What is urticaria?
Urticaria or hives are common skin eruptions. They are characterized by a short-lasting, reddish flat elevation of the skin associated with significant itching. They often disappear in one area and may reappear in another. Sometimes, they are associated with swelling around the eyes, lips, hands, and feet. This is known as angioedema.
What are the common causes of urticaria?
Urticaria is a very common condition. Sudden onset of urticaria (of less than 6 weeks duration, is described by dermatologists as acute urticaria) could be related to viral fever, drug allergy, insect bites, or food allergy. Chronic urticaria may be associated with thyroid disease, autoimmune conditions, chronic infections such as Hepatitis B or C.
Is urticaria dangerous?
Usually, urticaria is a self-limiting condition, which resolves by itself. Only symptomatic treatment is given. However, very rarely, some people develop swelling over the lips, hands, feet, and eyes. This is called angioedema. If left unchecked, then they can go on to develop difficulty in swallowing and breathing, which could have very serious consequences, if not addressed immediately. Angioedema is one of the rare dermatological emergencies.
What are the tests needed for a patient with urticaria?
The common tests which are prescribed for a patient with urticaria are to rule out any urticaria associated conditions like thyroid disorders, autoimmune conditions, chronic infections such as Hep C and Hep B, and basic blood work to ascertain the body’s ability to tolerate any medication which may need to be prescribed.
What foods should a person with urticaria avoid?
The person with urticaria should avoid foods that are rich in histamine like cheese, preserved foods, canned foods, foods with additives, fast food, fermented foods. Some patients may have also noted an increase in urticaria with gluten and eggs.
What is the treatment for urticaria?
The mainstay of urticaria treatment is oral antihistamines. There are many antihistamines, the choice of the primary agent is often the choice of treating dermatologist. Some of them are sedative and are best reserved for taking at bedtime. If the patient does not respond to one antihistamine, the dermatologist may offer a higher dose or a combination of different antihistamines.
There is a role of oral steroids and immunosuppressants in patients who do not respond to routine treatments.
Angioedema has to be treated as a dermatological emergency and treated in a hospital setting. Treatments include oral and injectable steroids, oral and injectable antihistamines, and if needed adrenaline.