- Dermatology Unit, Conditions
Urticaria
What is
What is urticaria?
Urticaria is a very common disorder characterized by the appearance of wheals or hives on the skin. These wheals are itchy and evanescent, i.e. they disappear in less than 24 hours, although new ones may appear in other locations.
Information
Causes
Who may be affected
The diagnosis is fundamentally clinical, and is made by clinical history and physical examination. If at the time of the visit the patient does not present lesions, it is helpful to provide photos taken when he/she did present lesions.
An exhaustive interrogation will be carried out in order to find any possible trigger, and in cases of chronic urticaria without apparent cause, an analytical study will be carried out to determine any possible associated cause.
Types of urticaria
Urticaria is divided into 2 main groups according to the time of evolution.
Acute urticaria is defined as urticaria that has been present for less than 6 weeks, and chronic urticaria is defined as urticaria that has been present for more than 6 weeks.
In addition, chronic urticaria can be separated into two subgroups:
- Physical urticaria: These are caused by stimuli external to the body, capable of producing the release of mediators, thus triggering urticaria. These include sun, cold, water, pressure or vibration.
- Idiopathic chronic urticariaIdiopathic chronic urticaria: In the vast majority of cases no trigger can be identified, although it is necessary to rule out the association to some factors, among which we find drugs, mainly anti-inflammatory drugs (NSAIDs, such as ibuprofen). It is also known that some foods can trigger or worsen it, such as milk, eggs, shellfish, fish, cereals or nuts, as well as insect bites.
Treatment
Treatment is based on 2 basic pillars: the first consists of avoiding the triggering drugs or situations that provoke urticaria, and the second is the administration of antihistamines, preferably second-generation antihistamines with a lower sedative profile, at high doses.
If the lesions are not controlled with an antihistamine at full doses, the drug should be changed or combined with a second antihistamine.
If this does not achieve symptom control, immunosuppressive drugs or a relatively recently marketed biologic drug called Omalizumab, which has been shown to be effective in the treatment of chronic urticaria, are indicated.
The disadvantage of this therapy is its high cost. On the other hand, immunosuppressive drugs can also be effective, although their potential risk of adverse effects must be weighed in the balance.
FAQs
Who can be affected by urticaria?
The diagnosis is fundamentally clinical, and is made by clinical history and physical examination. If at the time of the visit the patient does not present lesions, it is helpful to provide photos taken when he/she did present lesions.
An exhaustive interrogation will be carried out in order to find any possible trigger, and in cases of chronic urticaria without apparent cause, an analytical study will be carried out to determine any possible associated cause.