Urticaria, also known as hives, is a type of skin rash characterized by the development of itchy, raised red lesions on the skin. The lesions, called wheals, can range in size from a few millimeters to several centimeters in diameter and may appear on any part of the body.
Urticaria can be caused by a variety of factors, including allergic reactions to foods, medications, or other substances; exposure to physical triggers such as cold, heat, or pressure; and infections or underlying medical conditions such as autoimmune diseases or thyroid problems.
In some cases, the cause of urticaria is unknown and is also referred to as idiopathic urticaria. Urticaria can range from mild to severe, and it may resolve on its own or persist for an extended period.
Epidemiology
Urticaria is a common skin condition that can affect people of all ages. It is estimated to occur in up to 20% of the general population at some point in their lives. The prevalence of urticaria varies depending on the specific type of urticaria and the population being studied. Chronic urticaria, defined as urticaria that lasts for more than six weeks, is less common than acute urticaria.
It is estimated to occur in 0.1-0.5% of the general population. Chronic urticaria is more common in women than men and is more likely to occur in people between the ages of 20 and 40. Acute urticaria, defined as urticaria that lasts for less than six weeks, is more common than chronic urticaria.
It is estimated to occur in up to 10% of the general population at some point in their lives. Acute urticaria can affect people of all ages, but it is more common in children and young adults.
Anatomy
Pathophysiology
The pathophysiology of urticaria involves the release of histamine and other inflammatory mediators from mast cells in the skin. Mast cells are a type of immune cell that is found in the skin and other tissues throughout the body. They contain granules filled with histamine and other substances released when the mast cell is activated.
In the case of urticaria, the mast cells are activated by various stimuli, such as allergens, physical triggers, or underlying medical conditions. When the mast cells are activated, they release histamine and other substances into the surrounding tissues, leading to the symptoms of urticaria, such as swelling, redness, and itching.
The precise mechanisms by which the mast cells are activated in urticaria vary depending on the specific type of urticaria and the underlying cause. In some cases, the activation of the mast cells may be triggered by an immune response to an allergen or other substance.
Etiology
The etiology of urticaria is often challenging to determine and can be caused by various factors.
Common causes include allergic reactions to certain foods, medications, or substances in the environment, insect stings or bites, physical triggers such as cold, heat, pressure, or sunlight, infections, especially viral infections, autoimmune disorders such as lupus or thyroid disease, and idiopathic, which means the cause is unknown.
In many cases, the underlying cause of urticaria is not found. Some people develop chronic urticaria, which is defined as hives lasting longer than six weeks, and the cause of this condition is often difficult to determine.
Genetics
Prognostic Factors
The prognosis for urticaria, also known as hives, depends on the underlying cause of the condition and the severity of symptoms. In most cases, urticaria is a self-limiting condition that will resolve within a few days to weeks.
In some cases, the cause of urticaria may be difficult to determine, and the condition may become chronic, lasting for months or even years. Acute urticaria usually goes away in 6-8 weeks, and most people recover fully. However, in some cases, the symptoms may be recurrent or chronic.
Clinical History
Clinical History
Urticaria is characterized by the appearance of itchy, red, swollen patches on the skin, called papules and plaques, that typically have a pale center. These patches can vary in size and shape and may join together as they appear. The condition is usually temporary, and the affected areas usually disappear within 24 hours without leaving any discoloration or pigmentation behind.
The patches are often found on areas of the body under pressure, such as the waist, underarms, and groin, but can appear anywhere on the body. Scratching the affected areas can lead to further skin damage, such as scratches, erosions, and crusts.
Some people with urticaria may also experience swelling of deeper layers of the skin, called angioedema, which occurs in up to 40% of people with hives. This can affect areas such as the lips, eyelids, genitals, and extremities and causes discomfort and pain instead of itching.
Physical Examination
Physical Examination
Urticaria is characterized by raised, palpable wheals on the skin. These wheals can be linear, annular, or arcuate in shape and can appear on any area of the skin. They are often transient and migratory and may be separated by normal skin or rapidly coalesce to form larger areas of erythematous, raised lesions.
The physical examination of a person with urticaria focuses on identifying conditions that could potentially be life-threatening, such as angioedema of the lips, tongue, or larynx. Urticarial lesions that are painful, long-lasting, or ecchymotic, as well as those that leave residual hyperpigmentation or ecchymosis upon resolution, are present. Systemic signs or symptoms, such as fever, arthralgias, arthritis, weight changes, bone pain, or lymphadenopathy, are noted.
In addition, the examination should check for scleral icterus, hepatic enlargement, or tenderness that may indicate liver disease and thyromegaly, which may indicate autoimmune thyroid disease. The examination should also include a joint examination for any evidence of connective tissue disease, rheumatoid arthritis, systemic lupus erythematosus, and any signs of lung infections.
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Differential Diagnosis
Urticarial Vasculitis
Mastocytosis
Bullous Pemphigoid
Scabies
Allergic Contact Dermatitis
Atopic Dermatitis
Pityriasis Rossea
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Urticaria is typically managed with medications and lifestyle changes. The most common medications used to treat urticaria include antihistamines, which block the effects of histamine and can reduce itching, swelling, and other symptoms. Corticosteroids may also be used to reduce inflammation.
In severe cases, other medications, such as leukotriene antagonists or immunosuppressants, may be used. Managing urticaria may involve making certain lifestyle changes. One of the most important steps is identifying and avoiding triggers that cause hives, such as certain foods, medications, or environmental factors.
Wearing loose, cotton clothing can also help reduce irritation on the skin. It is also important to use non-irritating skin products and keep the skin cool and dry. These changes can help alleviate symptoms and prevent further outbreaks.
20 mg once daily
If the symptoms are not controlled after 2 weeks, increase the dose to 40 mg once daily
If, after additional 2 weeks, still, the symptoms are not controlled, increase the dose to 80 mg once daily
<6 years old: take 0.05 mg/kg daily as clemastine base divided every 8 to 12 hours and dose not more than 1.34 mg
6 to 12 years old: take 0.67 to 1.34 mg clemastine fumarate every 12 hours and a daily dose not more than 4.02 mg
>12 years old: follow dose as per adults
Urticaria, also known as hives, is a type of skin rash characterized by the development of itchy, raised red lesions on the skin. The lesions, called wheals, can range in size from a few millimeters to several centimeters in diameter and may appear on any part of the body.
Urticaria can be caused by a variety of factors, including allergic reactions to foods, medications, or other substances; exposure to physical triggers such as cold, heat, or pressure; and infections or underlying medical conditions such as autoimmune diseases or thyroid problems.
In some cases, the cause of urticaria is unknown and is also referred to as idiopathic urticaria. Urticaria can range from mild to severe, and it may resolve on its own or persist for an extended period.
Urticaria is a common skin condition that can affect people of all ages. It is estimated to occur in up to 20% of the general population at some point in their lives. The prevalence of urticaria varies depending on the specific type of urticaria and the population being studied. Chronic urticaria, defined as urticaria that lasts for more than six weeks, is less common than acute urticaria.
It is estimated to occur in 0.1-0.5% of the general population. Chronic urticaria is more common in women than men and is more likely to occur in people between the ages of 20 and 40. Acute urticaria, defined as urticaria that lasts for less than six weeks, is more common than chronic urticaria.
It is estimated to occur in up to 10% of the general population at some point in their lives. Acute urticaria can affect people of all ages, but it is more common in children and young adults.
The pathophysiology of urticaria involves the release of histamine and other inflammatory mediators from mast cells in the skin. Mast cells are a type of immune cell that is found in the skin and other tissues throughout the body. They contain granules filled with histamine and other substances released when the mast cell is activated.
In the case of urticaria, the mast cells are activated by various stimuli, such as allergens, physical triggers, or underlying medical conditions. When the mast cells are activated, they release histamine and other substances into the surrounding tissues, leading to the symptoms of urticaria, such as swelling, redness, and itching.
The precise mechanisms by which the mast cells are activated in urticaria vary depending on the specific type of urticaria and the underlying cause. In some cases, the activation of the mast cells may be triggered by an immune response to an allergen or other substance.
The etiology of urticaria is often challenging to determine and can be caused by various factors.
Common causes include allergic reactions to certain foods, medications, or substances in the environment, insect stings or bites, physical triggers such as cold, heat, pressure, or sunlight, infections, especially viral infections, autoimmune disorders such as lupus or thyroid disease, and idiopathic, which means the cause is unknown.
In many cases, the underlying cause of urticaria is not found. Some people develop chronic urticaria, which is defined as hives lasting longer than six weeks, and the cause of this condition is often difficult to determine.
The prognosis for urticaria, also known as hives, depends on the underlying cause of the condition and the severity of symptoms. In most cases, urticaria is a self-limiting condition that will resolve within a few days to weeks.
In some cases, the cause of urticaria may be difficult to determine, and the condition may become chronic, lasting for months or even years. Acute urticaria usually goes away in 6-8 weeks, and most people recover fully. However, in some cases, the symptoms may be recurrent or chronic.
Clinical History
Urticaria is characterized by the appearance of itchy, red, swollen patches on the skin, called papules and plaques, that typically have a pale center. These patches can vary in size and shape and may join together as they appear. The condition is usually temporary, and the affected areas usually disappear within 24 hours without leaving any discoloration or pigmentation behind.
The patches are often found on areas of the body under pressure, such as the waist, underarms, and groin, but can appear anywhere on the body. Scratching the affected areas can lead to further skin damage, such as scratches, erosions, and crusts.
Some people with urticaria may also experience swelling of deeper layers of the skin, called angioedema, which occurs in up to 40% of people with hives. This can affect areas such as the lips, eyelids, genitals, and extremities and causes discomfort and pain instead of itching.
Physical Examination
Urticaria is characterized by raised, palpable wheals on the skin. These wheals can be linear, annular, or arcuate in shape and can appear on any area of the skin. They are often transient and migratory and may be separated by normal skin or rapidly coalesce to form larger areas of erythematous, raised lesions.
The physical examination of a person with urticaria focuses on identifying conditions that could potentially be life-threatening, such as angioedema of the lips, tongue, or larynx. Urticarial lesions that are painful, long-lasting, or ecchymotic, as well as those that leave residual hyperpigmentation or ecchymosis upon resolution, are present. Systemic signs or symptoms, such as fever, arthralgias, arthritis, weight changes, bone pain, or lymphadenopathy, are noted.
In addition, the examination should check for scleral icterus, hepatic enlargement, or tenderness that may indicate liver disease and thyromegaly, which may indicate autoimmune thyroid disease. The examination should also include a joint examination for any evidence of connective tissue disease, rheumatoid arthritis, systemic lupus erythematosus, and any signs of lung infections.
Differential Diagnosis
Urticarial Vasculitis
Mastocytosis
Bullous Pemphigoid
Scabies
Allergic Contact Dermatitis
Atopic Dermatitis
Pityriasis Rossea
Urticaria is typically managed with medications and lifestyle changes. The most common medications used to treat urticaria include antihistamines, which block the effects of histamine and can reduce itching, swelling, and other symptoms. Corticosteroids may also be used to reduce inflammation.
In severe cases, other medications, such as leukotriene antagonists or immunosuppressants, may be used. Managing urticaria may involve making certain lifestyle changes. One of the most important steps is identifying and avoiding triggers that cause hives, such as certain foods, medications, or environmental factors.
Wearing loose, cotton clothing can also help reduce irritation on the skin. It is also important to use non-irritating skin products and keep the skin cool and dry. These changes can help alleviate symptoms and prevent further outbreaks.
20 mg once daily
If the symptoms are not controlled after 2 weeks, increase the dose to 40 mg once daily
If, after additional 2 weeks, still, the symptoms are not controlled, increase the dose to 80 mg once daily
<6 years old: take 0.05 mg/kg daily as clemastine base divided every 8 to 12 hours and dose not more than 1.34 mg
6 to 12 years old: take 0.67 to 1.34 mg clemastine fumarate every 12 hours and a daily dose not more than 4.02 mg
>12 years old: follow dose as per adults
Indicated for Allergic Urticaria
Age >6 years
Apply an adequate quantity of lotion to form a noticeable coating 15 min prior to contact with plants
medtigo
Urticaria
Updated :
January 17, 2023
Urticaria, also known as hives, is a type of skin rash characterized by the development of itchy, raised red lesions on the skin. The lesions, called wheals, can range in size from a few millimeters to several centimeters in diameter and may appear on any part of the body.
Urticaria can be caused by a variety of factors, including allergic reactions to foods, medications, or other substances; exposure to physical triggers such as cold, heat, or pressure; and infections or underlying medical conditions such as autoimmune diseases or thyroid problems.
In some cases, the cause of urticaria is unknown and is also referred to as idiopathic urticaria. Urticaria can range from mild to severe, and it may resolve on its own or persist for an extended period.
Urticaria is a common skin condition that can affect people of all ages. It is estimated to occur in up to 20% of the general population at some point in their lives. The prevalence of urticaria varies depending on the specific type of urticaria and the population being studied. Chronic urticaria, defined as urticaria that lasts for more than six weeks, is less common than acute urticaria.
It is estimated to occur in 0.1-0.5% of the general population. Chronic urticaria is more common in women than men and is more likely to occur in people between the ages of 20 and 40. Acute urticaria, defined as urticaria that lasts for less than six weeks, is more common than chronic urticaria.
It is estimated to occur in up to 10% of the general population at some point in their lives. Acute urticaria can affect people of all ages, but it is more common in children and young adults.
The pathophysiology of urticaria involves the release of histamine and other inflammatory mediators from mast cells in the skin. Mast cells are a type of immune cell that is found in the skin and other tissues throughout the body. They contain granules filled with histamine and other substances released when the mast cell is activated.
In the case of urticaria, the mast cells are activated by various stimuli, such as allergens, physical triggers, or underlying medical conditions. When the mast cells are activated, they release histamine and other substances into the surrounding tissues, leading to the symptoms of urticaria, such as swelling, redness, and itching.
The precise mechanisms by which the mast cells are activated in urticaria vary depending on the specific type of urticaria and the underlying cause. In some cases, the activation of the mast cells may be triggered by an immune response to an allergen or other substance.
The etiology of urticaria is often challenging to determine and can be caused by various factors.
Common causes include allergic reactions to certain foods, medications, or substances in the environment, insect stings or bites, physical triggers such as cold, heat, pressure, or sunlight, infections, especially viral infections, autoimmune disorders such as lupus or thyroid disease, and idiopathic, which means the cause is unknown.
In many cases, the underlying cause of urticaria is not found. Some people develop chronic urticaria, which is defined as hives lasting longer than six weeks, and the cause of this condition is often difficult to determine.
The prognosis for urticaria, also known as hives, depends on the underlying cause of the condition and the severity of symptoms. In most cases, urticaria is a self-limiting condition that will resolve within a few days to weeks.
In some cases, the cause of urticaria may be difficult to determine, and the condition may become chronic, lasting for months or even years. Acute urticaria usually goes away in 6-8 weeks, and most people recover fully. However, in some cases, the symptoms may be recurrent or chronic.
Clinical History
Urticaria is characterized by the appearance of itchy, red, swollen patches on the skin, called papules and plaques, that typically have a pale center. These patches can vary in size and shape and may join together as they appear. The condition is usually temporary, and the affected areas usually disappear within 24 hours without leaving any discoloration or pigmentation behind.
The patches are often found on areas of the body under pressure, such as the waist, underarms, and groin, but can appear anywhere on the body. Scratching the affected areas can lead to further skin damage, such as scratches, erosions, and crusts.
Some people with urticaria may also experience swelling of deeper layers of the skin, called angioedema, which occurs in up to 40% of people with hives. This can affect areas such as the lips, eyelids, genitals, and extremities and causes discomfort and pain instead of itching.
Physical Examination
Urticaria is characterized by raised, palpable wheals on the skin. These wheals can be linear, annular, or arcuate in shape and can appear on any area of the skin. They are often transient and migratory and may be separated by normal skin or rapidly coalesce to form larger areas of erythematous, raised lesions.
The physical examination of a person with urticaria focuses on identifying conditions that could potentially be life-threatening, such as angioedema of the lips, tongue, or larynx. Urticarial lesions that are painful, long-lasting, or ecchymotic, as well as those that leave residual hyperpigmentation or ecchymosis upon resolution, are present. Systemic signs or symptoms, such as fever, arthralgias, arthritis, weight changes, bone pain, or lymphadenopathy, are noted.
In addition, the examination should check for scleral icterus, hepatic enlargement, or tenderness that may indicate liver disease and thyromegaly, which may indicate autoimmune thyroid disease. The examination should also include a joint examination for any evidence of connective tissue disease, rheumatoid arthritis, systemic lupus erythematosus, and any signs of lung infections.
Differential Diagnosis
Urticarial Vasculitis
Mastocytosis
Bullous Pemphigoid
Scabies
Allergic Contact Dermatitis
Atopic Dermatitis
Pityriasis Rossea
Urticaria is typically managed with medications and lifestyle changes. The most common medications used to treat urticaria include antihistamines, which block the effects of histamine and can reduce itching, swelling, and other symptoms. Corticosteroids may also be used to reduce inflammation.
In severe cases, other medications, such as leukotriene antagonists or immunosuppressants, may be used. Managing urticaria may involve making certain lifestyle changes. One of the most important steps is identifying and avoiding triggers that cause hives, such as certain foods, medications, or environmental factors.
Wearing loose, cotton clothing can also help reduce irritation on the skin. It is also important to use non-irritating skin products and keep the skin cool and dry. These changes can help alleviate symptoms and prevent further outbreaks.
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