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Saturday, May 7, 2011

A Family Doctor's Tale - URTICARIA

DOC I HAVE URTICARIA

Urticaria is an itchy rash that occurs rapidly anywhere on the body.

The rash may occur often simultaneously at multiple sites.

It is usually temporary disappearing after 24 hours although new rashes may occur at other sites.

Urticaria is usually due to known mast cell stimulants although in the majority of cases the cause is unknown.

Urticaria is not contagious and for most patients the condition may be managed well with treatment and avoidance of mast cell stimulants:

1. Certain foods: eggs, nuts, fruits,shellfish, fish, chocolates

2. Certain drugs: antibiotics, NSAIDs

3. Physical stimulants: pressure, sweating, cold temperature, sunlight

4. Infections: viral, bacteria

5. Others: flowers, pollen, beestings, animal furs, soaps

The symptoms and signs of Urticaria are:
1.The rash is typically itchy and appear rapidly as localised red swelling on the skin measuring a few mm to more than 10 cm in size in different shapes.

2.The swelling can also occur on eyelids, lips, palms and soles.

3.Urticaria is usually harmless and disappear within a few days or week.

4.However because it can involve very extensive areas of the body, it can cause a lot of irritation and a lot of anxiety.

5.Very rarely the urticaria can lasts months to years causing disruption to work and social life.

In people with Urticaria, the mast cell stimulant can cause histamine release from mast cells.

The histamine is the predominant chemical which is responsible for the inflammatory response which leads to changes of the blood vessels of the skin.

This leads to more blood flow to the affected skin and excessive fluid moving into the surrounding tissues , causing itching and swelling.

Treatment of  Urticaria:
1.One of the most important part of treatment is to to try to identify the substance or underlying medical condtion which may cause the Urticaria.

2.Avoidance of the causative substance or treatment of the underlying medical conditions such as infections will lead to the resolution of the urticaria.

3.One of the most important components of an Urticaria treatment routine is to prevent scratching.

4.Cold compresses applied directly to itchy skin can also help relieve itching.

5.Antihistamine tablets will usually relieve the itch and suppress the eruption of the rash.

The antihistamine need to be taken regularly for long as the urticaria is active.

6.If the condition persists, worsens, or does not improve satisfactorily, another effective treatment is the application of nonprescription corticosteroid creams and ointments to reduce itch.

7.Corticosteroid tablets may be prescribed if necessary.

Prevention of Urticaria is by:
1.Find the causative agent and avoid it.

2.Avoid sudden changes in temperature or humidity

3.Avoid sweating or overheating

4.Avoid certain foods (e.g.,eggs, nuts, seafood, chocolates)

5.Avoid harsh soaps, detergents, and solvents

6.Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)

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