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Urticaria

This document provides an overview of urticaria (nettle rash), including its classification, causes, symptoms, diagnosis, and treatment approaches. Urticaria can be acute (<6 weeks) or chronic (>6 weeks) and is often caused by allergic reactions, infections, or physical stimuli. Common symptoms are itchy wheals and swelling under the skin that last less than 24 hours. Diagnosis is based on history and physical exam. Treatment focuses on avoiding triggers, using antihistamines, and addressing any underlying causes. Chronic urticaria can be more difficult to treat and may require additional immunosuppressants. Angioedema involves deeper swelling in the dermis or subcutaneous tissue.

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Ivan Ho
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190 views16 pages

Urticaria

This document provides an overview of urticaria (nettle rash), including its classification, causes, symptoms, diagnosis, and treatment approaches. Urticaria can be acute (<6 weeks) or chronic (>6 weeks) and is often caused by allergic reactions, infections, or physical stimuli. Common symptoms are itchy wheals and swelling under the skin that last less than 24 hours. Diagnosis is based on history and physical exam. Treatment focuses on avoiding triggers, using antihistamines, and addressing any underlying causes. Chronic urticaria can be more difficult to treat and may require additional immunosuppressants. Angioedema involves deeper swelling in the dermis or subcutaneous tissue.

Uploaded by

Ivan Ho
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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URTICARIA

Nettle rash
Hebberden abad 18
Laws Milton
Osler

nettle rash
angioedema

angioneurotic oedema

Classification

Acute urticaria
Physical urticaria
Chronic urticaria and angioedema
Urticaria vasculitis

ACUTE URTICARIA
<6W
IgE mediated hypersensitivity
Etiology :
- Cytomegalovirus
Coxsackie A
Hepatitis B Viruses
- > 40 % upper respiratory infection
- Infancy
- dairy products
- Adults
- > 50% food items :
peanuts, shellfish
fruits, sesame seed

Clinical features
- Wheals and swellings < 24 h
- Systemic symptoms ; head ache,
gastrointestimal upset wheezing
Pruritus >

Diagnosis

< 24 h
History of food or drug intake
Infection provoked
Prick test
confirm
Oral challenge test X (not recommended)
Dift count
ESR
not helpful
Total serum IgE

Treatment
Non medicameutos therapy :
a cool bedroom , ligh bed clothes
calamine lotion, tepid
shower
Medicamentos therapy :
- AH, first gen
- AH, 2 nd , 3 rd gen
For angioedeme oropharmx :
- Cedrenaline SC 0.5 mg / 0.5 cc
- Ephedrine 2% nebulizer
- Short tapp converse of corticosteroid !

Physical urticarias :
- as urticaria reaction to physical stimuli
Type of urticaria

Nature of stimulus

s. Dermographism
(factitious urticaria)

Shearing force

Delayed p urticaria

Perpendiculare of

Cold urticatia

lowering temp of skin

Heat urticatia

Reasing temp of skin

Solar urticatia

Sun exposure

Vibratory urticatia

High frequency, oscilation

Cholinergic urticatia

Rise in core temp of body , emotion

Aquagenic urticatia

Wetting urticaria

Management
PUVA
S. dermographism
Delayed pressured urticaria
poorly to therapy
chronicity
cetirizine and a potent topical
corticosteroid
Cold urticaria
- responsible to low sedation AH 1
Cholinergic urticaria
Strees
Systemicc symtoms
Tx : - AH 1
- Anabolic steroid
- Anxiolytic agent

Heat urtica
AH 1 moderately responsive ria
Aqua genic urticaria
- AH 1
- PUVA
Solar urticaria
- AH 1
- PUVA
Vibratory urticaria
- AH 1- specially terfenadine derived

CHRONIC URTICARIA AND ANGIOEDEMA


> 6 weeks
15 % of population USA
5 % of population UK
disabling condition
personal, social and occupational handicap
Etiology : - Candidosis
- Helicobacter phylari infection
- Parasite infection
- HIV infection
no confirmed

Pathogenesis ;
- Under autoimmun
TYPE1A
IgG antiIgE auto antibody

TYPE 1 IgG
anti FegRI auto
antibody

Degranulation Release of
histamine and other mediators

DX

autologous serum
Skin test

TX Supportive

cool enviroment
Woollen clothes
a tepid shower
nocturnal itching
alcohol
stress
Symptomatic maintstay H1 anti histamin
combine of low sedation AH1 and
a sedative AH at night
Cyclosporine 3.5 4.0 ng/kg/day
Immunoglubolin IV
Plasmopheresis

URTICARIA VASCULITIS

O Donnell and Black


Chronic urticaria idiopatic
Chronic urticaria symptom and sign
Early sign of systemic lupus
2 % - 20 %
Sign : - Widespread wheals
- Teider and painful
- > 24 h
- Fibrin deposition palpaple
- Arthralgie
- Livedo reticularis
- Episcleritis
Dx : Biopsi : Histologic fiding
- Post capillary venuter endothelial
- Leuko cytooclasis
- Fibrin deposition

Tx : - AH 1
- Oral Steroid
- Recommended :
- Colchicine
- Dapson
- Anti malaria
- Azathioprine

Angioedema
The pathology in the deep dermis & subcutan tissue
swelling as major manifestation, less pruritic
Pain or burning (+)
Overlying skin: erythema +/ Pathomechanisme same as urticaria

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