Urticaria Flashcards
What is the duration of acute?
What is the duration of acute?
What is duration of chronic?
> 6 wks, 50% resolve in 6 mo, 20% in 12-36 mo, small amount >36 mo
What is the recurrance rate of chronic urticaria?
25-40%
What is the etiology of urticaria?
Idiopathic Food/Food additives Drugs Physical contact Insect bites Hypersensitivity Infectious diseases Systemic disease
What are the physical causes of urticaria?
Dermatographism Cold Pressure Vibration Heat Sunlight (solar) Emotional stress Exercise
What are acute causes of urticaria?
Infection (40%)
Drug (10%)
Food (≤ 1%)
Idiopathic (50%)
What is the chronic cause of urticaria?
Autoimmune (40-50%)
Chronic Infection (≤5%)
Idiopathic (50%)
Who gets acute urticaria?
common in children
Who gets chronic urticaria?
4th to 5th decades, women
What labs do you want for urticaria?
CBC; Sed rate; Thyroid panel; ANA; RF; serology- Hep B
Parasitology
What skin testing do you do?
allergic extracts, screening for dermatographism
When do you get skin biopsy?
urticaria vasculitis
What is the tx for life threatening urticaria?
ED for resuscitation
What are the meds for urticaria?
Oral Histamines H1 blocker 1st generation Hydroxyzine 25 mg Po q 6 hrs Diphenhydramine 25-50 mg PO q 6-8 hrs H1 blocker 2nd generation Loratadine 10 mg qd Cetirizine 10 mg qd Fexofenadine 180 mg H2 blockers Cimetidine (Tagamet) 300 mg 4 x a day (or 800 mg qd) Famotidine (Pepcid) 40 mg qd Ranitidine (Zantac) 150 mg BID (or 300 mg qd) Tricyclic antidepressant/ antihistamine Doxepin (Sinequan)10-25 mg q 3-4 times a day (or 25-50 mg qd) Glucocorticoids Prednisone 40-60 mg daily x 5 days Not indicated for long term use
What is the treatment for chronic urticaria?
Omalizumab (Xolair)
Monoclonal antibody that binds to IgE and inhibits binding to cell receptors
Doxepin Cream (Zonalon) 5%
Capsaicin
When do you give dermatology referral?
chronic urticaria and urticarial vasculitis
What is the prognosis?
acute - excellent - resolves 1-4 days
chronic - variable
What is duration of chronic?
> 6 wks, 50% resolve in 6 mo, 20% in 12-36 mo, small amount >36 mo
What is the recurrance rate of chronic urticaria?
25-40%
What is the etiology of urticaria?
Idiopathic Food/Food additives Drugs Physical contact Insect bites Hypersensitivity Infectious diseases Systemic disease
What are the physical causes of urticaria?
Dermatographism Cold Pressure Vibration Heat Sunlight (solar) Emotional stress Exercise
What are acute causes of urticaria?
Infection (40%)
Drug (10%)
Food (≤ 1%)
Idiopathic (50%)
What is the chronic cause of urticaria?
Autoimmune (40-50%)
Chronic Infection (≤5%)
Idiopathic (50%)
