Urticaria is a very common skin disease and its basic lesion is the wheal. Hives are like welts, intensely itchy and swollen redness. They are characterized by the fact that after a few hours they disappear and may reappear on another area of the body. Hives can appear anywhere (eyelids, lips, extremities). However, those appearing on the palms of the hands and soles of the feet are the most annoying. Angioedema is also a clinical manifestation of urticaria, in which case the edema lasts up to 48 hours. Any person at any age can suffer from urticaria but it is more common in middle-aged women and young adults.
Acute urticaria and chronic urticaria
There are two types of urticaria:
- Acute urticarias that last less than 6 weeks, are very frequent. In the course of a lifetime, 20% of the population may experience acute urticaria. They can be triggered by the ingestion of certain drugs such as aspirin or ibuprofen, or by insect bites or other stimuli. Acute urticaria is not necessarily due to an allergy and non-allergic mechanisms have been implicated.
- Chronic urticaria is urticaria lasting more than 6 weeks. The episode may last from 6 months to 5 or even 10 years, the lesions change position and wheals may appear every day. They affect 1-2% of the population. These chronic urticarias can be of two types: spontaneous or inducible. In spontaneous chronic urticaria, the wheals appear by themselves, without a specific stimulus and can be explained by an autoimmune mechanism, in fact it is often associated with other diseases of this type such as hypothyroidism. Inducible chronic urticaria is provoked by a specific stimulus: cold, heat, increase in body temperature,…
Treatment of urticaria
Urticaria is cured by rapid control of its symptoms, itching and wheals. Although the treatment requires to be maintained for several months . Proper treatment is required as soon as possible. It is a disease that greatly affects the patient’s quality of life. The goal of treatment is to get the person to live a normal life. With an adequate treatment it can be achieved that the urticaria lasts less time, that instead of three years, the wheals for example only appear during one, it is about reducing and redirecting the episodes of urticaria as soon as possible.
The wheals are the consequence of the activation of cells in the dermis: mast cells. When mast cells react to the stimulus they release chemical mediators such as histamine, which is responsible for the itching. It is recommended to treat urticaria with second generation antihistamines (they do not make you sleepy). These stop the redness, itching and swelling. They can be taken as long as necessary. In case of exacerbations, oral cortisone is administered, but never for more than 10 days. A new treatment, omalizumab, which is currently in the registration phase, is an accepted indication for the treatment of urticaria.
It is important that the patient goes to his family doctor or dermatologist for examination, evaluation of the physical stimuli and to have a correct diagnosis of the disease. It is necessary to treat it as soon as possible so that it does not last for a long time. Symptoms should be controlled and triggers should be avoided if known.