Urticaria & Angioedema Flashcards

1
Q

Angioedema-Ürtiker Farkı

A

Ürtiker:
swelling of upper dermis cardinal symptom: pruritis

Angioedema:
deep dermiş & subcutaneous, major manifestation is swelling

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2
Q

Describe a typical presentation of urticaria

A

Ürtiker:
Kaşıntısı
Rengi solmuş
etrafı eritemli
deriden eleve
içi ödemli lezyon
ödemli ve şiş el

Lezyon: Wheal
Wheal surrounded by a red halo or flare (area of erythema)
1) Papules and plaques + erythematous area
2) Some of the lesions have their center paler
3) Within minutes some of the lesions will resolve as in this picture and new ones will appear.

A vascular reaction of the skin. Caused by swelling of the upper dermis.

Cardinal symptom is itching

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3
Q

Difference between Acute & Chronic urticaria

A

Akut-Kronik Ayrımı
Akut: 6 haftadan az zaman önce başlamış yeni başlangıçlı ürtiker

Kronik: 6 haftadan uzun sürmüş reküren ürtiker (haftada 2 günden fazla)

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4
Q

What are causing factors of acute & chronic urticaria? + 10 gündür varsa etiyolojide ne düşünürsün?

A

Akut Ürtiker:
İdiyopatik
Enfeksiyon: üst solunum yolu, streptokok, helmintler
Yemek: shellfish, nuts, meyve
İlaç Reaksiyonları
IV Administration: kan ürünleri, kontrast maddeler

Kronik Ürtiker:
İdiyopatik (yarısından fazlası)
Fiziksel (ısı, soğuk, vibrasyon)
Otoimmün
Enfeksiyonlar, ingestions, ilaçlar

Akut en sık enfeksiyon (özellikle çocukta), ikinci ilaç reaksiyonları, üçüncü psedudo? (ilaç alerjen)

Kronik ise %40 idiyopatik, %20 otoimmün, %20 akutun alevlenmesi

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5
Q

Differentiate chronic spontaneous urticaria with chronic inducible urticaria

A

Chronic inducible urticaria is also called physical urticaria.

Chronic inducible urticaria can be divided into different subgroups. Symptomatic dermatographism (dermographism) is the most common form.
> Sharply localized edema or wheal within seconds to minutes after the skin has been rubbed
>Affects 2-5% of the population

Chronic inducible urticaria differs from spontaneous ones in the way that younger patients are mostly affected and they have a longer attack duration.

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6
Q

Describe the tx of urticaria

A

Tedavi
Eğer altta yatan bir neden varsa tedavi edilmeli
Triggering faktörlerden uzak dur

Farmokolojik
H1 antihistamines:

  1. Jenerasyon: diphenyhydramine, hydroxyzine, chlorpheniramine
    First generations due to crossing BBB can cause dizziness, they have cholinergic side effects like dry mouth, blurred vision, urinary retention, due to adrenergic effects tachycardia, due to serotoninergic effects increase in appetite can be seen in the first generation forms.
  2. Jenerasyon: citirizine, levocetrizine, loratadine, desloratidine, fexofenadine, rupatidine, ebastine, acrivastine
    Better tolerated, fewer side effects (because they do not cross BBB)

Açıkla:
Tedavi aralarına düşük doz kortikosteroid ekleyebiliriz. Sistemik kortikosteroidler 3-7 günden uzun süre kullanılmamalıdır.

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7
Q

When would you question urticaria as the correct diagnosis?

A

Aşağıdaki durumlarda dermatolojiye yönlendirilmeli ve bir biyopsi yapılmalı.
1) 48 saatten fazla persiste eden tek lezyon veya lezyonlar
2) Kaşıntıdan ziyade ağrılı veya yanan lezyonlar
3) Lezyonlarda peteşiyel karakter varlığı
4) Sistemik Semptomlar: ateş, yorgunluk, kemik ağrısı, myalgia, arthralgia
5) Antihistaminiklere cevap yoksa
6) Rezolüsyondan sonra pigmentasyon değişikliği bırakan lezyonlar

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8
Q

Name ddx of urticaria

A

Eosinophilic cellulitis
Mastocytosis
Polymorphic eruption of pregnancy
Autoimmune progesteron dermatitis
Autoinflammatory syndromes

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9
Q

Differentiate btw urticaria and angioedema

A

Angioedema-Ürtiker Farkı
Ürtiker: swelling of upper dermis, cardinal symptom is pruritis

Angioedema: deep dermiş & subcutaneous, major manifestation is swelling

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