The term "urticaria" (aka urticaria) together under a group of diseases with similar clinical picture: itchy rash of blisters on the type, resembling a trace of burning nettle. Localization rash can be limited to any one part of the body or totally distributed throughout its surface. If the rash completely disappears for a time period not exceeding 6 weeks, then one speaks of acute urticaria. In more rare cases rash persists for years have chosen not wanting to leave the territory. In such cases, it leads to chronic hives.
Symptoms and types of hives
Symptoms of hives
Overriding clinical manifestations of urticaria - voldyreobraznaya rash, some elements of which may have a size from a couple of millimeters to a dozen centimeters in diameter. Skin rashes over time fade and disappear, but in their place, and often in an absolutely pristine parts of the body before there are new blisters, causing quite a significant itching and a burning desire to scratch.
Acute urticaria
In most cases, urticaria is a temporary phenomenon: suddenly appeared, it increases the severity of their presence within 8-12 hours, and 24-48 hours later, then gradually eroding.
Chronic urticaria
Another thing - chronic urticaria, manifestations of which are sometimes unpredictable. Typically, the clinical picture of this form urticaria can be represented as a sine wave, and is characterized by 6-12-week acute attacks, which are followed by periods of remission. The sharpening can be associated with exposure to certain triggers, which will be discussed below. Approximately 10% of patients with chronic urticaria are dominated by unpleasant symptoms during the time that lasts the disease. Clinical signs of chronic urticaria tend to get worse in the evening, which can cause problems falling asleep.
Urticaria vasculitis
It is not often, but, nevertheless, it happens that affects urticaria shallow blood vessels of the skin and cause an inflammation. In this case we speak about urticaria vasculitis (angina): it lasts more than 24 hours, and basic markers of disease - blisters - is quite painful to the touch and may leave a small scar. Urticaria vasculitis treatment requires not only an allergist and dermatologist.
Causes of urticaria
Urticaria caused massive local (s.c.) release of histamine and other mediators of inflammation, catalyzing the respective skin reactions.
Causes of acute urticaria
Factors that trigger chain reactions, causing an acute urticaria, about half of the cases remain unsolved. In general, those are:
The 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 the release of large amounts of histamine, thereby triggering skin reactions.
However, the real cause of chronic urticaria is not established yet. It is known that it may develop in combination with other autoimmune pathologies such as rheumatoid arthritis and systemic lupus erythematosus ("lupus").
Chronic urticaria, as, indeed, and severe, often begins under the influence of any trigger factors, such as the same stress, alcohol, caffeine, hot, squeezing the skin (eg - in tight clothes), certain nutritional supplements (salicylates, and others. ).
Treatment of urticaria
Treatment of acute urticaria
In most cases, urticaria not require any special treatment, because its symptoms are relatively mild and tested within a few days.
If the situation is not so optimistic, and signs of acute urticaria are more serious and do not want to pass, it's time to call for help antihistamines that blocking the effects of histamine, relieve itching and eliminate rashes. Here are just a few representatives of this group of drugs: cetirizine (allertek, Zyrtec, tsetrin), fexofenadine (Telfast, Rapid, feksofast, dinoks), loratadine (klarisens, lomilan, allergoferon, erius).
Modern antihistamines - this is not the relic diphenhydramine, causing drowsiness and sedation, though, lightly-irresponsible "cocktail" of alcohol, even ultra antihistamines may trigger a lowering of consciousness until his loss. If due to the symptoms of urticaria in a patient are present trouble falling asleep, in this case, you can kill two birds with appointing an antihistamine that promotes falling asleep: tavegil or Atarax.
But not by antihistamines alone ... In case of severe symptoms of the disease can be cut short by a short-term (3-5 days) receiving glucocorticoids, for example, this role can perform the same test of time prednisone. Preparations of this group suppress the immune system, and thus mitigate the symptoms of urticaria. Long-term use of glucocorticoids can cause side effects like plume of high blood pressure, glaucoma, cataracts and diabetes (or worsen during the last).
Treatment of chronic urticaria
As for the treatment of chronic urticaria, the situation is somewhat more complicated. It is possible to use the same antihistamines or glucocorticoids, taking them regularly and progressively increasing the dosage under medical supervision until the moment when the symptoms start to fade. Such a new antihistamine, as Spanish rupatadin (rupafin), well proven in the treatment of difficult flowing urticaria.
In the treatment of chronic urticaria, and this method is used, known as narrowband phototherapy. It is based on impact on a patient's skin high-intensity ultraviolet irradiation. To do this, several (2 to 5) times per week visit dedicated cabinet for completion of this procedure. Total for the improvement of the clinical picture may need about 20 of these sessions.
Leukotriene receptor antagonists (montelar, singular, ektalust, akolat) may help relieve redness and swelling of the skin. In the long term, they can serve as a good alternative to glucocorticoids, as not causing such unpleasant side effects.
Powerful drug cyclosporine (panimun Bioran, ekoral) has proven effective in the treatment of urticaria in 2/3 cases. Its operating principle is similar to that of glucocorticoids: cyclosporin eliminates the negative effects of the immune system. It should be noted that, as confirmed by the results of clinical trials, the longer used cyclosporin, the less its efficiency. Therefore, you should not use this medicine for more than 5 months, after which its effectiveness is only 25%.
And, of course, if you know the triggers that cause aggravation of urticaria in the individual patient, it is good to get out of their destructive influence. Factors provocateurs, like alcohol and caffeine can be easily erased from life. Since stress is more complicated, however, you should try to pry yourself from the clutches of making another step on the way to get rid of hives. In some cases, bad trigger relaxation techniques such as meditation or hypnosis, which can relieve stress and alleviate the symptoms of the disease.
Symptoms and types of hives
Symptoms of hives
Overriding clinical manifestations of urticaria - voldyreobraznaya rash, some elements of which may have a size from a couple of millimeters to a dozen centimeters in diameter. Skin rashes over time fade and disappear, but in their place, and often in an absolutely pristine parts of the body before there are new blisters, causing quite a significant itching and a burning desire to scratch.
Acute urticaria
In most cases, urticaria is a temporary phenomenon: suddenly appeared, it increases the severity of their presence within 8-12 hours, and 24-48 hours later, then gradually eroding.
Chronic urticaria
Another thing - chronic urticaria, manifestations of which are sometimes unpredictable. Typically, the clinical picture of this form urticaria can be represented as a sine wave, and is characterized by 6-12-week acute attacks, which are followed by periods of remission. The sharpening can be associated with exposure to certain triggers, which will be discussed below. Approximately 10% of patients with chronic urticaria are dominated by unpleasant symptoms during the time that lasts the disease. Clinical signs of chronic urticaria tend to get worse in the evening, which can cause problems falling asleep.
Urticaria vasculitis
It is not often, but, nevertheless, it happens that affects urticaria shallow blood vessels of the skin and cause an inflammation. In this case we speak about urticaria vasculitis (angina): it lasts more than 24 hours, and basic markers of disease - blisters - is quite painful to the touch and may leave a small scar. Urticaria vasculitis treatment requires not only an allergist and dermatologist.
Causes of urticaria
Urticaria caused massive local (s.c.) release of histamine and other mediators of inflammation, catalyzing the respective skin reactions.
Causes of acute urticaria
Factors that trigger chain reactions, causing an acute urticaria, about half of the cases remain unsolved. In general, those are:
- food allergy, such as peanuts, shrimp eggs or cheese;
- allergies to environmental factors (pollen, dust mites or chemical substances);
- latex allergy, which is characteristic for healthcare professionals;
- infection: from the banal to the SARS HIV;
- insect bites;
- emotional distress;
- side effects of certain medications, including antibiotics, NSAIDs, and antihistamines;
- physical factors such as mechanical or thermal effects on the skin, sunlight and water.
The 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 the release of large amounts of histamine, thereby triggering skin reactions.
However, the real cause of chronic urticaria is not established yet. It is known that it may develop in combination with other autoimmune pathologies such as rheumatoid arthritis and systemic lupus erythematosus ("lupus").
Chronic urticaria, as, indeed, and severe, often begins under the influence of any trigger factors, such as the same stress, alcohol, caffeine, hot, squeezing the skin (eg - in tight clothes), certain nutritional supplements (salicylates, and others. ).
Treatment of urticaria
Treatment of acute urticaria
In most cases, urticaria not require any special treatment, because its symptoms are relatively mild and tested within a few days.
If the situation is not so optimistic, and signs of acute urticaria are more serious and do not want to pass, it's time to call for help antihistamines that blocking the effects of histamine, relieve itching and eliminate rashes. Here are just a few representatives of this group of drugs: cetirizine (allertek, Zyrtec, tsetrin), fexofenadine (Telfast, Rapid, feksofast, dinoks), loratadine (klarisens, lomilan, allergoferon, erius).
Modern antihistamines - this is not the relic diphenhydramine, causing drowsiness and sedation, though, lightly-irresponsible "cocktail" of alcohol, even ultra antihistamines may trigger a lowering of consciousness until his loss. If due to the symptoms of urticaria in a patient are present trouble falling asleep, in this case, you can kill two birds with appointing an antihistamine that promotes falling asleep: tavegil or Atarax.
But not by antihistamines alone ... In case of severe symptoms of the disease can be cut short by a short-term (3-5 days) receiving glucocorticoids, for example, this role can perform the same test of time prednisone. Preparations of this group suppress the immune system, and thus mitigate the symptoms of urticaria. Long-term use of glucocorticoids can cause side effects like plume of high blood pressure, glaucoma, cataracts and diabetes (or worsen during the last).
Treatment of chronic urticaria
As for the treatment of chronic urticaria, the situation is somewhat more complicated. It is possible to use the same antihistamines or glucocorticoids, taking them regularly and progressively increasing the dosage under medical supervision until the moment when the symptoms start to fade. Such a new antihistamine, as Spanish rupatadin (rupafin), well proven in the treatment of difficult flowing urticaria.
In the treatment of chronic urticaria, and this method is used, known as narrowband phototherapy. It is based on impact on a patient's skin high-intensity ultraviolet irradiation. To do this, several (2 to 5) times per week visit dedicated cabinet for completion of this procedure. Total for the improvement of the clinical picture may need about 20 of these sessions.
Leukotriene receptor antagonists (montelar, singular, ektalust, akolat) may help relieve redness and swelling of the skin. In the long term, they can serve as a good alternative to glucocorticoids, as not causing such unpleasant side effects.
Powerful drug cyclosporine (panimun Bioran, ekoral) has proven effective in the treatment of urticaria in 2/3 cases. Its operating principle is similar to that of glucocorticoids: cyclosporin eliminates the negative effects of the immune system. It should be noted that, as confirmed by the results of clinical trials, the longer used cyclosporin, the less its efficiency. Therefore, you should not use this medicine for more than 5 months, after which its effectiveness is only 25%.
And, of course, if you know the triggers that cause aggravation of urticaria in the individual patient, it is good to get out of their destructive influence. Factors provocateurs, like alcohol and caffeine can be easily erased from life. Since stress is more complicated, however, you should try to pry yourself from the clutches of making another step on the way to get rid of hives. In some cases, bad trigger relaxation techniques such as meditation or hypnosis, which can relieve stress and alleviate the symptoms of the disease.
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