Urticaria

Question 1

What are hives?

Answer 1

Common disorder, approximately 20% of the general population
Typical lesion is intensely pruritic, erythematous plaque
May be accompanied by angiodema
Can be considered acute (present less than 6 weeks) or chronic (is recurrent, with signs and symptoms recurring most days of the week, for six weeks or longer)

Question 2

Describe the appearance of urticaria

Answer 2

Smooth, slightly elevated, discoloured area on the body surface, often accompanied by severe itching
May be round or oval and vary in size
Intense itch, symptoms often seem most severe at night

Question 3

Describe the pathophysiology of urticaria

Answer 3

Medicated by cutaneous mast cells and basophils in the superficial dermis. They release multiple mediators upon activation, including histamine, which cause itching and vasodilatory mediators, which cause localized swelling in the uppermost layers of the skin

Question 4

What is the cause of urticaria?

Answer 4

Allergic reaction (foods, medicines, insect bites and stings, animals, pollen, latex)
Infections
Illness
Exposure to sun, heat, cold or water
Exercise
Stress
Contact with chemicals
Scratching or itching

Question 5

What is the recommended treatment for acute urticaria?

Answer 5

Histamine H1 blockers (first-line)

H2 blockers

Question 6

When would you refer a patient?

Answer 6

Refer suspected cases of anaphylaxis to emergency care immediately