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Sắc đẹp & Phong cách : Glossary
Hives(urticaria)
[2007-09-21 02:40] (1,116)

The hives

 

The hives is a very common skin disease that causes temporary swelling of skin or membrane. Usually, it is accompanied by itchiness and occurs locally. When it gets serious, difficulty in breathing, gastrointestinal symptoms (sick feeling, vomiting and stomachache) can be experienced.

 

Definition

 

The hive is a disease that causes a local skin swelling by the partial swelling on the upper layer of the skin and most patients with hives claim to itchiness. It occurs abruptly and disappears in 24 hours. But if the symptom lasts for more than 24 hours, it should be differentiated with other skin diseases such as urticarial vasculitis, UV. There is a great difference in the size and shape of hives and usually they spread on the trunk, hips and chest. It is called angioedema when the swelling symptom is extended not only on the upper layer of the skin, but also to the deep layer of fat as well as under the membrane.

 

In general, this disease occurs on the face and accompanies hives. The hives sometimes accompany rhinitis, asthma, stomachache and headache. Especially when a person has an angioedema, there may be swelling on the air way, thus it may threaten one’s life. There are many standards in classifying hives. Clinically, they are divided depending on the period the disease is generated and the factor of the disease. Depending on the period, the hives are classified into acute and chronic hives.

 

The acute hives involves a bite from an insect and allergic reaction to food, drug. and other physical factors. Since the causes of acute hives are easily found, it can be quickly treated once the causes are removed. The chronic hives is a case when the symptoms last for more than 6 weeks. It is hard to identify the cause, therefore it is necessary to figure out the cause as well as find the right medication for both the medical professional and the patient.

 

Symptoms

 

Clinically, the size and shape of the hives vary and they last 3-4 hours and then disappear before generating new hives. Red spots surround a single hive. In most cases, it is accompanied by itchiness and can occur anywhere on the skin of body. In case of the angioimmunoblastic lymphadenopathy, which is the swelling of the blood vessels, there is no red spots or itchiness but instead, a burning sensation is experienced. Usually, around the eyes and lips are the areas that such symptoms occur.

 

In rare situations, it causes vomiting, stomach ache and diarrhea by interfering with the stomach and intestines. If there is swelling in the occipital region, difficulty in breathing and coarse voice may occur. However, such symptoms can be found for acute hives and angioedema in general and they rarely occur for the chronic hives.

 

Cause, conditions and physiological

 

There is diversity in the causes of hives making it hard to find a definite cause. Depending on the mechanisms, they are classified as the hives by immunity mechanism, the hives by non-immunity mechanism, the hives due to physical factors and the chronic idiopathic hives.

 

A. The hives by immunity mechanism - When the antibody called immunoglobulin E(IgE), that responses to various antigens, reacts to the antigens introduced into the body and causes deregulation of the mast cells, hives are generated by the chemical agencies like histamine. The antigens that cause the hives are inhaled (pollen, excrement of animals, bacteria, smog and dust), injected (drug, blood), internal medicine (drugs, various fruits, food, food additives), infection (by germs, bacteria, parasites) and other contact agents. Among the hives of immunity mechanism, there is a fatal disease called hereditary angioedema. This disease has shown genetic defect and causes not only hives but also severe symptoms like gastrointestinal trouble and difficulty in breathing. In general, it is a life threatening disease.

 

B. The hives by non-immunity mechanism - Depending on the substance, there is a case that causes hives by directly secreting histamine from the mast cells without the work of an antigen. Such substances are chemicals (radiation, contrast media), drugs (aspirin, antiphlogistic, morphine, codeine), food (strawberry, fish) and toxin. Among them, some cause hives as an immunity mechanism.

 

C. The hives due to physical factors - It involves the hives that are generated by an external factor. The are hives that are due to physical factors are as follows:

 

① Dermatographism: The hives occur to a stimulated area such as scratching and 3-5% of normal people have such hives, but they do not claim itchiness.

② Cholinergic urticaria: Small hives occur when the body sweats as the temperature goes up and usually happens after exercise or taking a bath with hot water.

③ Cold urticaria: The hives are generated when skin is exposed to ice or cold weather. It needs special care because it may cause sudden death when swimming or taking a bath with cold water.

④ Solar urticaria: The hives are formed on the area that is exposed to sunlight.

 

D. Chronic idiopathic urticaria - This hive involves a patient who could not find a particular cause for the hive he/she has, regardless of numerous examination and 80~90% of patients of hives belong to this category. Various factors or accompanied diseases may be related to the hive, thus it is recommended to have a thorough examination at least once.

 

Diagnosis

 

If skin swells temporarily, it is clinically diagnosed as the hives, thus there is no difficulty in its diagnosis. The most important thing in the diagnosis is to reveal the cause of the disease. However, it is also important to know the history of a patient’s disease. Especially if it is acute, infection, food intake or drug that can be the cause of the hives. If there is no particular disease history, a physical examination for systemic diseases is executed to find the cause. Through the various tests of skin reaction to figure out the response for antigens that can cause various hives, the E type immunoglobulin using a last and MAST, the causing substance can be figured out up to certain level.

 

Progress, prognosis

 

The patients of the chronic hives show various progresses. In general, the hives last for several moths to years and then disappear, and sometimes they last a long period of time. Usually, the hives occur only on skin and accompany pruritus. However, it shows a quite good convalescence except for such uncomfortable and bothersome itching. It is rare, but when the hives are related to a certain disease, they can be disappeared once the accompanied disease is treated.

 

Complications

 

There is no particular complication to chronic hives. Rarely, gastrointestinal problems (vomiting, stomachache) as well as respiratory problems (difficulty in breathing, coarse voice) happen. At that time, it requires emergency treatment.

 

Treatment

 

The most important thing in the hive treatment is find the cause and avoiding it. However, in most cases, the cause cannot be found immediately. For this reason, the symptoms are treated by prescribing antihistamines. Antihistamines are safe drugs that do not have much side effect in long-term use, but they may cause drowsiness depending on the patient. Recently, new antihistamines with decreased drowsiness effect have been developed. If the symptoms of acute hives are severe, the Oral Corticosteroids can be used for a short period. If the symptom is accompanied by difficulty in breathing, epinephrine is injected. When the symptoms of hives are severe and are accompanied by difficulty in breathing, go to an emergency room and receive a proper treatment monitoring the development of other symptoms and consequences.

 

Preventions

 

Almost every substance can cause the hives, so there is no particular prevention or things to keep in mind. However, people who tend to have the hives try to select medicines that may cause hives with care and avoid various stimulations that cause itching. It is also helpful to remember the names drug taken and have a record of the food intake in case the hives occur.

 

Consult a doctor in the following cases

 

If the symptoms of acute hives are severe, especially if the symptoms involve gastrointestinal problems (vomiting, stomachache) as well as respiratory problems (difficulty in breathing, coarse voice), go to an emergency room and receive the proper treatment, monitoring the development of other symptoms and consequences.

Sắc đẹp & Phong cáchUng thư và Phòng ngừaLối sống lành mạnhSức khỏe tinh thần và stressGiới tính Nam/NữChủ đề nóng bỏng
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