Urticaria & Angioedema PDF

Urticaria and Angioedema Dr. Abdulrahman Omar ABHS, Dermatology 5th grade – College of medicine University of Duhok  Urticaria Or puff Synonyms: Wheals, hives or nettle ras...

Urticaria and Angioedema Dr. Abdulrahman Omar ABHS, Dermatology 5th grade – College of medicine University of Duhok  Urticaria Or puff Synonyms: Wheals, hives or nettle rash Wheals : o are pruritic, pink or pale swellings of the superficial dermis that have an initial erythematous flare around them. The hallmark of wheals is that individual lesions o come and go rapidly, generally within 24 hours pit 424hL Train  Urticaria Urticaria is often used as a descriptive term for recurrent whealing of the skin. 11 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 angioedema case, not urticaria  Do Wheals can be small or large in size and but they still retain Occasionally, edematous the classic central pallor and plaques are seen erythematous flare. Urticaria- Pathogenesis 8  Intermittent urticaria ≤ 1 attack/week Acute URTICARIA (< 6 weeks) >1 attack/week β lactams, opiates, NSIADs Chronic Urticaria (> 6 weeks)  Physical urticaria (inducible) C Cold urticaria : urticarial swelling of the hands, face and elsewhere may occur after exposure to the cold I Heat urticaria: A very rare type of physical urticaria induced by direct contact of the skin with heat. Pressure urticaria: urticarial lesions develope hours after pressure on skin Solar urticaria: urticarial lesions that develope few minutes after exposure to the sun.  Cholinergic urticaria (inducible) I Small urticarial lesions that develope after hot baths or exercise ( conditions that stimulate sweating) its relatively common disorder that could be disabiling in some patients. Urticaria- examples  Urticaria- management Diagnosis is usually clinical Investigations are not usually required in acute urticaria , and only few so in chronic one. Treatment is with antihistamines as first line , other lines of management like short course of steroids and adrenaline subcutaneous injections in emergency conditions may be used when airway compromised by angioedema is an issue.  Angioedema Angioedema: swellings occur deeper in the dermis and in the subcutaneous or sub mucosal tissue. They may also affect the oropharynx and rarely the bowel in hereditary angioedema. The swelling is deeper than wheals and affect mucosal surfaces. Note the swelling of the lips and periorbital region and the lack of erythema.  Angioedema The areas of involvement tend to be normal in color or faint pink , O painful rather than pruritic, larger and less well-defined than wheals, and they often last for 2 to 3 days o Urticaria: recurrent whealing ± angioedema. Thank You