Condition- Urticaria

Question 1

What is a common complication of urticaria and in what % of patients does this develop?

Answer 1

ANGIOOEDEMA

Develops in 40% of sufferers

Question 2

Describe the pathophysiology of urticaria

Answer 2

1. Mast cell degranulation
2. Release of inflammatory mediators
3. Vasodilation + increased vascular permeability
4. => erythema + angiooedema

Question 3

List some of the causes of urticaria

Answer 3

The 5Is

• Infection
• Injection with drugs/ insect venom
• Inhalation of dust, mould, pollen
• Ingestion of food, drugs, chemicals
• Internal disease (autoimmune)

Question 4

Describe the timescales of acute and chornic urticaria

Answer 4

Acute < 6weeks

Chronic > 6 weeks

Question 5

List some of the causes of Chronic Urticaria

Answer 5

• Idiopathic
• Infectious
• Medications
• Stress
• Autoimmune

Question 6

Which dermatological lesion can be seen in thi photo. Describe the apearrance of the lesion and how a patient might generally present

Answer 6

URTICARIA

• erythematous, oedematous, pruritic, non-blanching lesion
• Usually resolves within 24hrs
• May show signs of angiooedema= swelling of lips, face and tongue

Question 7

Urticaria may be described as non-blanching. What does this mean?

Answer 7

Turns pale on palpation

Question 8

What might be heard on auscultation of a patient with severe urticaria and angiooedema? State a ddx if the rash is non-blanching

Answer 8

Stridor- due to airway obstruction

Non-blanching = Vasculitis

Question 9

List some investigations you might offer to a patient with chronic urticaria

Answer 9

• Blood: FBC, CRP, ESR, IgE, ANA, autoantibodies, TSH (hashimotos)
• Skin patch testing