Urticaria

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Urticaria


hives, nettle rash

  • acute development of itchy weals / swellings in skin due to leaky dermal vessels

Pathology

  • degranulation of cutaneous mast cells
  • release of histamine and inflammatory mediators
  • occasionally secondary to
    • viral / parasitic infection
    • drug reaction - aspirin, penicillin
    • food allergy
      • strawberries
      • food colourings
      • seafood
    • systemic lupus erythematosus
    • physical stimuli
      • heat / stress
      • cold
      • deep pressure
      • sunlight
      • water
      • chemicals

Presentation

  • usually child / young adults

Clinical Features

  • cutaneous swellings / weals developing over few minutes
  • anywhere
  • last minutes to hours
  • intensely itchy, no surface change or scaling
  • normally erythematous, may be flesh coloured or pale
  • may produce angioedema
  • dermographism

Investigations

  • none needed

Treatment

  • avoid
    • aspirin
    • opiates
  • oral antihistamines
    • cetirizine 10mg od

Angioedema

  • IV hydrocortisone
  • subcutaneous adrenaline

Prognosis

  • few weeks to months → spontaneous resolution

Variants

 

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