Urticaria

Question 1

What is it?

Answer 1

Superficial swelling of epidermis and mucous membranes
Can get angio-oedema deeper form swelling in dermis

Question 2

What are the causes?

Answer 2

Acute
- Viral infection
- Food/other non drug allergy
- Drug allergies e.g. penicillin, ACEi

Chronic
- spontaneous
- NSAIDs
- Viral infections and H.pylori
- Autoimmune including thyroiditis
- Extreme Temperatures

Question 3

What are the clinical features?

Answer 3

Red, (pale centre initially) raised and extremely itching rash
Angio-oedema often affects face, tongue, genitals, hand and feet
Consider vasculitic cause if painful and persists despite initial management

Question 4

What is the management?

Answer 4

Acute- often self limiting
Treat underlying cause

Chronic
- non sedating antihistamine OD for 6 weeks- can increase if treatment inadequate
- Severe symptoms- oral steroids for up to 7 days
- 50% of chronic go into remission
- refer to dermatology if above fail for ?long term immunosuppressants

Question 5

What are complications?

Answer 5

Skin infection from excoriation
Scarring
Psychological- poor sleep, social isolation, anxiety and depression