Urticaria

What is it about ?

Urticaria is manifested by raised spots (papules), small or very large, which appear quickly and are accompanied by itching. They appear and disappear, from one place to another, and can develop over a large part of the body.

Triggers:

• allergies to certain components or food products (eg wheat, crustaceans), dyes, preservatives, drugs (eg penicillin type), cosmetics;
• contact with nettles and insect bites or stings;
• sun allergy, exposure to cold, heat and pressure;
• physical exertion, intense emotions;
• factors specific to the body (endogenous) such as infections and certain (rare) diseases of the immune system;
• acute urticaria is often associated with infections (eg viral upper respiratory tract infections)

Often there is no trigger. In this case, it is called idiopathic urticaria.

What is its frequency?

In Belgium, general practitioners see an average of 4 to 5 new patients out of 1,000 consultations each year for urticaria problems. It is estimated that about 1 in 5 people are affected by hives in their lifetime.

How to recognize it?

Urticaria is manifested by raised spots (papules), small or very large, which appear quickly and are accompanied by itching. They appear and disappear, from place to place
other, and can develop over a large area of ​​the body.

We distinguish several types of urticaria:

• The acute hives, which last a maximum of 6 weeks. Sometimes the reaction is so intense that generalized and severe symptoms also occur, such as swelling of the eyelids, swollen tongue, difficulty swallowing, shortness of breath, or even a drop in blood pressure and shock.
• THE’recurrent acute urticaria, characterized by alternating episodes of acute urticaria and periods without symptoms …
• THE’chronic hives, which lasts more than 6 weeks.

How is the diagnosis made?

Urticaria is usually easily recognized. But it is often very difficult to find the cause. Your doctor will first ask you specific questions to get an idea of ​​the possible factors causing the symptoms: How often do you have them? Are the complaints still limited to the skin or are general symptoms also present? Do you have any known allergies? Do you take medication ? Are other family members also affected by the affection? Have you noticed anything in particular when you eat certain foods? Does temperature influence you? Do you work with products that may trigger an allergic reaction?

Additional examinations are only performed in case of severe symptoms, and in the presence of indications of underlying causes or diseases. It usually starts with a blood test and allergy skin tests.

What can you do ?

You can directly contribute to finding the cause of the condition, especially in cases of recurrent and chronic urticaria. For example, you can keep a journal and write in it when you have symptoms and how they are changing. Think about the fact that you may have recently changed some habits (using new cleaning products, cleaning products or cosmetics).

You can prevent a rash that occurs in cold weather or high heat by adapting your clothing.

If no cause is found, you can always try an exclusion diet. In this case, for a while you eat only fresh food, and avoid all dyes and preservatives. Your doctor, dermatologist, dietitian or nutritionist can give you a list of what is allowed and what is not. If the rashes go away this way, you can then reintroduce food one after another. If a rash appears, then the culprit is the last food added.

What can your doctor do?

In case of acute urticaria, the doctor will prescribe an antihistamine. It is an anti-allergic drug. The rashes go away very quickly on their own, without the need for treatment. The antihistamine acts on the itching.

If you have severe general symptoms, your doctor may prescribe cortisone.

In case of shock, an injection of adrenaline will prove to be life-saving.

For chronic urticaria, treatment depends on the identified cause.

Bacterial infections are treated with antibiotics and fungi with antimycotic drugs.

Hives due to cold or heat are sometimes treated in the cabin under ultraviolet light (as with psoriasis) for a month.

If no cause is identified, an antihistamine will be used daily for a longer period to relieve symptoms.

Want to know more?

• Urticaria – mongeneraliste.be – SSMG – Scientific Society of General Medicine
• Urticaria (image) – DermIS – Dermatology Information System

• Antihistamines – CBIP – Belgian Center for Pharmacotherapeutic Information

Source

Foreign clinical practice guide ‘Urticaria’ (2000), updated on 30.05.2017 and adapted to the Belgian context on 01.10.2017 – ebpracticenet