate foods eaten and drink consumed, herbal supplements, medication, exercise habits, and the presence of hives, the length of one single hive’s presence, and the surrounding events. When it has been determined that journaling can not indicate a common identifying factor, blood tests, allergy tests, and medical tests to rule out the presence of disease are then typically conducted.


Hives, whether chronic or a one time event, can cause the throat to swell and create a serious, life threatening condition. Patients who experience this phenomenon should seek immediate medical assistance. Alternatively, hives can indicate the presence of anaphylactic shock, which is an intense allergic reaction associated with severe symptoms, even death. Patients who experience any type of difficulty breathing associated with hives should report to the emergency room or call for an ambulance immediately.

URTICARIA TREATMENT

The most obvious method of treatment for those who can identify the cause of their hives is avoiding the triggers, if at all possible. Most patients will not have this luxury and are more likely to benefit from antihistamine medications, oral corticosteroids, low dose tricyclic antidepressants, epinephrine, and other medications currently under evaluation for their impact on urticaria.
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