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SKIN DISEASES
Urticaria
Hives is a temporary swelling of the skin, caused by a localized collection of fluid in the dermis due to leakage from blood vessels. It can result from any of the following:
a. Allergy to foods, pollens and drugs.
b. Change in the temperature
c. Infections, including the presence of worms.
d. Emotional upsets.
Sometimes, the cause cannot be accurately determined but if the cause can be made out, it is easy to cure urticaria. If the cause is not obvious, then a very effective way to get relief is to use anti-allergic drugs for some weeks ( with the consultancy of your doctor ) till the problem subsides.
Urticaria is an eruption of weals. Weals, the itching, pale or pink, edematous, raised lesions resembling those caused by the sting of a nettle, last for a short time of a few hours only, but reappear at the same or different sites. On areas like lips, eyelids and groins, edematous swellings may erupt because of the looseness of subcutaneous tissue where a large amount of fluid can accumulate. Urticaria is a reaction pattern of the skin which can be caused by a number of factors. The common ones are :
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Allergic urticaria is the commonest allergic condition of the skin. Substances which cause allergic urticaria enter the body by inhalation or injections. Drugs like penicillin,
sulphonamides, aspirin, tetracyclines and even B complex vitamins are among the commonest causes of
urticaria. Aspirin can also cause urticaria by non-allergic means. Many foods like fish, pork, eggs, mushroom, milk, wheat, rice and pulses, etc., can also cause
urticaria. Pollens, dust, horse dander, etc., can be inhaled and cause
urticaira, though more frequently they are a cause of naso-respiratory allergy. Vaccines and anti-toxin injections can also cause
urticaria. Some parasitic infections of the intestines and the stings of mosquitoes, wasps and bees can also cause widespread allergic
urticaria. At times a focus of infection in the throat, sinuses, ears , teeth or kidney may be the cause of
urticaria.
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Physical factors like cold, heat, exertion, ultraviolet radiation and pressure can produce urticaria in sensitive individuals.
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Psychological stress resulting from sex problems and problems regarding employment, family and finances have been known to cause urticaria in some persons.
In all cases of urticaria, a careful history is taken, especially with regard to drug intake, relationship of urticaria with ingestion of any particular food or any of the physical factors mentioned above. A psychological assessment of the patient is also made. A physical examination is important to exclude or confirm the presence of a focus of infection or some other underlying disease. Microscopic stool examination is done to detect any intestinal worm infestation. The prick and intra-dermal tests on the skin, used for identification of allergy in asthma, are generally unless in urticaria.
Suppressive treatment of urticaria is carried out by administering antihistaminic drugs like Chloropheneramine (Avil) triprolidine hydrochloride, Actidil and Cyproheptadine hydrochloride ( Periactin). The dose and the frequency should be adjusted to give adequate coverage for 24 hours. All these drugs cause varying degrees of drowsiness, hence driving, operating machines and other jobs which require mental alertness should be avoided while undergoing treatment. Urticaria, if not responsive to oral antihistamines, may have to be treated with injections of adrenaline or steroids especially for patients complaining of a choking sensation in the throat which occurs due t swelling in the respiratory passage.
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