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Urticaria
Classification and external resources

Urticaria on foot, with visible wheals
ICD-10 L50.
ICD-9 708
DiseasesDB 13606
MedlinePlus 000845
eMedicine topic list
MeSH D014581
.Urticaria (from the Latin urtica, nettle (whence It.^ [New Latin urticāria , from Latin urtica , nettle .
  • Urticaria Definition | Definition of Urticaria at Dictionary.com 17 January 2010 23:44 UTC dictionary.reference.com [Source type: Reference]

^ The name urticaria comes from the name of the stinging nettle plant ( Latin, urtica).
  • URTICARIA AND ANGIOEDEMA � Bob Lanier M 17 January 2010 23:44 UTC www.askdrbob.com [Source type: Academic]

^ ETYMOLOGY: New Latin urtic ria , from Latin urtica , nettle OTHER FORMS: ur ticar ial (Adjective) .
  • urticaria - Dictionary definition and pronunciation - Yahoo! Education 17 January 2010 23:44 UTC education.yahoo.com [Source type: Reference]

ortica, Sp. ortiga, Pg. urtiga) .urere, to burn)[1] (or hives) are a kind of skin rash notable for dark red, raised, itchy bumps.^ Red itchy rash .

^ Hives are small, itchy, red swellings on the skin.
  • UT Medical Group, Inc. - Health Library 17 January 2010 23:44 UTC healthlibrary.epnet.com [Source type: Academic]
  • Hives - Health Library - Willis Knighton Health Systems 3 February 2010 15:54 UTC healthlibrary.epnet.com [Source type: Academic]

^ Hives are characterized by red, itchy, and swelling on the skin that comes in clusters.
  • Suffering From Recurring Hives? Take Necessary Hives Treatment To Avoid It! | Skin Care Beauty Zone 3 February 2010 15:54 UTC www.skincarebeautyzone.com [Source type: General]

.Hives are frequently caused by allergic reactions; however, there are many non-allergic causes.^ Urticaria Cause There are many factors that can cause urticaria.
  • Urticaria cause and treatment : by Ray Sahelian, M.D. herbs, supplements, and urticaria 17 January 2010 23:44 UTC www.raysahelian.com [Source type: Academic]

^ It is histamine that causes hives related to an allergic reaction.

^ There are many reasons for the causes of hives.
  • Causes of Hives 3 February 2010 15:54 UTC www.smugbox.com [Source type: General]

.For example, most cases of hives lasting less than six weeks (acute urticaria) are the result of an allergic trigger.^ Hives lasting less than six weeks are caused by "acute urticaria".
  • Urticaria 17 January 2010 23:44 UTC nejat.net [Source type: FILTERED WITH BAYES]
  • Urticaria treatments for NYC Dermatology - Dr. Dmitry Khasak Board Certified Dermatologist 17 January 2010 23:44 UTC www.nycdermatology.com [Source type: General]

^ Fortunately, most cases of hives are not critical.
  • The Horse | Hives Symptoms and Treatment 3 February 2010 15:54 UTC www.thehorse.com [Source type: General]

^ And in a majority of cases, what triggers hives that last for less than 6 weeks (acute) is different than what causes hives that last longer (chronic).
  • Causes of Hives - What causes hives 3 February 2010 15:54 UTC allergies.about.com [Source type: General]

.Chronic urticaria (hives lasting longer than six weeks) are rarely due to an allergy.^ Hives lasting less than six weeks are caused by "acute urticaria".
  • Urticaria 17 January 2010 23:44 UTC nejat.net [Source type: FILTERED WITH BAYES]
  • Urticaria treatments for NYC Dermatology - Dr. Dmitry Khasak Board Certified Dermatologist 17 January 2010 23:44 UTC www.nycdermatology.com [Source type: General]

^ Although this cutoff is somewhat arbitrary, hives that last longer than 6 weeks are considered chronic.
  • Urticaria - a knol by Alan Rockoff, M.D. 17 January 2010 23:44 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ How long can chronic urticaria last for?
  • CEU Test - Hives 3 February 2010 15:54 UTC ncraonline.org [Source type: FILTERED WITH BAYES]

.The majority of patients with chronic hives have an unknown (idiopathic) cause.^ Chronic hives (often from an unknown cause) can last for weeks or months.

^ Diseases can be another major cause of hives.
  • Hives Treatment Information 3 February 2010 15:54 UTC fwdmagazine.com [Source type: FILTERED WITH BAYES]

^ The cause of hives is still exactly unknown.
  • Suffering From Recurring Hives? Take Necessary Hives Treatment To Avoid It! | Skin Care Beauty Zone 3 February 2010 15:54 UTC www.skincarebeautyzone.com [Source type: General]

.Perhaps as many as 30-40% of patients with chronic idiopathic urticaria will, in fact, have an autoimmune cause.^ Urticaria Cause There are many factors that can cause urticaria.
  • Urticaria cause and treatment : by Ray Sahelian, M.D. herbs, supplements, and urticaria 17 January 2010 23:44 UTC www.raysahelian.com [Source type: Academic]

^ Theophylline as 'add-on' therapy to cetirizine in patients with chronic idiopathic urticaria.
  • URTICARIA AND ANGIOEDEMA � Bob Lanier M 17 January 2010 23:44 UTC www.askdrbob.com [Source type: Academic]

^ Management of a patient with chronic idiopathic urticaria can be both frustrating and rewarding.
  • Management of difficult urticaria Yadav S, Bajaj AK - Indian J Dermatol 17 January 2010 23:44 UTC www.e-ijd.org [Source type: Academic]

.Acute viral infection is another common cause of acute urticaria (viral exanthem).^ B. Infections: particularly are viral disease thought to be among the most common causes for acute urticaria.
  • URTICARIA AND ANGIOEDEMA � Bob Lanier M 17 January 2010 23:44 UTC www.askdrbob.com [Source type: Academic]

^ The most common cause of acute hives, particularly in children, is a viral infection .
  • Causes of Hives - What causes hives 3 February 2010 15:54 UTC allergies.about.com [Source type: General]

^ Viral respiratory infections are particularly common causes of hives in children.
  • Allergy Associates | Specialists in Allergy, Sinus & Asthma 3 February 2010 15:54 UTC www.incaudomd.com [Source type: FILTERED WITH BAYES]

.Less common causes of hives include friction, pressure, temperature extremes, exercise, and sunlight.^ Stress, temperature extremes, pressure on the skin, and insect bites can also cause hives to appear.
  • Hives - Natural Treatment for Hives 3 February 2010 15:54 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

^ Colds are a common cause of hives in children.
  • Urticaria 17 January 2010 23:44 UTC www.nwgadermatology.com [Source type: FILTERED WITH BAYES]
  • Hives - Urticaria 17 January 2010 23:44 UTC www.metrohealth.org [Source type: FILTERED WITH BAYES]
  • MoonDragon's Health & Wellness: Hives 3 February 2010 15:54 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]
  • Hives and Skin Allergies - Miramar Dermatology 3 February 2010 15:54 UTC www.miramardermatology.com [Source type: FILTERED WITH BAYES]
  • Hives Treatment in Lapeer Bad Axe Caro Sandusky Pigeon 3 February 2010 15:54 UTC www.newlookskincare.com [Source type: FILTERED WITH BAYES]

^ How Common are these Causes of Hives?

.Wheals (raised areas surrounded by a red base) from urticaria can appear anywhere on the surface of the skin.^ Urticaria appears on the surface of the skin as swollen, red, itchy welts that vary in size.

^ Urticaria is characterized by redness, swelling, and itching of small areas of the skin.
  • Hives Information on Healthline 3 February 2010 15:54 UTC www.healthline.com [Source type: Academic]
  • Hives: Encyclopedia of Nursing & Allied Health 3 February 2010 15:54 UTC www.enotes.com [Source type: Academic]
  • Hives - KidsGrowth 3 February 2010 15:54 UTC www.kidsgrowth.com [Source type: FILTERED WITH BAYES]

^ The wheals can appear on any area of the body.

.Whether the trigger is allergic or non-allergic, there is a complex release of inflammatory mediators, including histamine from cutaneous mast cells, resulting in fluid leakage from superficial blood vessels.^ The result is the release of histamines and other allergy mediators that are responsible for causing an allergic reaction.

^ Histamine is released during an allergic reaction.
  • UT Medical Group, Inc. - Health Library 17 January 2010 23:44 UTC healthlibrary.epnet.com [Source type: Academic]
  • Hives - Health Library - Willis Knighton Health Systems 3 February 2010 15:54 UTC healthlibrary.epnet.com [Source type: Academic]

^ Histamine is released from cells called "mast cells" which lie along the blood vessels in the skin.
  • Urticaria 17 January 2010 23:44 UTC nejat.net [Source type: FILTERED WITH BAYES]
  • Urticaria 17 January 2010 23:44 UTC www.nyallergy.com [Source type: FILTERED WITH BAYES]
  • Urticaria treatments for NYC Dermatology - Dr. Dmitry Khasak Board Certified Dermatologist 17 January 2010 23:44 UTC www.nycdermatology.com [Source type: General]
  • Welcome To West LA Medical & Skincare - Dr. David P Melamed 17 January 2010 23:44 UTC www.westlamed.com [Source type: FILTERED WITH BAYES]

.Wheals may be pinpoint in size, or several inches in diameter.^ They range in size from a few millimeters to several inches in diameter.
  • Hives (Urticaria) & Angioedema Causes, Symptoms and Treatment on MedicineNet.com 3 February 2010 15:54 UTC www.medicinenet.com [Source type: FILTERED WITH BAYES]
  • Hives - Natural Treatment for Hives 3 February 2010 15:54 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

^ Hives usually are more or less round in shape and vary in size, up to several inches in diameter.
  • Hives (Urticaria) - Overview - Types - dermatologychannel 17 January 2010 23:44 UTC www.dermatologychannel.net [Source type: General]

^ These hives (also called welts, weals, or wheals) can range from pencil eraser size to several inches, and are usually flat-topped.

.Angioedema is a related condition (also from allergic and non-allergic causes), though fluid leakage is from much deeper blood vessels.^ This causes fluid to leak from the small blood vessels under the skin.
  • Help With Hives 3 February 2010 15:54 UTC kidshealth.org [Source type: General]
  • Help With Hives 3 February 2010 15:54 UTC kidshealth.org [Source type: General]

^ Some non-allergic causes of urticaria: .
  • The Allergy Site, detailed information and images on atopic dermatitis or eczema 17 January 2010 23:44 UTC www.theallergysite.co.uk [Source type: FILTERED WITH BAYES]

^ Urticaria is caused by leakage of the small blood vessels in the skin.

.Individual hives that are painful, last >24 hours, or leave a bruise as they heal are more likely to be a more serious condition called urticarial vasculitis.^ Hives can sting, be painful, and can leave bruises on your child’s skin.
  • Antihistamine, Zyrtec and Urticaria (hives). - ZYRTEC Medication - All about Zyrtec (Cetirizine), ZYRTEC-D 12 HOUR, ZYRTEC syrup, ZYRTEC 10 mg, ZYRTEC 5 mg, ZYRTEC on-line, where is to buy Zyrtec, buy Zyrtec on-line, buy Zyrtec 17 January 2010 23:44 UTC zyrtecmed.info [Source type: General]

^ The hives usually do not last more than an hour.
  • Urticaria Types - Acute and Chronic 17 January 2010 23:44 UTC www.healthy-skincare.com [Source type: FILTERED WITH BAYES]

^ Individual hives usually last for two to twenty four hours.

.Hives caused by stroking the skin (often linear in appearance) are due to a benign condition called dermatographism.^ Often the cause of the hives cannot be determined.
  • Women's Health Advisor 2009.1: Hives 3 February 2010 15:54 UTC www.med.umich.edu [Source type: General]

^ Hives are often caused when the body releases a chemical called histamine.
  • Northern Arizona Healthcare - Hives 3 February 2010 15:54 UTC www.nahealth.com [Source type: FILTERED WITH BAYES]

^ Hives caused by pressure on the skin.

Contents

Pathophysiology

Allergic urticaria on the back
.The skin lesions of urticarial disease are caused by an inflammatory reaction in the skin, causing leakage of capillaries in the dermis, and resulting in an edema which persists until the interstitial fluid is absorbed into the surrounding cells.^ Urticaria is dermal edema resulting from vascular dilatation and leakage of fluid into the skin in response to molecules released from mast cells.
  • Urticaria cause and treatment : by Ray Sahelian, M.D. herbs, supplements, and urticaria 17 January 2010 23:44 UTC www.raysahelian.com [Source type: Academic]

^ Hives are the result of an allergic reaction in the skin.
  • Healthopedia.com - Hives (Urticaria) 3 February 2010 15:54 UTC www.healthopedia.com [Source type: FILTERED WITH BAYES]

^ Localized arm edema may result from infiltration of I.V. fluid into the interstitial tissue.
  • Causes of Urticaria - WrongDiagnosis.com 17 January 2010 23:44 UTC www.wrongdiagnosis.com [Source type: Academic]

Allergic urticaria on the skin induced by an antibiotic
.Urticaria are caused by the release of histamine and other mediators of inflammation (cytokines) from cells in the skin.^ Histamine is one of the primary mediators of urticaria.
  • Clinical topic - Urticaria...View whole topic 17 January 2010 23:44 UTC www.cks.nhs.uk [Source type: Academic]

^ Causes 3 , 2 Urticaria is thought to be due to release of histamine and other mediators from mast cells in the skin; why this occurs is not always understood.
  • Urticaria | Doctor | Patient UK 17 January 2010 23:44 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ Urticaria happens when histamine is released by the cells in your skin.
  • Urticaria - information, symptoms and treatment 17 January 2010 23:44 UTC hcd2.bupa.co.uk [Source type: General]

.This process can be the result of an allergic or non-allergic reaction, differing in the eliciting mechanism of histamine release.^ Allergic reactions, chemicals in foods and medications can cause histamine release.
  • Hives, urticaria, angiodema, allergic reactions | The Children's Hospital of Philadelphia 17 January 2010 23:44 UTC www.chop.edu [Source type: FILTERED WITH BAYES]

^ Allergic or non-allergic; massive histamine release from mast cells in skin.
  • RxMed: Illness Information 17 January 2010 23:44 UTC www.rxmed.com [Source type: Academic]
  • RxMed: Illness Information 17 January 2010 23:44 UTC www.rxmed.com [Source type: Academic]

^ Histamine is released during an allergic reaction.
  • Hives - Health Library - Willis Knighton Health Systems 3 February 2010 15:54 UTC healthlibrary.epnet.com [Source type: Academic]
  • Northern Arizona Healthcare - Hives 3 February 2010 15:54 UTC www.nahealth.com [Source type: FILTERED WITH BAYES]
  • Tufts Medical Center - Hives 3 February 2010 15:54 UTC www.tufts-nemc.org [Source type: FILTERED WITH BAYES]

Allergic urticaria on the arm
Allergic urticaria 
Histamine and other pro-inflammatory substances are released from mast cells in the skin and tissues in response to the binding of .allergen-bound IgE antibodies to high affinity cell surface receptors.^ Antibodies to IgE or IgE receptor .
  • World Allergy Organization | Allergic Diseases Resource Center 17 January 2010 23:44 UTC www.worldallergy.org [Source type: Academic]

^ Autoantibodies to the high-affinity IgE receptor in children with chronic urticaria.
  • URTICARIA AND ANGIOEDEMA � Bob Lanier M 17 January 2010 23:44 UTC www.askdrbob.com [Source type: Academic]

^ These allergens cross-link immunoglobulin E (IgE) bound to the high-affinity receptor for IgE (FcεRI), leading to activation of mast cells.
  • Cecil's Textbook of Medicine: Urticaria and Angioedema: Urticaria 17 January 2010 23:44 UTC www.merckmedicus.com [Source type: Academic]

.Basophils and other inflammatory cells are also seen to release histamine and other mediators, and are thought to play an important role, especially in chronic urticarial diseases.^ The other test is the basophil-histamine release test, which is a blood test run in a lab.

^ In addition to histamine, other mast cell mediators are also thought to play a role in urticaria.
  • Urticaria: eMedicine Allergy and Immunology 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]

^ Histamine is the most important chemical mediator.
  • UCLA Department of Medicine - wfsection-Chronic Urticaria 17 January 2010 23:44 UTC www.med.ucla.edu [Source type: Academic]

Autoimmune urticaria 
In the past decade, it has been noted that many cases of chronic idiopathic urticaria are the result of an autoimmune trigger. For example, roughly one third of patients with chronic urticaria spontaneously develop auto-antibodies directed at the receptor .FcεRI located on skin mast cells.^ Urticaria is dermal edema resulting from vascular dilatation and leakage of fluid into the skin in response to molecules released from mast cells.
  • Urticaria cause and treatment : by Ray Sahelian, M.D. herbs, supplements, and urticaria 17 January 2010 23:44 UTC www.raysahelian.com [Source type: Academic]

^ Hives happen when the calls in the skin called mast cells release histamine, a chemical that causes tiny blood vessels (capillaries) to leak fluid.
  • AESTHETIC SURGERY & DERMATOLOGY offers information about Hives. 3 February 2010 15:54 UTC www.drghatan.com [Source type: FILTERED WITH BAYES]

^ Mast” cells present throughout the body release a chemical called histamine into the skin or blood stream.
  • Products and Answers to Common Skin Problems; Acne Treatment, Glycolic Peels, Alpha Hydroxyl Acids, Age Spots, Retinol and more! 3 February 2010 15:54 UTC www.yourskindoctor.com [Source type: FILTERED WITH BAYES]

.Chronic stimulation of this receptor leads to chronic hives.^ This shape change stimulates the IgE receptor and leads to the release of histamine, resulting in itching, redness and hives.

^ Activation of one group of receptors stimulates the conversion of ATP to cAMP which inhibits histamine release while activation of another group of receptors stimulates the conversion of GTP to cGMP which leads to histamine release.
  • UCLA Department of Medicine - wfsection-Chronic Urticaria 17 January 2010 23:44 UTC www.med.ucla.edu [Source type: Academic]

^ The first outbreak of hives can lead to others on body parts not directly stimulated, scraped or scratched.
  • Flickr: Dermatographic Urticaria (Skin Writing) 17 January 2010 23:44 UTC www.flickr.com [Source type: General]

.Patients often have other autoimmune conditions such as autoimmune thyroiditis.^ This is a condition that can occur in gluten sensitivity, thyroid conditions and other autoimmune conditions.
  • Rashes and Hives: Causes of Chronic Urticaria and Angioedema in Autoimmune Diseases 17 January 2010 23:44 UTC autoimmunedisease.suite101.com [Source type: FILTERED WITH BAYES]

^ Antigens are also produced within the body by other factors, such as inflammation or systemic illnesses such as cancer, thyroid disease or lupus.
  • Hives - Frequently Asked Questions (FAQs) | SnappyFingers 3 February 2010 15:54 UTC www.snappyfingers.com [Source type: FILTERED WITH BAYES]

^ Autoimmune diseases like thyroid disease, vitiligo, diabetes mellitus, pernicious anemia and rheumatoid arthritis were reported more commonly in patients with autoimmune urticaria.
  • Chronic idiopathic urticaria: Comparison of clinical features with positive autologous serum skin test George M, Balachandran C, Prabhu S - Indian J Dermatol Venereol Leprol 17 January 2010 23:44 UTC www.ijdvl.com [Source type: Academic]

Infectious 
Hive-like rashes commonly accompany viral illnesses, such as the common cold. They usually appear 3–5 days after the cold has started, and may even appear a few days after the cold has resolved.
Non-allergic urticaria 
Mechanisms other than allergen-antibody interactions are known to cause histamine release from mast cells. Many drugs, for example morphine, can induce direct histamine release not involving any immunoglobulin molecule. .Also, a diverse group of signaling substances called neuropeptides have been found to be involved in emotionally induced urticaria.^ Neuropeptides may well be involved in dermographism and in emotional exacerbation of urticaria.
  • Urticaria: eMedicine Allergy and Immunology 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]

^ But cold-induced urticaria is not a typical allergy in that there is no specific IgE, the allergic antibody, created to respond to a particular substance.

^ If the substance or allergy responsible for your urticaria can not be found, the symptoms of urticaria will need to be treated.
  • hives: causes, symptoms, treatment, & tips 17 January 2010 23:44 UTC www.allergyescape.com [Source type: General]

.Dominantly inherited cutaneous and neurocutaneous porphyrias (porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria and erythropoietic protoporphyria) have been associated with solar urticaria.^ Some chronic or recurrent urticarias are hereditary, and some are physically induced, such as cold, solar exposure or delayed pressure urticaria.
  • Primary Psychiatry: Psychiatric Issues in Dermatology, Part 2: Alopecia Areata, Urticaria, and Angioedema 17 January 2010 23:44 UTC www.primarypsychiatry.com [Source type: Academic]

^ Solar urticaria must be distinguished from other types of light sensitivity, including metabolic abnormalities (e.g., erythrogenic porphyria) and photosensitivity due to drugs.
  • Cecil's Textbook of Medicine: Urticaria and Angioedema: Urticaria 17 January 2010 23:44 UTC www.merckmedicus.com [Source type: Academic]

^ Rarely, cold urticaria is associated with an inherited condition called familial cold autoinflammatory syndrome.

.The occurrence of drug-induced solar urticaria may be associated with porphyrias.^ Autoimmune thyroiditis may be associated with urticaria .
  • Urticaria and Angioedema | Hunter Area Pathology Service 17 January 2010 23:44 UTC www.haps.nsw.gov.au [Source type: Academic]

^ Urticaria associated with a drug reaction.
  • Urticaria: eMedicine Emergency Medicine 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]
  • Urticaria: eMedicine Allergy and Immunology 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]

^ Drug-induced urticaria .
  • Urticaria and allergy 17 January 2010 23:44 UTC www.allergyclinic.co.uk [Source type: FILTERED WITH BAYES]
  • Urticaria - Hives 3 February 2010 15:54 UTC www.aad.org [Source type: FILTERED WITH BAYES]

.This may be caused by IgG binding not IgE.^ Other histamine-releasing factors in the serum that cause a wheal-and-flare reaction independent of IgE or the high-affinity IgE receptor may be present.
  • Urticaria: eMedicine Allergy and Immunology 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]

^ Serum-specific IgE testing (which takes preference over skin prick testing, as physical urticaria may be a cause of symptoms and could lead to a false positive result) b.
  • Educational Review Nov 2007 17 January 2010 23:44 UTC allergyadvisor.com [Source type: Academic]

^ It is now well established that urticaria may result from the binding of IgG auto-antibodies to IgE and/or to the receptor for IgE molecules on mast cells, thus corresponding to a type II HS reaction.
  • Urticaria cause and treatment : by Ray Sahelian, M.D. herbs, supplements, and urticaria 17 January 2010 23:44 UTC www.raysahelian.com [Source type: Academic]

Dietary histamine poisoning 
This is termed scombroid food poisoning. .Ingestion of free histamine released by bacterial decay in fish flesh may result in a rapid-onset allergic-type symptom complex which includes urticaria.^ Histamine is released during an allergic reaction.
  • Northern Arizona Healthcare - Hives 3 February 2010 15:54 UTC www.nahealth.com [Source type: FILTERED WITH BAYES]

^ The intense pruritus of urticaria is a result of histamine released into the dermis.
  • Urticaria: eMedicine Emergency Medicine 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]
  • Rare condition of urticaria.....details please? - Yahoo! Answers 17 January 2010 23:44 UTC answers.yahoo.com [Source type: General]

^ It is believed that stress causes release of histamine which is the chemical mediator basically responsible for the onset of urticarial attack.
  • Home Treatment for Hives - Associated Content - associatedcontent.com 17 January 2010 23:44 UTC www.associatedcontent.com [Source type: General]
  • Home Treatment For Hives – The Urticaria Remedies in Your Pantry 3 February 2010 15:54 UTC www.yousaytoo.com [Source type: FILTERED WITH BAYES]

.However, the urticaria produced by scromboid is reported not to include wheals.^ However, it is of interest since it is the first case of urticaria reported to cause death.
  • eshdv - The History of Urticaria and Angioedema 17 January 2010 23:44 UTC sfhd.chez.com [Source type: Academic]

^ Drugs that can produce urticaria include aspirin, codeine, dextrans, immune serums, insulin, morphine, penicillin, quinine, sulfonamides, and vaccines.
  • Causes of Urticaria - WrongDiagnosis.com 17 January 2010 23:44 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Physical urticaria includes dermographism, where pressure alone is enough to release histamine and cause an urticarial wheal at the site of trauma.

[2]
Stress and chronic idiopathic urticaria 
Chronic idiopathic urticaria has been anecdotally linked to stress since the 1940s.[3] .There is a large body of evidence demonstrating an association between this condition and both poor emotional well-being[4] and reduced health related quality of life.^ Because bee pollen contains all the nutrients needed to sustain life, it is being used on an ever larger scale for human nourishment and health.

^ H. pylori infection, thyroid disease, connective tissue disorder), although there is limited evidence that correcting these conditions will improve the urticaria itself.
  • Clinical topic - Urticaria...View whole topic 17 January 2010 23:44 UTC www.cks.nhs.uk [Source type: Academic]

^ Researchers concluded that there is a significant association between chronic urticaria and thyroid autoimmunity, but only the thyroid antibody tests are relevant in patients with chronic urticaria, versus thyroid function tests.
  • Hives Linked to Autoimmune Thyroid Disease 3 February 2010 15:54 UTC thyroid.about.com [Source type: General]

[5] .More recent research has investigated hypotheses about stress as a causal factor in triggering the condition.^ Nervous conditions and stress can trigger hives.
  • MoonDragon's Health & Wellness: Hives 3 February 2010 15:54 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

^ I know of no evidence that psychological stress is can be anything more than an aggravating factor for urticaria.

^ Common triggers for episodes of chronic urticaria are intercurrent viral infections and possibly stress but there is little evidence for any other more specific triggers for truly idiopathic urticaria.
  • Pulse - Need to know - urticaria 17 January 2010 23:44 UTC www.pulsetoday.co.uk [Source type: FILTERED WITH BAYES]

.Evidence has been found for a link between stressful life events (e.g.^ I’m glad I found your page in my search for a link between viruses and hives.
  • Amanita.net » Blog Archive » About My Chronic Urticaria 17 January 2010 23:44 UTC journal.amanita.net [Source type: Original source]

^ Alopecia areata patients also had a higher mean number of stressful life events.
  • Primary Psychiatry: Psychiatric Issues in Dermatology, Part 2: Alopecia Areata, Urticaria, and Angioedema 17 January 2010 23:44 UTC www.primarypsychiatry.com [Source type: Academic]

^ A similar case-control study 7 found an increase in stressful life events in patients with recurrent alopecia areata but not in those with first episodes.
  • Primary Psychiatry: Psychiatric Issues in Dermatology, Part 2: Alopecia Areata, Urticaria, and Angioedema 17 January 2010 23:44 UTC www.primarypsychiatry.com [Source type: Academic]

bereavement, divorce etc...)[6] and preliminary evidence has been reported for a link between .posttraumatic stress and chronic idiopathic urticaria.^ Final diagnosis Chronic Idiopathic Urticaria.
  • Allergy Cases: Chronic Idiopathic Urticaria - Case-based Curriculum of Allergy and Immunology 17 January 2010 23:44 UTC allergycases.org [Source type: FILTERED WITH BAYES]

^ Chronic urticaria is referred to as chronic idiopathic urticaria.
  • Antihistamine, Zyrtec and Urticaria (hives). - ZYRTEC Medication - All about Zyrtec (Cetirizine), ZYRTEC-D 12 HOUR, ZYRTEC syrup, ZYRTEC 10 mg, ZYRTEC 5 mg, ZYRTEC on-line, where is to buy Zyrtec, buy Zyrtec on-line, buy Zyrtec 17 January 2010 23:44 UTC zyrtecmed.info [Source type: General]

^ Therefore, most chronic urticaria is idiopathic.
  • ALLSA - Urticaria and Angioedema 17 January 2010 23:44 UTC www.allergysa.org [Source type: Academic]

[7] .Less is known about the individual experiences and characteristics of people who develop chronic idiopathic urticaria following stress.^ What can I do about chronic urticaria?

^ Seen in less than 1% of people with chronic urticaria.
  • eMJA: 5: Allergy and the skin: eczema and chronic urticaria 17 January 2010 23:44 UTC www.mja.com.au [Source type: Academic]

^ The rest of this page is about chronic urticaria.

.Research into these factors in the relationship between stress and chronic idiopathic urticaria is ongoing by a number of researchers, including an online project[8] currently being undertaken by researchers at the University of Plymouth.^ Final diagnosis Chronic Idiopathic Urticaria.
  • Allergy Cases: Chronic Idiopathic Urticaria - Case-based Curriculum of Allergy and Immunology 17 January 2010 23:44 UTC allergycases.org [Source type: FILTERED WITH BAYES]

^ Urticaria is categorised as either acute or chronic and can be triggered by a number of factors.
  • urticaria, hives, nettle rash, skin rash, skin welts 17 January 2010 23:44 UTC www.gotosee.co.uk [Source type: FILTERED WITH BAYES]

^ Therefore, most chronic urticaria is idiopathic.
  • ALLSA - Urticaria and Angioedema 17 January 2010 23:44 UTC www.allergysa.org [Source type: Academic]

[9]

Differential diagnosis

.The rash that develops from poison ivy, poison oak, and poison sumac contact is commonly mistaken for urticaria.^ Examples: poison ivy or poison oak .
  • CompassHealth, Inc. : Help for Hives 3 February 2010 15:54 UTC www.compasshealth.net [Source type: FILTERED WITH BAYES]

^ Angioedema Flea bites Poison ivy, oak or sumac .
  • Urticaria -- eCureMe.com 17 January 2010 23:44 UTC www.ecureme.com [Source type: Academic]

^ Common skin rashes include poison ivy, hives, shingles, eczema, contact dermatitis, ringworm, psoriasis and impetigo.
  • Hives (Urticaria) & Angioedema Causes, Symptoms and Treatment on MedicineNet.com 3 February 2010 15:54 UTC www.medicinenet.com [Source type: FILTERED WITH BAYES]
  • Hives definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms 3 February 2010 15:54 UTC www.medterms.com [Source type: General]

.This rash is caused by contact with urushiol and results in a form of contact dermatitis called Urushiol-induced contact dermatitis.^ Another type of rash is “contact dermatitis”.
  • Uticaria.org - relief for itchy kives suffers 3 February 2010 15:54 UTC www.uticaria.org [Source type: FILTERED WITH BAYES]

^ Skin inflammation caused by contact with irritants is called irritant contact dermatitis.
  • Singapore Family Physician 17 January 2010 23:44 UTC www.cfps.org.sg [Source type: FILTERED WITH BAYES]

^ This is actually called contact dermatitis.
  • Uticaria.org - relief for itchy kives suffers 3 February 2010 15:54 UTC www.uticaria.org [Source type: FILTERED WITH BAYES]

.Urushiol is spread by contact, but can be washed off with a strong grease/oil dissolving detergent and cool water and rubbing ointments.^ In contrast, weak irritants such as water and mild detergents tend to cause irritant contact dermatitis in susceptible individuals only (e.g.
  • Singapore Family Physician 17 January 2010 23:44 UTC www.cfps.org.sg [Source type: FILTERED WITH BAYES]

^ For localized hives, wash the allergic substance off the skin with soap and water.
  • Hives - The Children's Hospital-Denver Area, Colorado, Rocky Mountain Region 3 February 2010 15:54 UTC www.thechildrenshospital.org [Source type: General]

^ Localized Hives: For localized hives, wash the allergic substance off the skin with soap and water.

Types

.
  • Acute urticaria usually show up a few minutes after contact with the allergen and can last a few hours to several weeks.^ Acute Hives is of recent onset (hours, days or a few weeks).
    • Leigh and Williams Limited - Hives - Histarix Hives treatment and prevention. 3 February 2010 15:54 UTC www.treatfast.com [Source type: FILTERED WITH BAYES]

    ^ Acute urticaria is of recent onset (hours, days or a few weeks).
    • Urticaria, angioedema (hives). DermNet NZ 17 January 2010 23:44 UTC www.dermnetnz.org [Source type: FILTERED WITH BAYES]
    • Urticaria: Dermnet Health Information sheets: NEVDGP 17 January 2010 23:44 UTC www.nevdgp.org.au [Source type: FILTERED WITH BAYES]
    • The Allergy Site, detailed information and images on atopic dermatitis or eczema 17 January 2010 23:44 UTC www.theallergysite.co.uk [Source type: FILTERED WITH BAYES]

    ^ But, some last a few weeks or longer.
    • UT Medical Group, Inc. - Health Library 17 January 2010 23:44 UTC healthlibrary.epnet.com [Source type: Academic]
    • Hives - Health Library - Willis Knighton Health Systems 3 February 2010 15:54 UTC healthlibrary.epnet.com [Source type: Academic]
    • Northern Arizona Healthcare - Hives 3 February 2010 15:54 UTC www.nahealth.com [Source type: FILTERED WITH BAYES]
    • Tufts Medical Center - Hives 3 February 2010 15:54 UTC www.tufts-nemc.org [Source type: FILTERED WITH BAYES]

    .Food allergic reactions often fit in this category.^ Allergic reaction to food, additives or drugs .

    ^ Hives are an allergic reaction often due to food or plants.
    • Hives - WrongDiagnosis.com 3 February 2010 15:54 UTC www.wrongdiagnosis.com [Source type: General]
    • Hives Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 3 February 2010 15:54 UTC www.wrongdiagnosis.com [Source type: General]

    ^ These are often caused by an allergic reaction.
    • Hives - DermaTechRx Research Center 3 February 2010 15:54 UTC dermatechrx.com [Source type: General]

    .The most common food allergies in adults are shellfish and nuts.^ Food Allergies , especially allergies to shellfish, eggs, fruits, and various nuts.
    • MoonDragon's Health & Wellness: Hives 3 February 2010 15:54 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

    ^ Allergy to egg is the most common food allergy associated with eczema.
    • eMJA: 5: Allergy and the skin: eczema and chronic urticaria 17 January 2010 23:44 UTC www.mja.com.au [Source type: Academic]

    ^ Food – the most common cause of hives .
    • Home Treatment For Hives – The Urticaria Remedies in Your Pantry 3 February 2010 15:54 UTC www.yousaytoo.com [Source type: FILTERED WITH BAYES]

    .The most common food allergies in children are shellfish, nuts, peanuts, eggs, wheat, and soy.^ Here are some common causes: • Food and environmental allergens The most common food allergens that cause hives are milk, eggs, nuts, soy, wheat, fish, and shellfish.

    ^ Consider: Allergy to: Food such as nuts, strawberries, eggs, additives, spices, shellfish.
    • Clinical topic - Urticaria...View whole topic 17 January 2010 23:44 UTC www.cks.nhs.uk [Source type: Academic]

    ^ Allergy to egg is the most common food allergy associated with eczema.
    • eMJA: 5: Allergy and the skin: eczema and chronic urticaria 17 January 2010 23:44 UTC www.mja.com.au [Source type: Academic]

    .It is uncommon for patients to have more than 2 true food allergies.^ (Read more on food allergies .

    ^ If food allergies are suspected, refer patient to allergy.
    • Urticaria 17 January 2010 23:44 UTC enotes.tripod.com [Source type: FILTERED WITH BAYES]

    ^ Other than allergies, it is not known what causes this more persistent and severe type of urticaria.
    • Delayed Pressure Urticaria - Body detoxification Products 17 January 2010 23:44 UTC www.healthynewage.com [Source type: General]

    .A less common cause is exposure to certain bacteria, such as streptococcus or possibly Helicobacter pylori.^ Other less common causes of hives include insect stings , side-effects of pharmaceutical drugs and stress .
    • Cat & Dog Hives - Treatments for Sudden Red, Itchy Skin Welts 3 February 2010 15:54 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

    ^ Less common causes of hives include friction, pressure, temperature extremes, exercise, and sunlight.
    • Hives - eHow.com 3 February 2010 15:54 UTC www.ehow.com [Source type: FILTERED WITH BAYES]

    ^ Certain viral infections such as glandular fever and hepatitis B or blood transfusions can also cause hives.
    • Urticaria (Hives) - Symptoms, Causes, Treatment And Cure 17 January 2010 23:44 UTC www.online-family-doctor.com [Source type: FILTERED WITH BAYES]

    [10] .In these cases, the hives may be exacerbated by other factors, such as those listed under Physical Urticarias below.
  • Chronic urticaria refers to hives that persists for 6 weeks or more.^ Chronic urticaria and/or angioedema: Hives or swelling lasting more than six weeks.
    • Allergies and Hives (Urticaria and Angioedema) 3 February 2010 15:54 UTC www.webmd.com [Source type: General]

    ^ These patients may have concomitant physical urticaria.
    • Urticaria: eMedicine Allergy and Immunology 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]

    ^ Chronic urticaria lasts more than six weeks and may be intermittent.
    • URTICARIA AND ANGIOEDEMA � Bob Lanier M 17 January 2010 23:44 UTC www.askdrbob.com [Source type: Academic]

    .There are no visual differences between acute and chronic urticaria.^ This type of urticaria can be acute or chronic.
    • Urticaria - information, symptoms and treatment 17 January 2010 23:44 UTC hcd2.bupa.co.uk [Source type: General]

    ^ There is no visual difference between the two.
    • Hives Treatment :: Shop.QBased.com :: Safe enough to be used on the worse cases of hives, yet strong enough to get rid of the welps and itching quickly and safely. 3 February 2010 15:54 UTC shop.qbased.com [Source type: General]

    ^ Acute and chronic urticaria .
    • Allergy Cases: Chronic Idiopathic Urticaria - Case-based Curriculum of Allergy and Immunology 17 January 2010 23:44 UTC allergycases.org [Source type: FILTERED WITH BAYES]

    .Some of the more severe chronic cases have lasted more than 20 years.^ Chronic hives last more than six weeks.
    • Urticaria (Hives) - Symptoms, Causes, Treatment And Cure 17 January 2010 23:44 UTC www.online-family-doctor.com [Source type: FILTERED WITH BAYES]

    ^ Chronic urticaria, by definition, lasts for more than six weeks.
    • Meducation - Urticaria Medical Revision Note 17 January 2010 23:44 UTC www.meducation.net [Source type: Academic]

    ^ Chronic Urticaria lasts for longer than this.
    • Urticaria - Hives/Nettle Rash - ExpressChemist.co.uk - Buy Online 17 January 2010 23:44 UTC www.expresschemist.co.uk [Source type: FILTERED WITH BAYES]

    .A survey indicated that chronic urticaria lasted a year or more in more than 50% of sufferers and 20 years or more in 20% of them.^ Chronic urticaria lasts more than six weeks and may be intermittent.
    • URTICARIA AND ANGIOEDEMA � Bob Lanier M 17 January 2010 23:44 UTC www.askdrbob.com [Source type: Academic]

    ^ Chronic urticaria, by definition, lasts for more than six weeks.
    • Meducation - Urticaria Medical Revision Note 17 January 2010 23:44 UTC www.meducation.net [Source type: Academic]

    ^ H ives last more than 1 week.
    • Hives - The Children's Hospital-Denver Area, Colorado, Rocky Mountain Region 3 February 2010 15:54 UTC www.thechildrenshospital.org [Source type: General]

    .Of course this does mean that in almost half the people it clears up within a year and in 80% it clears up within 20 years or less.^ Of course this does mean that in almost half the people it clears up within a year and in 80% it clears up within 20 years or less (Champion and others, British Journal of Dermatology 1969).

    ^ Although the specific cause of chronic papular urticaria can seldom be identified and removed, spontaneous remissions usually occur within 2 years in about half of the cases.
    • Urticaria, Papular - Caring4Cancer 17 January 2010 23:44 UTC www.caring4cancer.com [Source type: FILTERED WITH BAYES]

    ^ Our allergist predicted that Morgan would need to begin allergy shots within a few years, once his eczema clears up.
    • Our Story of Food Allergies 3 February 2010 15:54 UTC www.allergicchild.com [Source type: FILTERED WITH BAYES]

    [11]
  • .
  • Drug-induced urticaria has been known to result in severe cardiorespiratory failure.^ Drug-induced urticaria .

    ^ Urticaria also can result from a combination of factors, e.g., eating a particular food and then exercising (a condition known as exercise induced urticaria ); so the process of diagnostic evaluation can be complex.
    • Treatment of asthma and allergies by board certified allergists, serving Miami-Dade, Palm Beach, and Broward Counties." 17 January 2010 23:44 UTC www.allergyweb.com [Source type: Academic]

    ^ This would suggest that a diagnosis of nickel-induced food allergy should be considered in patients with unexplained chronic urticaria, especially if they are known to suffer from nickel dermatitis.

    .The anti-diabetic sulphonylurea glimepiride (trade name Amaryl), in particular, has been documented to induce allergic reactions manifesting as urticaria.^ Urticaria and angioedema are common allergic reactions.
    • Causes of Urticaria - WrongDiagnosis.com 17 January 2010 23:44 UTC www.wrongdiagnosis.com [Source type: Academic]

    ^ Urticaria is sometimes due to an allergic reaction to drugs, food or preservatives, but may also be due to fever, heat, exercise or physical pressure.
    • Urticaria - myDr.com.au 17 January 2010 23:44 UTC www.mydr.com.au [Source type: Academic]

    ^ Urticaria, more commonly known as Hives, is most often the sign of an allergic reaction although the exact cause is frequently unknown.
    • Hives Treatment :: Shop.QBased.com :: Safe enough to be used on the worse cases of hives, yet strong enough to get rid of the welps and itching quickly and safely. 3 February 2010 15:54 UTC shop.qbased.com [Source type: General]

    .Other cases include dextroamphetamine,[12] aspirin, penicillin, clotrimazole, sulfonamides and anticonvulsants.
  • Physical urticarias are often categorized into the following.^ Other urticarias The physical urticarias.

    ^ Clinical classification includes: Physical urticaria — follows certain physical stimuli .
    • Clinical topic - Urticaria...View whole topic 17 January 2010 23:44 UTC www.cks.nhs.uk [Source type: Academic]

    ^ Common allergens that cause hives include fish, milk products, nuts, food additives, flavorings, preservatives, penicillin, and aspirin.
    • Hives - Natural Treatment for Hives 3 February 2010 15:54 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

    • Aquagenic: Reaction to water (exceedingly rare)
    • Cholinergic: Reaction to body heat, such as when exercising or after a hot shower
    • Cold (Chronic cold urticaria): Reaction to cold, such as ice, cold air or water - worse with sudden change in temperature
    • Delayed Pressure: Reaction to standing for long periods, bra-straps, elastic bands on undergarments, belts
    • Dermatographic: Reaction when skin is scratched (very common)
    • Heat: Reaction to hot food or objects (rare)
    • Solar: Reaction to direct sunlight (rare, though more common in those with fair skin)
    • Vibration: Reaction to vibration (rare)
    • Adrenergic: Reaction to adrenaline / noradrenaline (extremely rare)

Related conditions

.Angioedema is similar to urticaria,[13] but in angioedema, the swelling occurs in a lower layer of the dermis than it does in urticaria,[14] as well as in the subcutis.^ Urticaria and angioedema can occur together or separately.
  • Urticaria - information, symptoms and treatment 17 January 2010 23:44 UTC hcd2.bupa.co.uk [Source type: General]

^ Angioedema is similar to urticaria, but the swelling occurs beneath the skin instead of on the surface.
  • Skin Conditions: Hives 3 February 2010 15:54 UTC www.webmd.com [Source type: General]
  • MoonDragon's Health & Wellness: Hives 3 February 2010 15:54 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

^ Angioedema is tissue swelling similar to urticaria, but the swelling occurs beneath the skin instead of on the surface.

.This swelling can occur around the mouth, in the throat, in the abdomen, or in other locations.^ Swelling from angioedema can also occur around your hands, feet, and throat.
  • Hives 3 February 2010 15:54 UTC www.healthscout.com [Source type: FILTERED WITH BAYES]
  • Hives Medical Information 3 February 2010 15:54 UTC www.drugs.com [Source type: FILTERED WITH BAYES]
  • Hives | LIVESTRONG.COM 3 February 2010 15:54 UTC www.livestrong.com [Source type: General]
  • Hives 3 February 2010 15:54 UTC www.texashealth.org [Source type: FILTERED WITH BAYES]
  • Hives - Health Information 3 February 2010 15:54 UTC www.qualityhealth.com [Source type: General]
  • Hives - Scripps Health - San Diego 3 February 2010 15:54 UTC www.scripps.org [Source type: Academic]
  • Health Los Angeles - Hives. Hives are raised, often itchy, red welts on the... 3 February 2010 15:54 UTC www.uclahealth.org [Source type: FILTERED WITH BAYES]
  • Hives - Lee Memorial Health System 3 February 2010 15:54 UTC www.leememorial.org [Source type: FILTERED WITH BAYES]
  • Hives 3 February 2010 15:54 UTC www.drexelmed.edu [Source type: FILTERED WITH BAYES]
  • Hives 3 February 2010 15:54 UTC www.mercksource.com [Source type: FILTERED WITH BAYES]

^ If the swelling occurs in the throat, it can cause suffocation.
  • GHI - Health & Wellness: Hives (The Basics) 3 February 2010 15:54 UTC www.ghi.com [Source type: Academic]

^ Deeper swellings, known as angioedema, are most often found in the mouth, eyelids, or genitalia, but may occur anywhere.
  • Auckland Allergy Clinic – Urticaria and Angioedema 17 January 2010 23:44 UTC www.allergyclinic.co.nz [Source type: Academic]

.Urticaria and angioedema sometimes occur together in response to an allergen and is a concern in severe cases as angioedema of the throat can be fatal.^ Urticaria and angioedema can occur together or separately.
  • Urticaria - information, symptoms and treatment 17 January 2010 23:44 UTC hcd2.bupa.co.uk [Source type: General]

^ In severe cases, ulceration may occur.
  • Urticaria 17 January 2010 23:44 UTC enotes.tripod.com [Source type: FILTERED WITH BAYES]

^ Angioedema of the throat may cause respiratory obstruction in severe cases.
  • Urticaria and Angioedema | Hunter Area Pathology Service 17 January 2010 23:44 UTC www.haps.nsw.gov.au [Source type: Academic]

.Urticaria can be a complication and symptom of a parasitic infection as Fascioliasis (Fasciola Hepatica)and Ascariasis (Ascaris Lumbricoides).^ Urticaria has also been reported with chronic parasitic infections.
  • Urticaria: eMedicine Allergy and Immunology 17 January 2010 23:44 UTC emedicine.medscape.com [Source type: Academic]

^ Urticaria pigmentosa (systemic mastocytosis), cutaneous vasculitis, serum sickness, malignancy, infections (viral, Parasitic), acquired C1 inhibitor deficiency .
  • ALLSA - Urticaria and Angioedema 17 January 2010 23:44 UTC www.allergysa.org [Source type: Academic]

^ Contents Urticaria: Introduction Drugs/substances (77 causes) Excerpts from book chapters Complication causes Causes of symptoms News Related cause information Causes of Urticaria (Diseases Database): .
  • Causes of Urticaria - WrongDiagnosis.com 17 January 2010 23:44 UTC www.wrongdiagnosis.com [Source type: Academic]

[citation needed]

Management

.Chronic urticaria can be difficult to treat.^ Keywords: Chronic idiopathic urticaria, difficult urticaria, urticaria .
  • Management of difficult urticaria Yadav S, Bajaj AK - Indian J Dermatol 17 January 2010 23:44 UTC www.e-ijd.org [Source type: Academic]

^ Cholinergic urticaria can be very difficult to treat.
  • Cold Urticaria 17 January 2010 23:44 UTC www.raising-special-kids.com [Source type: FILTERED WITH BAYES]
  • cholinergic urticaria/hives - Allergy - MedHelp 17 January 2010 23:44 UTC www.medhelp.org [Source type: General]

^ Background: Chronic idiopathic urticaria (CIU), in its extremely severe form, can pose a therapeutic challenge to the treating physician.
  • Chronic idiopathic urticaria: Comparison of clinical features with positive autologous serum skin test George M, Balachandran C, Prabhu S - Indian J Dermatol Venereol Leprol 17 January 2010 23:44 UTC www.ijdvl.com [Source type: Academic]

.There are no guaranteed treatments or means of controlling attacks, and some sub-populations are treatment-resistant, with medications spontaneously losing their effectiveness and requiring new medications to control attacks.^ There are no guaranteed means of controlling attacks.
  • Management of difficult urticaria Yadav S, Bajaj AK - Indian J Dermatol 17 January 2010 23:44 UTC www.e-ijd.org [Source type: Academic]

^ There is no cure for it, but there are ways to control it.
  • Hives - DermaTechRx Research Center 3 February 2010 15:54 UTC dermatechrx.com [Source type: General]

^ Treatment There is no uniformly effective treatment for vitiligo.
  • Urticaria 17 January 2010 23:44 UTC enotes.tripod.com [Source type: FILTERED WITH BAYES]

.It can be difficult to determine appropriate medications since some, such as loratadine, require a day or two to build up to effective levels, and since the condition is intermittent and outbreaks typically clear up without any treatment.^ It can be difficult to determine the appropriate medication, as the condition is intermittent and outbreaks also typically clear up without any treatment.
  • Management of difficult urticaria Yadav S, Bajaj AK - Indian J Dermatol 17 January 2010 23:44 UTC www.e-ijd.org [Source type: Academic]

^ It cleared up in 3 days, never been back since.
  • Amanita.net » Blog Archive » About My Chronic Urticaria 17 January 2010 23:44 UTC journal.amanita.net [Source type: Original source]

^ Some common allergic triggers are certain foods (like milk, shellfish, berries, and nuts), medications (such as antibiotics), and insect stings or bites.
  • RealAge Message Boards • View topic - Help with Hives 3 February 2010 15:54 UTC www.realage.com [Source type: General]

.Most treatment plans for urticaria involve being aware of one's triggers, but this can be difficult since there are several different forms of urticaria and people often exhibit more than one type.^ Among the most popular forms of treatment are antihistamines.
  • Hives Treatment Information 3 February 2010 15:54 UTC fwdmagazine.com [Source type: FILTERED WITH BAYES]

^ The etiology of different forms of urticaria in childhood.
  • Etiology and diagnosis of urticaria 17 January 2010 23:44 UTC www.uptodate.com [Source type: Academic]

^ Most treatment plans for cholinergic urticaria involve being aware of one's triggers.
  • cholinergic urticaria/hives - Allergy - MedHelp 17 January 2010 23:44 UTC www.medhelp.org [Source type: General]

.Also, since symptoms are often idiopathic (unknown reason) there might not be any clear trigger.^ Common triggers for episodes of chronic urticaria are intercurrent viral infections and possibly stress but there is little evidence for any other more specific triggers for truly idiopathic urticaria.
  • Pulse - Need to know - urticaria 17 January 2010 23:44 UTC www.pulsetoday.co.uk [Source type: FILTERED WITH BAYES]

^ Often there is no way of knowing whether someone who is stressed really does get more symptoms, or whether they just notice the symptoms more when stressed.

^ But, there are other reasons you may suffer from long-lasting hives symptoms.
  • Hives Treatment Information 3 February 2010 15:54 UTC fwdmagazine.com [Source type: FILTERED WITH BAYES]

.If one's triggers can be identified then outbreaks can often be managed by limiting one's exposure to these situations.^ Tell your doctor if you have any of these: Exposure to an allergen (something that causes an allergic reaction) Exposure to an allergen that triggered hives in the past .
  • Tufts Medical Center - Hives 3 February 2010 15:54 UTC www.tufts-nemc.org [Source type: FILTERED WITH BAYES]

^ These hives are triggered by exposure to cold water or air .
  • Hives - DrGreene.com 17 January 2010 23:44 UTC www.drgreene.org [Source type: General]

^ It is not known what causes the excess of mast cells that characterises UP, but environmental triggers have been identified that activate mast cells and cause symptoms associated with UP. These include: .

Histamine antagonists

.Drug treatment is typically in the form of antihistamines such as diphenhydramine, hydroxyzine, cetirizine and other H1 receptor antagonists.^ Among the most popular forms of treatment are antihistamines.
  • Hives Treatment Information 3 February 2010 15:54 UTC fwdmagazine.com [Source type: FILTERED WITH BAYES]

^ Drug treatment is typically in the form of antihistamines,H2-receptor antagonists such as cimetidine.
  • cholinergic urticaria/hives - Allergy - MedHelp 17 January 2010 23:44 UTC www.medhelp.org [Source type: General]

^ Many people who suffer from acute attacks find at least temporary relief from the symptoms of hives by taking antihistamines such as hydroxyzine (Atarax, Vistaril), chlorpheniramine (Chlor-Trimeton, Teldrin, and others), or diphenhydramine (Benadryl and others).
  • MoonDragon's Health & Wellness: Hives 3 February 2010 15:54 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

[15] .These are taken on a regular basis to protective effect, lessening or halting attacks.^ They must be taken on a regular basis, rather than as needed.
  • Urticaria: Approach to the Dermatologic Patient: Merck Manual Professional 17 January 2010 23:44 UTC www.merck.com [Source type: Academic]

^ Help to prevent the disease when taken on a regular basis.
  • Auckland Allergy Clinic – Allergies and Allergy Terminology 17 January 2010 23:44 UTC www.allergyclinic.co.nz [Source type: Academic]

.While the disease may be physiological in origin, psychological treatments such as stress management can sometimes lessen severity and occurrence.^ Severity may lessen with tanning.
  • eMJA: 5: Allergy and the skin: eczema and chronic urticaria 17 January 2010 23:44 UTC www.mja.com.au [Source type: Academic]

^ As the disease may be physiological in origin, psychological treatments such as stress management can sometimes lessen severity and occurrence.
  • cholinergic urticaria/hives - Allergy - MedHelp 17 January 2010 23:44 UTC www.medhelp.org [Source type: General]

^ Less frequently, physical agents, such as cold, heat, insect bites, and mechanical injury, as well as parasitic and other infectious diseases, may be triggers.
  • hives (dermatology) -- Britannica Online Encyclopedia 3 February 2010 15:54 UTC www.britannica.com [Source type: FILTERED WITH BAYES]

.Additionally, methods similar to psychological pain management can be used to shift focus away from the discomfort and itchiness during an attack.^ And for over a century, dentists have used hypnosis to ease discomfort during dental procedures.
  • Overcome hives Self Hypnosis CD and downloadable MP3 by Steve G. Jones, Clinical Hypnotherapist 3 February 2010 15:54 UTC www.stevegjones.com [Source type: General]

^ Explains the medication ibuprofen (Advil, Motrin, Nuprin, Medipren) a drug used for the management of mild to moderate pain, fever, and inflammation.
  • Hives (Urticaria) & Angioedema Causes, Symptoms and Treatment on MedicineNet.com 17 January 2010 23:44 UTC www.medicinenet.com [Source type: FILTERED WITH BAYES]

^ During my recent summer hols this year, I experimented by stopping the meds.It used to pain like hell when I used to workout.
  • cholinergic urticaria/hives - Allergy - MedHelp 17 January 2010 23:44 UTC www.medhelp.org [Source type: General]

.The H2-receptor antagonists such as cimetidine and ranitidine may help control symptoms either prophylactically or by lessening symptoms during an attack.^ Treatment involves identification and subsequent avoidance of the allergen; administration of epinephrine and antihistamines may help to control the acute skin symptoms.
  • hives (dermatology) -- Britannica Online Encyclopedia 3 February 2010 15:54 UTC www.britannica.com [Source type: FILTERED WITH BAYES]

^ As the disease may be physiological in origin, psychological treatments such as stress management can sometimes lessen severity and occurrence.
  • cholinergic urticaria/hives - Allergy - MedHelp 17 January 2010 23:44 UTC www.medhelp.org [Source type: General]

^ H2 blockers (e.g., raitidine) may be of benefit, as well as leukotriene receptor antagonists (e.g., montelukast).  Occasionally oral steroids may be needed to control the process.  In severe hives, an injection of epinephrine (adrenalin) or a cortisone medication may be needed.
  • Hives - Urticaria 17 January 2010 23:44 UTC www.metrohealth.org [Source type: FILTERED WITH BAYES]

[16] .When taken in combination with a H1 antagonist it has been shown to have a synergistic effect which is more effective than either treatment alone.^ Combinations of agents may be more effective than a single agent.
  • UCLA Department of Medicine - wfsection-Chronic Urticaria 17 January 2010 23:44 UTC www.med.ucla.edu [Source type: Academic]

^ Water is lighter than syrup and will float, effectively keeping the bees from their feed until the water is finally taken in by the syrup.

^ In difficult cases, a combination of H1 and H2 antihistamines (as Tagemet-Cimetidine 300 mg q6h) may be more effective.
  • Urticaria 17 January 2010 23:44 UTC enotes.tripod.com [Source type: FILTERED WITH BAYES]

.December 2007" style="white-space:nowrap;">[citation needed] The use of ranitidine (or other H2 antagonist) for urticaria is considered an off-label use, since these drugs are primarily used for the treatment of peptic ulcer disease and gastroesophageal reflux disease.^ Which drugs are not recommended for the treatment of urticaria?
  • Clinical topic - Urticaria...View whole topic 17 January 2010 23:44 UTC www.cks.nhs.uk [Source type: Academic]

^ Other kinds of urticaria Treatment of urticaria Other websites on urticaria .

^ Some of these may not be licensed for urticaria, but can be useful treatments.

Other

.Tricyclic antidepressants, such as doxepin, also are often potent H1 and H2 antagonists and may have a role in therapy, although side effects limit their use.^ Doxepin is a tricyclic antidepressant with very potent H-1 and H-2 antihistaminic properties.
  • Management of difficult urticaria Yadav S, Bajaj AK - Indian J Dermatol 17 January 2010 23:44 UTC www.e-ijd.org [Source type: Academic]

^ Tricyclic antidepressants are potent blockers of H 1 and H 2 receptors.
  • UCLA Department of Medicine - wfsection-Chronic Urticaria 17 January 2010 23:44 UTC www.med.ucla.edu [Source type: Academic]

^ The tricyclic antidepressant doxepin (10 to 100 mg nightly at bedtime) has highly potent H 1 and H 2 antihistamine activity, with an H 1 receptor affinity almost 800 times that of diphenhydramine and an H 2 receptor affinity six times that of cimetidine, but its use can be limited by significant sedation.
  • Cecil's Textbook of Medicine: Urticaria and Angioedema: Urticaria 17 January 2010 23:44 UTC www.merckmedicus.com [Source type: Academic]

.For very severe outbreaks, an oral corticosteroid such as Prednisone is sometimes prescribed.^ Severe cases might require oral corticosteroids such as prednisone (Deltasone®, Orasone®).

^ Rarely, in cases of extremely severe hives, your doctor may recommend stronger medications such as oral steroids (prednisone) to control eruptions.
  • Hives Treatment | AHealthyMe.com 3 February 2010 15:54 UTC www.ahealthyme.com [Source type: General]

^ As the disease may be physiological in origin, psychological treatments such as stress management can sometimes lessen severity and occurrence.
  • cholinergic urticaria/hives - Allergy - MedHelp 17 January 2010 23:44 UTC www.medhelp.org [Source type: General]

.However this form of treatment is controversial because of the extensive side effects common with corticosteroids and as such is not a recommended long-term treatment option.^ They are rarely recommended long term because of serious adverse effects.
  • Urticaria, angioedema (hives). DermNet NZ 17 January 2010 23:44 UTC www.dermnetnz.org [Source type: FILTERED WITH BAYES]

^ Long-term treatment with oral steroids cannot be justified, because of side effects.
  • eMJA: 5: Allergy and the skin: eczema and chronic urticaria 17 January 2010 23:44 UTC www.mja.com.au [Source type: Academic]

^ Do these treatments have any side effects?
  • OhioHealth - Chronic hives (urticaria) 17 January 2010 23:44 UTC www.ohiohealth.com [Source type: General]
  • Chronic hives (urticaria) 3 February 2010 15:54 UTC www.cnn.com [Source type: General]
  • Chronic hives (urticaria) 3 February 2010 15:54 UTC edition.cnn.com [Source type: General]
  • Chronic hives (urticaria) 3 February 2010 15:54 UTC images.cnn.com [Source type: General]
  • Chronic hives (urticaria) 3 February 2010 15:54 UTC www.cnnstudentnews.cnn.com [Source type: General]

.As of 2008 an Australian company is performing clinical trials with an analogue of alpha-melanocyte-stimulating hormone called afamelanotide (formerly CUV1647)[17] for the treatment of solar urticaria,[18][19] a type of urticaria that develops in response to exposure to specific wavelengths of light.^ Erythema solare: erythema in response of exposure to sun.
  • Principles of Pediatric Dermatology - Chapter 29 : ERYTHEMAS AND URTICARIA 17 January 2010 23:44 UTC www.drmhijazy.com [Source type: Academic]

^ Hydroxyzine (Atarax) is considered specific in the treatment of such type of urticaria .
  • Principles of Pediatric Dermatology - Chapter 29 : ERYTHEMAS AND URTICARIA 17 January 2010 23:44 UTC www.drmhijazy.com [Source type: Academic]

^ Treatment depends on which type or types of urticaria you have.
  • Urticaria - Everybody - Health Information for New Zealanders 17 January 2010 23:44 UTC www.everybody.co.nz [Source type: Academic]

[20]

Dietary

.Children with intermittent or recurrent urticaria-angiodema were fed 7 food-additives: tartrazine (E102), sunset yellow (E110), erythrosine (E127), annatto (E160b), sodium benzoate (E211), acetyl-salicylic acid (ASA), and aspartame.^ Foods and food additives may also provoke urticaria by mechanisms other than true allergy and these are less easy to diagnose.

^ Six children underwent DBPCC with food additives, tyramine and acetylsalicylic acid.
  • Research on Diet and Eczema 17 January 2010 23:44 UTC www.feingold.org [Source type: Academic]

^ Alcoholic drinks Foods additives - preservatives and artificial colourings Natural salicylates - in certain spices, fruits, fruit juices Foods rich in amines - e.g.

.Reactions to the food additives were common: E102 = 50%, E110 = 64%, E127 = 35%, E160b = 60%, E211: 57%; ASA = 12%, aspartame = 48%.^ Numerous clinical studies demonstrate that diets that are free of foods or food additives that commonly trigger allergic reactions typically produce significant reductions in symptoms in 50-75% of people with chronic hives.
  • Hives - [Alternative Medicine] 17 January 2010 23:44 UTC www.peacehealth.org [Source type: Academic]
  • Hives - Providence Health & Services 3 February 2010 15:54 UTC www.providence.org [Source type: Academic]
  • Hives : University of Michigan Health System 3 February 2010 15:54 UTC health.med.umich.edu [Source type: Academic]
  • Citizens Health Information 3 February 2010 15:54 UTC www.citizensmemorial.com [Source type: Academic]

^ Lessof MH. Reactions to food additives.
  • Hives - [Alternative Medicine] 17 January 2010 23:44 UTC www.peacehealth.org [Source type: Academic]
  • Hives 3 February 2010 15:54 UTC www.publix.com [Source type: Academic]
  • Hives - Providence Health & Services 3 February 2010 15:54 UTC www.providence.org [Source type: Academic]
  • Hives : University of Michigan Health System 3 February 2010 15:54 UTC health.med.umich.edu [Source type: Academic]
  • PCC | Healthnotes | Hives 3 February 2010 15:54 UTC www.pccnaturalmarkets.com [Source type: Academic]
  • Citizens Health Information 3 February 2010 15:54 UTC www.citizensmemorial.com [Source type: Academic]
  • Harris Teeter - Herbal Remedies 3 February 2010 15:54 UTC www.harristeeter.com [Source type: Academic]

^ Adverse reactions to food additives.
  • Research on Diet and Eczema 17 January 2010 23:44 UTC www.feingold.org [Source type: Academic]

.The authors suggest that food additive intolerance is frequent in children with recurrent or intermittent urticaria-angiodema, and that aspartame may contribute directly to urticaria-angiodema in childhood.^ Guillet MH, Guillet G. [Food urticaria in children.
  • UCLA Department of Medicine - wfsection-Chronic Urticaria 17 January 2010 23:44 UTC www.med.ucla.edu [Source type: Academic]

^ Food additives and preservatives may also cause Urticaria.
  • Hives - Homeopathic Treatment of Hives 3 February 2010 15:54 UTC www.amcofh.org [Source type: FILTERED WITH BAYES]

^ Food intolerance A food or food additive intolerance is sometimes suspected to be the cause of chronic urticaria.

[21]

See also

Virus identified as likely cause[citation needed]  

References

  1. ^ "urticaria" The Oxford English Dictionary. 2nd ed. 1989. OED Online. Oxford University Press. 2 May 2009.
  2. ^ http://dermnetnz.org/reactions/scombroid.html
  3. ^ Mitchell, J., Curran, C., and Myers, R. (1947) Some Psychosomatic Aspects of Allergic Diseases. Psychosomatic Medicine: 9(3), 184-191. [1].
  4. ^ Uguz, F., Engin, B., and Yilmaz, E. (2008a) Axis I and Axis II diagnoses in patients with chronic idiopathic urticaria. Journal of Psychosomatic Research, 64: 225-229. [2].
  5. ^ Engin, B., Uguz, F., Yilmaz, E., Özdemir, M., and Mevlitoglu, I. (2007) The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria. Journal of the European Academy of Dermatology and Venereology, 22(1): 36-40. [3].
  6. ^ Yang, H., Sun, C., Wu, Y., and Wang, J. (2005) Stress, insomnia, and chronic idiopathic urticaria: a case-control study. Journal of the Formos Medical Association, 104(4): 254-263. [4].
  7. ^ Chung, M., Symons, C., Gilliam, J., and Kaminski, E. (2008b) The relationship between post-traumatic stress resulting from past traumas, coping strategies and chronic idiopathic urticaria (CIU). Poster presented at the British Psychological Society Annual Conference.
  8. ^ Life Events and Chronic Idiopathic Urticaria research project, University of Plymouth, England. [5].
  9. ^ [6]
  10. ^ Tebbe B, Geilen CC, Schulzke JD, Bojarski C, Radenhausen M, Orfanos CE (April 1996). "Helicobacter pylori infection and chronic urticaria". J. Am. Acad. Dermatol. 34 (4): 685–6. doi:10.1016/S0190-9622(96)80086-7. PMID 8601663. http://linkinghub.elsevier.com/retrieve/pii/S0190-9622(96)80086-7. 
  11. ^ Champion RH, Roberts SO, Carpenter RG, Roger JH (1969). "Urticaria and angio-oedema. A review of 554 patients". Br. J. Dermatol. 81 (8): 588–97. doi:10.1111/j.1365-2133.1969.tb16041.x. PMID 5801331. 
  12. ^ "Prescribing Information Dexedrine". GlaxoSmithKline. June 2006. http://dailymed.nlm.nih.gov/dailymed/fdaDrugXsl.cfm?id=1215&type=display. 
  13. ^ angioedema at Dorland's Medical Dictionary
  14. ^ "Hives (Urticaria and Angioedema)". 2006-03-01. http://www.webmd.com/allergies/guide/hives-urticaria-angioedema. Retrieved 2007-08-24. 
  15. ^ Greaves MW, Tan KT (2007). "Chronic Urticaria: Recent Advances". Clin Rev Allergy Immunol 33 (1-2): 134–143. doi:10.1007/s12016-007-0038-3. PMID 18094952. 
  16. ^ Lee EE, Maibach HI (2001). "Treatment of urticaria. An evidence-based evaluation of antihistamines". Am J Clin Dermatol 2 (1): 27–32. doi:10.2165/00128071-200102010-00005. PMID 11702618. 
  17. ^ "World Health Organisation assigns CUV1647 generic name" (PDF). Clinuvel. 2008. http://www.clinuvel.com/resources/pdf/asx_announcements/2008/20080617WHOGenericName.pdf. Retrieved 2008-06-17. 
  18. ^ McDonald, Kate (2007-04-13). "Tackling skin cancer in organ transplant patients". Australian Life Scientist. http://www.biotechnews.com.au/index.php/id;444900667. Retrieved 2007-12-24. 
  19. ^ "Clinuvel gets green light". Biotechnews.com.au (LifeScientist). 2007-06-11. http://www.biotechnews.com.au/index.php/id;1708412693;fp;16;fpid;1. Retrieved 2008-06-13. 
  20. ^ Baron, ED; Taylor, CR (2007-03-29). "Urticaria, Solar". WebMD. http://www.emedicine.com/derm/topic448.htm. Retrieved 2007-12-26. 
  21. ^ de Martino M, Peruzzi M, Galli L, Lega L, Zammarchi E, Vierucci A (1992). "Food-additive intolerance and its correlation with atopy in children with recurrent or intermittent urticaria-angioedema". Pediatric Allergy and Immunology 3 (1): 33–38. doi:10.1111/j.1399-3038.1992.tb00024.x. http://www3.interscience.wiley.com/journal/119332669/abstract. 

External links


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Up to date as of December 14, 2010

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