aka hives
Release of histamine and other pro-inflammatory cytokines by mast cells.
May be associated with angioedema and flushing of the skin - can be acute or chronic
Causes
Exogenous interactions
- Allergies to food, medications or animals
- Contact with chemicals, latex or stinging nettles
- Medications
- Viral infections
- Insect bites
- Dermatographism (rubbing of the skin)
Chronic urticaria
Can be with or without a trigger. Triggers can be
- Sunlight
- Temperature change
- Exercise
- Strong emotions
- Hot or cold weather
- Pressure (dermatographism)
Management
Antihistamines are the main treatment for urticaria.
Fexofenadine is usually the antihistamine of choice for chronic urticaria.
Oral steroids may be considered as a short course for severe flares.
In very problematic cases referral to a specialist may be required to consider treatment with:
- Anti-leukotrienes such as montelukast
- Omalizumab, which targets IgE
- Cyclosporin