Urticaria or Wheal or Skin Hive
Urticaria: Skin Hives, Itching and Swelling
Dr. KS Prasanna,
Dermatologist, Institute of Applied Dermatology, Kasaragod, Kerala
After lockdown, on Monday
morning, my first OP was a boy with intensely itchy red lesions all over the
body with swollen lips. Besides, he had watering of eyes and abdominal pain.
The mother was anxious and crying. She said "doctor, my son is having
itching all over the body for the past five days. When he scratches, the area
becomes red, raised, and hot, and within a half, to one hour it completely goes
off. Yesterday night he had abdominal pain and couldn't sleep. Look at his
face, we can't recognize his face. Why is it swollen so much like a monkey? I
was not able to consult a doctor before, because, by the time he gets ready to
consult a doctor, his itching reduces and nothing is visible. So today, early
morning, we came to show this to you. I am afraid doctor, is it a serious
problem?"
Urticaria symptoms
Definitely, it is a common
problem, but not a serious problem. Yet some patients end up in the emergency
department with breathing problems and anaphylaxis. It is a condition called
Urticaria. It is characterized by transient skin or mucosal swellings due to
plasma leakage. Superficial dermal bumps are wheals, and deep swelling of skin
and mucosa are called Angio-oedema. Wheals are characteristically pruritic and
pink or pale in the center. In contrast, Angio-oedema is often painful, less
well defined, and shows no color change.
Causes for Urticaria
There are several clinical
patterns and different causes. There could be an environmental allergy,
autoimmunities like Thyroid problem, Drug intakes like pain killers, dietary
pseudo allergens, and any kind of infection anywhere in the body like caries tooth.
Many cases of spontaneous Urticaria remain unexplained what we call idiopathic,
even after extensive evaluation.
Urticaria Diagnosis
Diagnosis is based primarily on
history and clinical examination. Determination of the cause, or triggering
factor as well as the exclusion of other diagnoses may require detailed
investigation, which will be expensive but necessary.
Urticaria is a common disease that may cause considerable distress in the house, even for the professionals. But the symptoms can be reduced by appropriate management. You need to take medicine, which is known as an antihistamine for months and sometimes for years. There are different groups of antihistamines. Your doctor will select an antihistamine, which will take a minimum of 48 hours to give the desired response. If you don't respond then your doctor will change the group of antihistamine. Always keep the tablet, whichever is suitable for you in your purse, and take it at the same time. Also, your doctor will treat, whatever the cause is identified like infection, thyroid problem, etc. Don't get disturbed or get afraid of this itching, but take the treatment appropriate for a long time. Don't be scared of the drug. Antihistamine is a safe drug..
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