URTICARIA

<p>URTICARIA</p><p>Urticaria present with short lived itchy wheel which may be pale or pink in centre surrounded by a red flare in centre.</p><p>They are usually on mouth ,eyelids,or genitals or anywhere in body. Urticaria is the sudden occurrence in the skin of red itchy swollen patches. It appears in one area and disappers quickly in minutes or hours from there, only to reappear in another area. Urticaria may be localized at some part of the body or spread all over the body. Urticaria is a manifestation of allergy. In some people, it comes up only in a particular season; in others, it persists for weeks, months and years, making life miserable.<br> Angioedema<br>, is the rapid edema (swelling) of the deep layers of skin - the dermis, subcutaneous tissue, mucosa and submucosal tissues. Although similar to urticaria (hives), urticaria only occurs in the upper dermis.</p><p>PATHOGENESIS</p><p>It is caused by transient leekage of plasma through small vessels usually as a result of release of histamine through skin mast cell.</p><p>IT IS TYPE 1 HYPERSENSITIVITY REACTION.</p><p>AETIOLOGY</p><p>Drug</p><p>Food</p><p>Inhalants</p><p>Infective</p><p>Food adductive</p><p>Emotional stress</p><p>Type of urtcaria</p><p>• <br>Dermographism<br> is urticaria that develops when the skin is stroked with a firm object.</p><p>• <br>Cold-induced urticaria<br> appears after a person is exposed to low temperatures.</p><p>• <br>Cholinergic urticaria<br>, which is associated with exercise, hot showers and/or anxiety, is a form of hives that is related to release of certain chemicals from parts of the nervous system that controls such body functions as blood pressure and heart rate.</p><p>• <br>Pressure urticaria<br> develops from the constant pressure of constricting clothing such as sock bands, bra straps, belts or other tight clothing.</p><p>• <br>Solar urticaria<br> arises on parts of the body exposed to the sun; this may occur within a few minutes after exposure.</p><p>General considerations</p><p>History</p><p>Even though urticaria is usually an obvious clinical diagnosis,</p><p>a careful history is still important to identify a possible trigger or aggravating factor. Specifically ask the patient about:</p><p>• bites<br> - mosquitoes, sandflies,</p><p>• drug intake<br> - both prescription and nonprescription.</p><p>• food intake<br> - patients will almost always consider</p><p>something in their diet as the cause of their</p><p>urticaria.</p><p>• <br>infection<br> - viral infections are a common cause of</p><p>urticaria in children.1 Bacterial infections such as</p><p>Escherichia coli <br>can also trigger urticaria.</p><p>• <br>duration of lesions<br> - individual lesions typically last</p><p>for less than 24 hours</p><p>• <br>bruising <br> - bruising is not a usual feature of urticaria.</p><p>• <br>physical causes<br> - exposure to cold, pressure, vibration,</p><p>exercise and sun, can all cause urticaria.</p><p>Chronic urticaria is defined as that lasting longer than 6 weeks.</p><p>Examination</p><p>Typical urticaria has a distinctive appearance of raised</p><p>pink papules and plaques scattered randomly any where on the body. Check the surface of the lesions - the epidermis should be normal. If scaling or weeping are present, it is not urticaria.</p><p>Investigations</p><p>full blood count (iron deficiency can be an aggravating</p><p>factor) and erythrocyte sedimentation rate (ESR).</p><p>• creatinine and electrolytes</p><p>• liver functions tests, and</p><p>• thyroid function.</p><p>Homoeopathic Treatment..</p><p>Homoeopathic medicines work towards eliminating the basic sensitivity to develop such a lesion using internal Constitutional remedies. This approach not only successfully treats Urticaria but also removes the tendency to this Hypersensitivity. Urticaria is not just an superficial condition which can be managed with local applications or anti-histamines. We need an Internal medicine to cures the person as a whole.</p>