Urticaria and Its Types

Synonyms for Urticaria

• Wheals, hives or nettle rash

Wheals

• Pruritic, pink or pale swellings of the superficial dermis
• Have an initial erythematous flare around them
• Come and go rapidly, generally within 24 hours

Urticaria

• Often used as a descriptive term for recurrent whealing of the skin
• May present with wheals, angioedema, or both
• Lesions may be a few millimeters in diameter or as large as a hand
• Number of lesions can vary

Angioedema

• If only angioedema presents, then it’s regarded as an angioedema case, not urticaria

Wheals

• Can be small or large in size
• Retain the classic central pallor and erythematous flare
• Occasionally, edematous plaques are seen

Urticaria Types

• Acute Urticaria (< 6 weeks)
  • Intermittent ≤ 1 attack/week

  • 1 attack/week

    • Causes include: beta lactams, opiates, NSIADs, etc.
• Chronic Urticaria (> 6 weeks)

Physical Urticaria (Inducible)

• Cold Urticaria: urticarial swelling of the hands, face, and elsewhere may occur after exposure to the cold
• Heat Urticaria: A very rare type of physical urticaria induced by direct contact of the skin with heat
• Pressure Urticaria: urticarial lesions develop hours after pressure on the skin
• Solar Urticaria: urticarial lesions that develop a few minutes after exposure to the sun

Cholinergic Urticaria (Inducible)

• Small urticarial lesions that develop after hot baths or exercise
• Often associated with sweating
• Relatively common disorder that could be disabling in some patients

Urticaria Management

• Diagnosis is usually clinical
• Investigations are not usually required in acute urticaria
• Investigations are only sometimes required in chronic urticaria

Urticaria

• Urticaria is known as Wheals, hives or nettle rash
• Wheals are pruritic, pink or pale swellings of the superficial dermis that have an initial erythematous flare around them
• Wheals come and go rapidly, generally within 24 hours.
• Urticaria is often a descriptive term for recurrent whealing of the skin.
• Urticaria may present with wheals, angioedema, or both.
• Lesions may be a few millimeters in diameter or as large as a hand, and the number can vary from a few to numerous.
• If there is only angioedema, then it's regarded as an angioedema case, not urticaria
• Wheals can be small or large in size, but they still retain the classic central pallor and erythematous flare.

Urticaria Types

• Acute Urticaria: lasts less than six weeks with one or more attacks per week
• Chronic Urticaria: lasts longer than six weeks

Urticaria Causes

• Physical Urticaria: induced by external factors
  • Cold Urticaria: urticarial swelling of the hands, face, and elsewhere may occur after exposure to the cold
  • Heat Urticaria: rare type of physical urticaria induced by direct contact of the skin with heat.
  • Pressure Urticaria: urticarial lesions develop hours after pressure on skin
  • Solar Urticaria: urticarial lesions that develop a few minutes after exposure to the sun.
• Cholinergic Urticaria: induced by sweating
  • Small urticarial lesions that develop after hot baths or exercise (conditions that stimulate sweating)
  • Relatively common disorder that could be disabling in some patients.

Urticaria Management

• Diagnosis is usually clinical
• Investigations are not usually required in acute urticaria, and only a few are needed in chronic urticaria.

Urticaria

• A skin condition characterized by itchy, red welts or hives, known as wheals.
• Wheals are raised, temporary swellings that typically appear suddenly and disappear within 24 hours.
• Urticaria can manifest as wheals, angioedema, or both.
• Angioedema refers to swelling deeper in the skin that can affect the face, lips, and other areas.

Types of Urticaria

• Acute urticaria lasts less than 6 weeks.
• Chronic urticaria persists for more than 6 weeks.
• Physical urticaria is triggered by specific external stimuli:
  • Cold urticaria: triggered by exposure to cold.
  • Heat urticaria: triggered by exposure to heat.
  • Pressure urticaria: triggered by pressure applied to the skin.
  • Solar urticaria: triggered by sunlight exposure.
• Cholinergic urticaria is triggered by heat-induced sweating, such as after exercise or a hot bath.

Causes of Urticaria

• Acute urticaria causes may include:
  • Medication reactions: e.g., penicillin, NSAIDs.
  • Food allergies: e.g., shellfish, nuts.
  • Insect stings or bites.
  • Viral or bacterial infections.
• Chronic urticaria often has an unknown cause, but potential triggers may include:
  • Autoimmune disorders.
  • Chronic infections.
  • Underlying medical conditions.

Urticaria Symptoms

• Wheals are raised, red or pale welts with a central pallor.
• Angioedema is swelling that can involve the face, lips, tongue, and other areas.
• Itching is a common symptom.
• Pain may occur in severe cases of angioedema.
• Feeling unwell or feverish may be present.

Urticaria Diagnosis

• Clinical diagnosis is often enough, based on the characteristic symptoms.
• Investigations are typically unnecessary for acute urticaria, but may be considered for chronic cases.

Management of Urticaria

• Avoid known triggers of urticaria.
• Antihistamines are often used to relieve itching and reduce wheal formation.
• Corticosteroids may be prescribed for more severe cases or for angioedema.
• Immunotherapy is sometimes used in chronic cases to reduce the body's immune response.
• Referral to a dermatologist may be recommended for persistent or severe cases.

Explore the different types of urticaria, including acute and chronic forms, as well as their characteristics like wheals and angioedema. This quiz covers definitions, symptoms, and causes associated with this skin condition. Test your knowledge on how to differentiate between various presentations of urticaria.