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Diagnosis & Specialist Care of Allergy & Clinical Immunology - Since 1982
Understanding Urticaria & Angioedema
Urticaria - also known as hives, weals, welts or nettle rash - is a raised, itchy rash that appears on the skin. It may appear on one part of the body or be spread across large areas. The rash often appears red, but can also match the natural skin colour.
Urticaria is surprisingly common, affecting 1 in 5 people at some point in their lives.
It is often associated with (and occurs alongside) angioedema, which is swelling of the body. Angioedema classically impacts the face, especially the lips, tongue and the region around the eyes. But it can also impact other parts of the body including the neck, hands and feet.
Either urticaria or angioedema can present on their own, or together.
The condition can either be acute or chronic (lasting for 6 weeks or more).
When Does It Occur?
Urticaria occurs when high levels of histamine are released in the affected area. Histamine causes the skin to itch and the blood vessels to dilate and leak fluid which results in redness and swelling.
Urticaria & angioedema can have the following causes:
1) An acute reaction following contact with an allergen (for example a food allergen, or an insect sting).
2) An induced reaction (see below).
3) A spontaneous reaction (the most common form, spontaneous urticaria & angioedema has no obvious trigger).
Inducible urticaria can be triggered by (amongst other things):
Exercise
Hot temperatures
Water (aquagenic urticaria)
Cold temperatures
The sun (solar urticaria)
Skin pressure or friction
Causes vary from person-to-person, but typically a rash will arise within minutes of the trigger, and will last for up to 1 hour. It can arise in patients of any age, and some patients can be affected by more than one type.
Spontaneous urticaria & angioedema
With no obvious cause, the sudden onset of a rash and/or swelling, can be very distressing for patients. Most patients try to identify what the cause may have been, blaming certain foods, make-up or other products. But in many cases there is no cause, leading to a diagnosis of idiopathic spontaneous urticaria & angioedema.
Spontaneous urticaria & angioedema can be chronic in nature (meaning it lasts for 6 weeks or more). The condition can either be continuous over that period, or it can settle down and flare up in a cyclical fashion.
Whilst there is no cause, per se, there are known triggers for this condition which can contribute to flare ups.
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Intercurrent illness/infection
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Stress
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A class of Drugs called NSAIDs such as Asprin & Ibuprofen
Interestingly, up to 30% of patients who suffer with this condition also report co-existing hypothyroidism.
In terms of treatment, a short course of steroids can be helpful to manage an acute flare-up, but they are not advisable for long-term use.
Treatment options
No matter what type or urticaria or angioedema you are suffering with, be it acute or chronic, rest assured that treatment options are available.
The condition is usually managed with antihistamines, but where this is not sufficient, other options are available for instance Xolair (omalizumab therapy).
Arrange an appointment to see a specialist who can determine the nature of your urticaria or angioedema and recommend treatment accordingly.
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