Urticaria is a skin disorder where a patient experiences raised red rashes on the body commonly called as "hives". Medically, these rashes are called "wheals".
As a dermatologist in Kochi, urticaria is one of the common skin conditions we see.
Types of urticaria
There are 2 types of urticaria-
Acute urticaria- when the rashes start abruptly and last less than 6 weeks
Chronic urticaria - when the rashes last more than 6 weeks
What causes urticaria?
Acute urticaria -
Food - Many cases of urticaria are related to an intake of a new food item. The rashes in food induced urticaria appear within few minutes to hours of eating the food item. It lasts for a few hours to days and then disappears. The patient experiences wheals every time he/ she eats the allergic food.
Medicines - another common cause of acute urticaria is medicine intake. This is similar to food induced urticaria and appears within few hours of taking the medicine and subsides after stopping the medicine.
Infections - A common cause in children, wheals appear after few days of recovering from an upper respiratory or gastrointestinal infection. It can last for weeks.
Idiopathic - Many a times, we will not be able to get a specific reason for the rashes. Such cases are termed as " Idiopathic" . They can last for few weeks and also progress into chronic urticaria.
Chronic Urticaria -
Autoimmune - Most cases of chronic urticaria are "auto immune" where the body prodcues antibodies against its own cells involved in histamine release. This type of urticaria lasts for months and sometimes years. This is sometimes associated with thyroid auto antiboidies.
Physical Urticaria - This is a subset of urticaria where hives appear in response to specific physical triggers such as
Pressure - Hives appear in areas of pressure like belts ( waistline) , bra straps( shoulder), prolonged sitting (buttocks),etc.
Cold - Hives appear on areas exposed to extreme cold temperature like hands and face in chilly weather.
Cholinergic - Hives appear in response to heat and sweat.
Idiopathic - In most of the cases of chronic urticaria, we are not able to find out the trigger and this is termed as " Idiopathic".
As a dermatologist, it is very important to take a detailed history in cases of urticaria. There are no specific blood tests that help to diagnose the trigger. Food allergen tests are not very specific.
Observation for triggers, keeping a diet diary and avoiding allergenic foods are the key to preventing urticaria outbreaks. Patients will have to be on antihistamines as per the dermatologist's advice.
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