Hives (urticaria): Difference between revisions
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'''Urticaria''', also known as '''hives''', is a dermatological medical condition in which red itchy bumps form on the skin. Hives are usually caused by an [[allergic]] reaction to a food or medication. People with allergies are more prone to develop urticaria; stress and infections can also cause it.<ref> {{cite web | url = http://www.nlm.nih.gov/medlineplus/hives.html | title = Hives (Urticaria) | accessdate = 2011-06-01}}</ref> | '''Urticaria''', also known as '''hives''', is a dermatological medical condition in which red itchy bumps form on the skin. Hives are usually caused by an [[allergic]] reaction to a food or medication. People with allergies are more prone to develop urticaria; stress and infections can also cause it.<ref> {{cite web | url = http://www.nlm.nih.gov/medlineplus/hives.html | title = Hives (Urticaria) | accessdate = 2011-06-01}}</ref> Physical exercise may also cause hives.<ref> {{cite web | url = http://www.aafp.org/afp/2001/1015/p1374.html | title = Hives and Exercise–What It Means and What to Do | accessdate = 2011-06-02 | work = Am Fam Physician. 2001 Oct 15;64(8):1374.}}</ref> | ||
==Symptoms== | ==Symptoms== | ||
Itching and the formation of red welts, called [[wheals]], typify hives. The wheals have clearly defined edges and appear individually or eventually group together forming large reddish formations. A wheal when pressed in the center will turn white: this is called blanching. The wheals can disappear within minutes or remain for hours. "A hive often will go away in 24 hours or less, but bouts can last longer."<ref>{{cite web | url = http://www.aad.org/skin-conditions/dermatology-a-to-z/hives/diagnosis-treatment/hives-diagnosis-treatment-and-outcome | title = Hives: Diagnosis, treatment, and outcome | accessdate = 2011-06-01}}</ref> | Itching and the formation of red welts, called [[wheals]], typify hives. The wheals have clearly defined edges and appear individually or eventually group together forming large reddish formations. A wheal when pressed in the center will turn white: this is called blanching. The wheals can disappear within minutes or remain for hours. "A hive often will go away in 24 hours or less, but bouts can last longer."<ref>{{cite web | url = http://www.aad.org/skin-conditions/dermatology-a-to-z/hives/diagnosis-treatment/hives-diagnosis-treatment-and-outcome | title = Hives: Diagnosis, treatment, and outcome | accessdate = 2011-06-01}}</ref> | ||
== | ==Diagnosis== | ||
A | ===Physical examination=== | ||
A healthcare provider can visually diagnose the presence of hives, and tests can determine whether the cause is an allergy. | |||
The presence of [[angioedema]] is important. | |||
===Laboratory tests=== | |||
Laboratory tests are rarely helpful.<ref name="pmid21875543">{{cite journal| author=Tarbox JA, Gutta RC, Radojicic C, Lang DM| title=Utility of routine laboratory testing in management of chronic urticaria/angioedema. | journal=Ann Allergy Asthma Immunol | year= 2011 | volume= 107 | issue= 3 | pages= 239-43 | pmid=21875543 | doi=10.1016/j.anai.2011.06.008 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21875543 }} </ref> [[Clinical practice guideline]]s vary in their recommendations: | |||
* Joint Task Force on Practice Parameters: Complete blood count, urinalysis, [[liver function test]]s, [[erythrocyte sedimentation rate]], and [[thyroid-stimulating hormone]]<ref name="pmid11190256">{{cite journal| author=Joint Task Force on Practice Parameters| title=The diagnosis and management of urticaria: a practice parameter part I: acute urticaria/angioedema part II: chronic urticaria/angioedema. Joint Task Force on Practice Parameters. | journal=Ann Allergy Asthma Immunol | year= 2000 | volume= 85 | issue= 6 Pt 2 | pages= 521-44 | pmid=11190256 | doi= | pmc= | url= }} </ref> | |||
* British Association of Dermatologists: complete blood count, [[erythrocyte sedimentation rate]]<ref name="pmid11298527">{{cite journal| author=Grattan C, Powell S, Humphreys F, British Association of Dermatologists| title=Management and diagnostic guidelines for urticaria and angio-oedema. | journal=Br J Dermatol | year= 2001 | volume= 144 | issue= 4 | pages= 708-14 | pmid=11298527 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11298527 }} </ref> | |||
If patients only have [[angioedema]], C1 esterase inhibitor may be measured. | |||
==Treatment== | ==Treatment== | ||
No treatment | No treatment may be needed for mild hives. Patients can take an [[antihistamine]] such as diphenhydramine to help reduce the itching and swelling. Patients who have throat swelling due to hives may receive [[epinephrine]] (adrenaline) or steroids. In some severe cases those same medications may be used to treat the condition. | ||
For chronic urticaria, [[omalizumab]] is a "an anti-IgE; a recombinant humanised monoclonal [[antibody]] which specifically binds to the C epsilon3 domain of immunoglobulin (Ig) E, the site of high-affinity IgE receptor binding"<ref>{{MeSH|omalizumab}}</ref>that may help.<ref name="pmid21762974">{{cite journal| author=Saini S, Rosen KE, Hsieh HJ, Wong DA, Conner E, Kaplan A et al.| title=A randomized, placebo-controlled, dose-ranging study of single-dose omalizumab in patients with H(1)-antihistamine-refractory chronic idiopathic urticaria. | journal=J Allergy Clin Immunol | year= 2011 | volume= 128 | issue= 3 | pages= 567-573.e1 | pmid=21762974 | doi=10.1016/j.jaci.2011.06.010 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21762974 }} </ref> | |||
==Potential complications== | ==Potential complications== | ||
Complications include [[anaphylaxis]] and swelling in the throat.<ref> {{cite web | url = http://www.nlm.nih.gov/medlineplus/ency/article/000845.htm | title = Hives | accessdate = 2011-06-01 | last = Berman | first = Kevin}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 10:08, 30 September 2011
Urticaria, also known as hives, is a dermatological medical condition in which red itchy bumps form on the skin. Hives are usually caused by an allergic reaction to a food or medication. People with allergies are more prone to develop urticaria; stress and infections can also cause it.[1] Physical exercise may also cause hives.[2]
Symptoms
Itching and the formation of red welts, called wheals, typify hives. The wheals have clearly defined edges and appear individually or eventually group together forming large reddish formations. A wheal when pressed in the center will turn white: this is called blanching. The wheals can disappear within minutes or remain for hours. "A hive often will go away in 24 hours or less, but bouts can last longer."[3]
Diagnosis
Physical examination
A healthcare provider can visually diagnose the presence of hives, and tests can determine whether the cause is an allergy.
The presence of angioedema is important.
Laboratory tests
Laboratory tests are rarely helpful.[4] Clinical practice guidelines vary in their recommendations:
- Joint Task Force on Practice Parameters: Complete blood count, urinalysis, liver function tests, erythrocyte sedimentation rate, and thyroid-stimulating hormone[5]
- British Association of Dermatologists: complete blood count, erythrocyte sedimentation rate[6]
If patients only have angioedema, C1 esterase inhibitor may be measured.
Treatment
No treatment may be needed for mild hives. Patients can take an antihistamine such as diphenhydramine to help reduce the itching and swelling. Patients who have throat swelling due to hives may receive epinephrine (adrenaline) or steroids. In some severe cases those same medications may be used to treat the condition.
For chronic urticaria, omalizumab is a "an anti-IgE; a recombinant humanised monoclonal antibody which specifically binds to the C epsilon3 domain of immunoglobulin (Ig) E, the site of high-affinity IgE receptor binding"[7]that may help.[8]
Potential complications
Complications include anaphylaxis and swelling in the throat.[9]
References
- ↑ Hives (Urticaria). Retrieved on 2011-06-01.
- ↑ Hives and Exercise–What It Means and What to Do. Am Fam Physician. 2001 Oct 15;64(8):1374.. Retrieved on 2011-06-02.
- ↑ Hives: Diagnosis, treatment, and outcome. Retrieved on 2011-06-01.
- ↑ Tarbox JA, Gutta RC, Radojicic C, Lang DM (2011). "Utility of routine laboratory testing in management of chronic urticaria/angioedema.". Ann Allergy Asthma Immunol 107 (3): 239-43. DOI:10.1016/j.anai.2011.06.008. PMID 21875543. Research Blogging.
- ↑ Joint Task Force on Practice Parameters (2000). "The diagnosis and management of urticaria: a practice parameter part I: acute urticaria/angioedema part II: chronic urticaria/angioedema. Joint Task Force on Practice Parameters.". Ann Allergy Asthma Immunol 85 (6 Pt 2): 521-44. PMID 11190256. [e]
- ↑ Grattan C, Powell S, Humphreys F, British Association of Dermatologists (2001). "Management and diagnostic guidelines for urticaria and angio-oedema.". Br J Dermatol 144 (4): 708-14. PMID 11298527. [e]
- ↑ Anonymous (2024), omalizumab (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Saini S, Rosen KE, Hsieh HJ, Wong DA, Conner E, Kaplan A et al. (2011). "A randomized, placebo-controlled, dose-ranging study of single-dose omalizumab in patients with H(1)-antihistamine-refractory chronic idiopathic urticaria.". J Allergy Clin Immunol 128 (3): 567-573.e1. DOI:10.1016/j.jaci.2011.06.010. PMID 21762974. Research Blogging.
- ↑ Berman, Kevin. Hives. Retrieved on 2011-06-01.