[47] Urticaria Flashcards

1
Q

What is urticaria also known as?

A

Hives

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2
Q

What is urticaria?

A

A skin rash with red, raised, itchy bumps

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3
Q

What are the timescales of urticaria?

A

Acute or chronic

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4
Q

When does urticaria become chronic?

A

When it lasts over 6 weeks

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5
Q

Is chronic urticaria common in children?

A

No, its rare

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6
Q

What is the underlying cause of acute urticaria?

A

IgE mediated type-I hypersensitivity reaction

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7
Q

What causes the skin lesion of urticaria?

A

Inflammatory reaction in the skin leading to leaky capillaries in the dermis resulting in oedema

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8
Q

How doe the oedema of urticaria subside?

A

When the interstitial fluid is absorbed into the surrounding cells

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9
Q

What are the causes of urticaria?

A
  • Idiopathic
  • Infections
  • Dietary
  • Drugs
  • Plants
  • Hereditary
  • Urticarial vasculitis
  • Physical urticarial
  • Autoimmune
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10
Q

What are some dietary causes of urticaria?

A
  • Fish
  • Shellfish
  • Nuts
  • Eggs
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11
Q

What drugs can cause urticaria?

A
  • Penicillin
  • Aspirin
  • NSAIDs
  • ACE inhibitors
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12
Q

What can cause physical urticaria?

A
  • Water contact
  • Exercise induced
  • Vibratory
  • Cold contact
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13
Q

What autoimmune condition can cause urticaria?

A

SLE

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14
Q

What are the risk factors for urticaria?

A
  • Hay fever

- Asthma

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15
Q

What is acute urticaria characterised by?

A

Short-lived, itchy wheals, angioedema or both

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16
Q

How long do the wheals last in acute urticaria?

A

2-24 hours depending on cause

17
Q

What investigations are required in acute urticaria?

A

None

18
Q

What tests may be require in severe, chronic urticaria?

A
  • FBC
  • ESR
  • TFT
  • ANA
  • LFT
  • IgE
  • Allergy testing
  • Physical challenge
19
Q

What are the differentials of urticaria?

A
  • Drug eruptions
  • Stevens-Johnson syndrome
  • Erythema multiforme
20
Q

How can urticaria be managed?

A
  • Avoid trigger
  • Non-sedating antihistamine
  • Menthol 1% in aqeuos cream to sooth itch
21
Q

When may short-term prednisolone be indicated?

A

If child remains symptomatic on maximal antihistamine dose

22
Q

What other medications may be useful?

A
  • H2 blocker
  • Anti-leukotrienes
  • Adrenaline
23
Q

When should a referral to dermatologist be made?

A
  • Severe acute urticaria
  • Failure of treatment
  • Chronic urticaria lasting > 6 weeks