Cold urticaria: features of diagnosis and treatment

The article was checked by a cardiologist, member of the European Society of Cardiology, the Eurasian Association of Cardiologists, the Russian Society of Holter Monitoring O.A. Lozbineva. , is for general informational purposes only and does not replace specialist advice. For recommendations on diagnosis and treatment, consultation with a doctor is necessary.

Edema is the medical term for the abnormal accumulation of fluid in certain tissues of the body. Parts of the body swell from injury or inflammation. Medicines, pregnancy and infections can also cause swelling. Fluid accumulation occurs when it is released from small blood vessels into nearby tissues.

Fluid accumulation may occur under the skin, usually in the lower extremities or lungs. The localization area can give the practitioner the first clues as to the main cause of the development of the pathological process in the body.

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Types of edema

Depends on origin:

• Lymphatic - those types of edema that are caused by causes and changes associated with the lymphatic system are considered as such. Among them are primary (there are congenital malformations of the lymphatic system, usually affecting the limbs), or secondary (there are acquired damage). The latter may be the result of operations to remove tumors in the lymphatic system, or in cases of burns, strokes or infections that cause vessel destruction.
• Dynamic - the lymphatic system does not show any changes, but excess fluid is felt. These include swelling of the veins caused by blood clots or problems with the blood vessels caused by strokes, inflammation, and medications. In women, the cause is varicose veins and exposure to hormones during pregnancy and the postpartum period.

The main factors are changes in the biochemical composition of tissue fluid and blood plasma. Disturbances also occur against the background of hormonal changes and increased capillary permeability.

...and the treatment is the essence

When the reasons why the fingers are swollen and painful have been established, the patient is prescribed symptomatic and pathogenetic (the purpose of which is to eliminate the cause itself) drugs, which include analgesics, NSAIDs, antihistamines, antibiotics, diuretics, and chondroprotectors. Medicines containing synthetic hormones are prescribed to people with hormonal imbalance.

When the fingers are swollen and the joints hurt, treatment may include complex therapy with physiotherapy (ultrahigh frequency, centimeter, ultraviolet therapy, electrophoresis).

Reasons for development

The veins in the legs have valves that act as "check valves" to prevent blood from flowing into the legs due to gravity. The heartbeat pushes blood through the arteries down to the legs. The blood must return to the heart to be recirculated through the veins. Blood pressure through the system and contracting leg muscles push blood up the veins, while valves prevent backflow down against gravity.

Valve insufficiency allows blood to pool in the legs and feet, eventually leading to swelling. When blood stagnates or pools in an area, fluid leaks into the surrounding tissue.

Valve insufficiency can occur for the following reasons:

• with age;
• from standing for long periods of time;
• from sitting for many hours;
• from varicose veins.

Regardless of the cause, as the valves in the legs become dysfunctional, blood pools and causes swelling, which puts pressure on the veins, causing them to widen and widen. This prevents the valves from working effectively, leading to even more swelling.

Main reasons for development:

• kidney diseases: glomerulonephritis, nephrotic syndrome, renal failure;
• heart diseases: heart failure;
• vein lesions (varicose veins, inflammation, thrombosis);
• liver diseases: cirrhosis of the liver, blockage of the hepatic veins;
• diseases of the endocrine system: hypothyroidism, diabetes;
• severe cancer;
• nutritional dystrophy;
• pregnancy;
• allergic reactions: insect bites, contact with an allergen.

Depending on the type, swelling can lead to retinal detachment, stroke, seizures, and even death. It is unacceptable to ignore the problem. To determine the cause, sign up for a consultation with specialists at the Yauza Hospital.

The reasons for everything are trouble

The most common cause of finger swelling is injury.
In this case, along with swelling, symptoms such as pain, hematoma, bleeding, and difficulty moving can be observed. A bruise, cut, sprain, dislocation, fracture or burn can cause the phalanges of the fingers to hurt and swell. In addition, an insect bite can also be the “culprit” of swelling. It seems that for no particular reason the finger is swollen and hurts, but such symptoms can be associated with various forms of arthritis (infectious, post-traumatic, rheumatoid, metabolic and post-operative). It should also be noted that joints may be susceptible to osteoarthritis or degenerative tissue damage. Symptoms of the above diseases are accompanied by the appearance of swelling of the entire hand, an increase in temperature (at the affected area, less often the entire body), as well as redness of the skin areas. There are cases when in young men, psoriasis (chronic skin inflammation), as well as ankylosing spondylitis (characterized by damage to the joints in the sacroiliac joints and spine) occur together with rheumatoid arthritis. In this case, either both hands or only one of them can be affected by the pathological factor.

Symptoms of reactive arthritis, which appears after suffering from infectious diseases (genitourinary, intestinal, nasopharyngeal), may include swollen and red fingers on the upper and lower extremities. Arthrosis, in which the cartilage lining between the joints is destroyed and osteophytes (bone growths) appear, is accompanied by swelling and pain in the thumb, and in particular the bone on it. Oncological processes in tissues can also cause a tumor, these include:

• melanoma,
• basilioma,
• nevus.

Meanwhile, as clinical practice shows, it is rare to see new bone formations on the upper extremities.

Accompanying the tumor with symptoms of intoxication (head pain, vomiting, chills, nausea, high fever, thirst) may indicate the presence of erysipelas. The disease appears when the immune system decreases and group B streptococcus develops. Redness of the skin in the affected area is observed, heat is felt when touched and painful sensations appear.

With contact dermatitis, it swells in a specific place on the finger. This usually happens when the watch bracelet fits very close to the hand or the material of the accessory causes an allergic reaction. Swelling on the fingers can also be the result of a cold allergy, which is characterized by swelling, itching and rashes in the form of red spots.

Spasm in the blood vessels of the hands, which appears as a result of exposure to negative temperatures or an increased level of stress, is called Raynaud's syndrome. Reversible unpleasant sensations appear in the form of changes in skin color (at first it turns white, then turns blue and red), which are provoked by a decrease in blood circulation and its subsequent normalization. Because of this, swelling is observed, a burning sensation and pain are felt.

Edema as symptoms of diseases

In addition to vein problems, swelling can be caused by many other problems. In this case, clinical manifestations are usually observed on both legs.

Heart pathologies

When the heart begins to fail as a pump, fluid pools in areas such as the legs and lungs and causes swelling. In addition, less blood flows to the kidneys, causing fluid retention.

Lung diseases

The cause is acute pulmonary failure, which is associated with the release of transudate from the capillaries. This is fraught with infiltration of the alveoli and a sharp disruption of gas exchange in the lungs.

It manifests itself as shortness of breath at rest, suffocation, a feeling of tightness in the chest, cough with the release of foamy bloody sputum. Accompanied by the development of acidosis and hypoxia.

Kidney diseases

Excess fluid and sodium in the circulation can cause fluid to accumulate. Swelling associated with kidney disease usually occurs in the legs and around the eyes.

Damage to the tiny filtering blood vessels in the kidneys can lead to nephrotic syndrome. In nephrotic syndrome, decreased levels of protein (albumin) in the blood can lead to fluid accumulation.

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Severe liver pathologies

With cirrhosis, as a rule, fluid accumulates in the abdominal cavity. Accompanied by liver failure, dilation of hemorrhoidal veins and bleeding from the esophagus.

Quincke's edema

An acute disease that is characterized by the appearance of limited angioedema of the skin and subcutaneous tissue, body systems and various organs. The reasons are autoimmune and infectious diseases, false and true allergies. It occurs acutely and goes away within 2-3 days.

Arthritis

During the inflammatory process in the joint area, a large amount of synovial fluid is released. It accumulates in the cavity of the articular structure. When inflammation spreads to adjacent soft tissues, extensive (spread) edema develops.

What to do if your face, arms or legs are swollen

Home — Social networks — What to do if your face, arms or legs swell

The fact that you are swelling is an unpleasant thing. Firstly, it’s not aesthetically pleasing, and secondly, it’s alarming: what if it’s a signal of some kind of illness. Now we’ll figure out what to think and do if your face, arms or legs swell.

Edema, in essence, is fluid retention in tissues: in the intercellular space, where normally it should not exist. How does she get there? From lymphatic or blood vessels. If everything is swollen at the site of injury or acute inflammation, the situation is clear: call a doctor and be treated as prescribed. But what if the body increases in volume for no obvious reason?

Face swelling

IT'S NORMAL IF...

• Yesterday there was a party. A puffy appearance and bags under the eyes are normal after drinking alcohol: it retains fluid and, as a punishment for intemperance, localizes swelling around the eyes.
• Drank a lot of fluids before bed. Popular wisdom says that 2 liters of water at night is the best cure for wrinkles. The next morning, the face will be large and smooth, because it is difficult for the kidneys to remove large volumes of fluid at night. And if you snack on what you drink with something salty (salt, as you know, retains moisture), you’re definitely in for trouble.
• I drank little during the day. Not receiving enough fluid, the body stores water just in case, and it accumulates in the tissues.
• She slept on a low pillow or with her head down, like a bat. In this case, it is physically difficult for blood and lymph to flow away from the face against gravity.

What to do?

The path to salvation is obvious: drink water during the day, but in the evening - without fanaticism. Don't sleep like a bat. Well, if it’s a holiday... Be prepared for the consequences and hide the mirror in advance.

THIS IS WORRYING IF...

• My face swells every morning. And without the reasons described above. “Regular swelling of the face in the morning, in which fluid accumulates under the lower eyelids, has a name – “renal”
  , says our expert Iraida Belyaeva. Don't panic: this doesn't mean you're already deficient. But it seems that life is not very comfortable for the kidneys and for some reason they are not working at their best.

What to do?

Don’t immediately run to a urologist - go to a therapist, describe the problem and get examined. “To exclude renal pathology, the doctor will first prescribe general urine and blood tests plus an ultrasound examination of the organ,” continues Iraida. This way you and your doctor will find the cause and eliminate it.

The swelling is accompanied by regular headaches or neck discomfort. In this case, you can suspect some kind of disorder in the cervical spine: osteochondrosis, hernia or protrusion. The more complexities there are in the column, the worse the blood and lymph flow from the head - the more fluid goes into the tissues.

What to do?

Go to a neurologist, he will prescribe an X-ray or MRI of the cervical spine.

Swelling ankles

IT'S NORMAL IF...

• It's hot outside. “Then the capillaries expand, their permeability increases - and the fluid flows into the tissue. The body’s reaction to elevated temperature is quite adequate,” explains Iraida Belyaeva.
• You walked 20 km in sneakers or 5 km in stilettos without preparation. In general, the legs are tired: the vessels cannot cope with the removal of fluid. They have the right, after all!
• You are pregnant. In this case, swelling can occur even after a slight load: the larger your unborn child becomes, the more it interferes with the outflow of blood from the lower extremities.

What to do?

Take the American cowboy's favorite pose: put your feet up on the table. Or somewhere else, it doesn’t matter, the main thing is that the feet are higher than the level of the hips. This way you will ease the outflow and the swelling will subside. Give your lower extremities a cool shower: not cold (so that they don’t cramp in horror), but cool. If you are expecting a baby, talk to your doctor about compression socks or stockings.

THIS IS WORRYING IF...

• The ankles swell regularly and out of nowhere. “ This is one of the symptoms that can signal heart disease
  ,” says the therapist. Plus, blue discoloration may appear on the ankles. Pay attention to whether there are other signals from the main muscle: rhythm disturbances, chest pain, shortness of breath. Remember everything - and go to the doctor.

What to do?

Obediently take tests - again urine and blood, do an ECG and, possibly, an echocardiogram. Plus, the doctor will probably order a kidney test (just in case, just to rule out any complications on their part).

• The feet and legs swell after slight exertion, this is accompanied by cramps at night, and bluish wreaths appear under the skin. The complex of these symptoms clearly hints at varicose veins. “It is precisely with this that the permeability of the vascular wall increases, and fluid easily enters the surrounding tissues,” Iraida Belyaeva reveals the “technology” for the formation of this type of edema.

What to do?

Go to a surgeon or a more specialized specialist - a phlebologist. The gold standard for examining potentially problematic veins is Doppler ultrasound (feels the same as ultrasound). And if they suddenly find something enlarged, get treatment, of course!

Hands become swollen

IT'S NORMAL IF...

• You are in the second half of your menstrual cycle. Counting from the beginning of the last menstruation, day fourteen or fifteen. “During this period, there is a lack of progesterone, which can lead to swelling of the lower abdomen, buttocks and arms,” continues the expert. “Most often, women notice the “rings” that appear on their wrists.”

What to do?

Don't forget to report this at your next visit to the gynecologist. At the moment - nothing extraordinary. But if other hormonal symptoms are added, the information may be relevant.

THIS IS WORRYING IF...

• Along with swelling, belching or nausea regularly occurs after eating. And this is already a hint of liver disease. It is a resilient organ: it recovers well, holds on until the last, practically does not communicate its suffering in any way, and does not even hurt (because it has no nerve endings). Therefore, swelling of the hands (and fingers!), along with heartburn and nausea, can be the only signal of a problem for a long time
  . And if the yellowness of the sclera (whites of the eyes) or skin is added to this, then there is no doubt: the liver is failing!

What to do?

If you don't believe it, see a doctor! First of all, see a therapist. If problems are found in the liver, contact a hepatologist. The tests include the same blood and urine tests plus an ultrasound of the biliary tract.

What not to do

Doctors agree that it is possible to get rid of edema only if its cause is identified and eliminated. However, despite this, some ladies prefer to expel excess fluid from the body on their own by drinking a diuretic.

– to quickly restore a spectacular appearance. We do not condone such behavior. “Such products wash out essential microelements from the body,” says Iraida Belyaeva. – And without the latter we cannot live, in the literal sense of the word. Not only the quality of skin, hair and nails, but also bone density and even heart rate depend on them. Therefore, diuretics should not be taken under any circumstances without a doctor’s prescription!”

We treat all types of edema

Specialists at the Yauza Clinical Hospital diagnose and treat edema of various origins. We follow international protocols and use modern equipment.

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For cardiovascular diseases

“Cardiac” edema develops slowly – over several weeks or months. They are characterized by symmetry and increase in size in the evening. They first appear on the lower extremities or lower abdomen, in severe cases they spread throughout the body and are accompanied by the accumulation of fluid in the abdominal cavity (ascites) and enlarged liver. In this case, the skin most often feels cold to the touch and the swelling is dense. When pressed, a hole remains.

Patients complain of shortness of breath, which worsens when lying down, and low exercise tolerance. They have wheezing in the lungs, tachycardia, pallor of the lips, and cyanosis of the nasolabial triangle. As circulatory failure is compensated, swelling decreases or disappears.

Swelling due to venous insufficiency also becomes more pronounced in the evening, causing the sensation of shoes suddenly becoming tight (due to swelling of the feet), and the legs become visually thicker, often not symmetrically. Swelling in the legs is accompanied by a feeling of heaviness, fatigue, and pain in the legs. Spider veins and an enhanced pattern of veins are noticeable on the skin. In severe cases, swelling persists constantly, cramps in the calves are possible, trophic changes develop - thinning of the skin, persistent redness, peeling, itching, and poorly healing ulcers. Timely professional medical care helps prevent or reduce the risk of such progression of the disease.

For kidney diseases

“Renal” edema can develop very quickly - in less than a day. Swelling appears mainly on the face. Swelling under the eyes is noticeable in the morning. They can also be localized on the limbs and abdominal wall. When changing postures, bodies quickly shift. Fluid accumulation often occurs - ascites or hydrothorax. Edema skin is soft or dense, pale, dry.

Swelling due to kidney disease may be accompanied by a decrease in the amount of urine excreted, a change in its color, and possibly the appearance of blood (red blood cells) and protein in a urine test. Pain appears in the lumbar region. Nonspecific manifestations include headache and weakness. Shortness of breath and liver enlargement, characteristic of circulatory failure, are not observed. Renal edema can be a consequence of an infectious disease (tonsillitis, viral infection, etc.) and requires observation and treatment by a specialist (nephrologist, rheumatologist, therapist).

Allergic

Allergic edema develops quickly (in a few minutes) and is regional in nature. They arise as a result of contact with an allergen or an insect bite. They develop most often on the face (eyes, eyelids, mucous membranes, lips), arms (fingers, hands), elbows and knees.

The development of allergic edema is accompanied by itching and rash. In severe cases, due to bronchospasm, attacks of difficulty breathing are possible, usually in the exhalation phase. Swelling of the larynx can lead to suffocation and pose a threat to the patient's life. Therefore, patients prone to such a reaction should be prepared for a dangerous situation.

It is necessary to discuss in advance with the doctor what medications will help the patient safely wait for the ambulance to arrive (delivery to the hospital) in case of an acute allergy attack and always have them available.

Prolonged swelling causes stretching of the skin, makes blood vessels less elastic, and impairs blood circulation. Swelling negatively affects the joints and causes difficulty moving. Ulcers may develop at the site of swelling, which are subsequently difficult to treat. Don't take things to the extreme. Make an appointment with a doctor and get rid of the problem.

Surgical methods - in case of emergency

Surgery will be necessary if there is an open fracture, ligament damage or severe injury. Panaritium can also serve as an indication for surgical intervention. To cope with this disease, it is imperative to eliminate the inflamed area with pus, thoroughly clean the cavity with the infection and apply stitches. After surgery, it is necessary to do dressings, take antibiotics and anti-inflammatory drugs.

Surgery may be required if the cartilage and surfaces of the joints are severely damaged in the later stages of arthritis or arthrosis, and the fingers become swollen, stiff, and painful. In especially severe cases, endoprosthetics is prescribed, when a worn-out joint is replaced with an artificial one.

Surgery may be performed in the presence of a malignant tumor. The oncologist prepares an individual therapy program for each patient.

Diagnostic stages

Consultation and examination by a therapist. After a detailed conversation and medical examination, the patient can be referred for consultation to other specialists depending on the etiology of the disease: cardiologist, allergist, endocrinologist, nephrologist, urologist, etc.

Laboratory research. First of all, the following are carried out:

• general (with leukocyte formula) and biochemical blood tests;
• general urine analysis.
• Instrumental studies:
• ECG;
• echocardiography;
• Ultrasound of blood vessels of the lower extremities;
• X-ray of the chest organs.

Next, the doctor prescribes a set of studies on an individual basis in each individual case.

To effectively eliminate swelling, you need to know exactly what disease is causing it. Edema is not an independent disease, but a symptom. Diagnostics using modern equipment will allow us to determine the cause of the pathology. The information obtained allows the doctor to choose the most effective treatment. Don't put off taking care of your health until later. Schedule a consultation with your doctor today to stay energized for years to come.

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Diagnostics

Orthopedic traumatologists are often involved in determining the cause of hand swelling. If indicated, patients are referred to surgeons, rheumatologists, vascular surgeons, and other specialists. The diagnosis is made based on the results of the following procedures:

• Questioning, physical examination
  . The specialist determines the circumstances and time of swelling, identifies other symptoms, and monitors the dynamics of the disease. Evaluates the localization, prevalence, severity of edema, range of motion in joints, color, density, tissue temperature.
• Radiography
  . Prescribed for injuries, joint diseases, and some purulent processes. Allows you to confirm the presence of fragments or displacement of the articular ends of the bone, inflammatory and degenerative changes.
• Ultrasonography.
  It is carried out to confirm thrombosis, determine the condition of venous and lymphatic vessels, and assess the prevalence of purulent processes.
• Other imaging techniques
  . In doubtful cases, MRI is performed for a detailed study of soft tissues, and for the study of hard structures.
• Laboratory research
  . Tests help detect signs of inflammation, markers of rheumatic diseases, and renal dysfunction.

Pressotherapy of hands

Treatment of swelling

Treatment of edema is carried out in accordance with the cause of its development. Here are some general recommendations:

• Limit fluid intake to 1.5 liters per day, and sometimes less.
• Reduce salt intake to 1–1.5 g per day.
• Diuretics should be taken only under the supervision of a doctor who monitors the patient’s condition and monitors the level of electrolytes in the blood. Diuretics can lead to a decrease in potassium levels in the body, so it is recommended to eat dried apricots, raisins, rice, baked potatoes and other foods rich in this trace element.
• For cardiovascular diseases, a cardiologist, after diagnosing “cardiac” edema, selects therapy to maintain a stable state of the vascular system. A patient with heart failure should visit a cardiologist regularly throughout his life. In case of venous insufficiency, conservative or surgical treatment is carried out by a vascular surgeon-phlebologist.
• If the swelling is caused by kidney disease, in addition to relieving the swelling, the doctor (therapist or nephrologist) prescribes therapy for the underlying disease, which may include antibiotics, anti-inflammatory hormonal drugs, etc.
• In case of allergic edema, which is accompanied by difficulty breathing, urgent medical attention is required. Before help is provided, you should take an antihistamine, if the condition is severe - prednisolone or dexamethasone. In case of an attack of suffocation of an allergic nature, take 1-2 breaths from an inhaler recommended by your doctor (allergist).

Treatment

Pre-hospital assistance

General recommendations include placing the limb in an elevated position. In case of traumatic injuries, the arm should be fixed with a splint or bandage, cold should be applied, and the victim should be given an anesthetic. For joint diseases, local medications with analgesic and anti-inflammatory effects can be used. The presence of rapidly growing swelling and intense pain is grounds for immediate contact with a specialist.

Conservative therapy

In case of injuries, the injury site is anesthetized, the arm is straightened or reduced, and a plaster cast is applied. For burns and frostbite, dressings are performed. The treatment regimen for diseases accompanied by hand swelling may include the following methods:

• Protective mode
  . The patient is advised to limit the load on the arm. Orthopedic devices are used according to indications.
• NSAIDs
  . They are used for joint diseases in the form of topical agents, tablets or injections. Reduce the severity of pain. Eliminate inflammation and, as a result, swelling of the hands.
• Glucocorticoids
  . Blockades with hormonal drugs are performed for joint damage. Indications are intense pain, active inflammatory process, which is not relieved by other medications.
• Vascular agents
  . Angioprotectors, phlebotonics and antispasmodics are recommended for diseases of the veins and lymphatic vessels.
• Physiotherapy
  . To reduce pain, relieve inflammation, and improve blood circulation, medicinal electrophoresis, magnetic therapy, laser therapy, UHF, mud therapy, and lymphatic drainage massage are prescribed.
• Physiotherapy
  . Special exercise therapy complexes are used during the rehabilitation period after injuries, and for diseases of blood vessels and joints. Therapeutic exercise is supplemented with massage and manual therapy.

Surgery

Taking into account the characteristics of the pathology that causes swelling of the hands, the following surgical interventions can be performed:

• Injuries
  : osteosynthesis of the humerus or forearm bones, open reduction of dislocations of the shoulder and elbow joint, opening of hematomas, excision of areas of necrosis during frostbite, plastic surgery for burns.
• Infectious processes
  : opening of felon, boil, carbuncle, abscess or phlegmon, arthrotomy, sequestrectomy.
• Joint diseases
  : arthroplasty, arthrodesis, endoprosthetics.
• Vascular pathologies
  : regional thrombolysis for venous thrombosis, tunneling for lymphedema, lymphovenous shunting.

After operations, painkillers are prescribed, antibiotic therapy is carried out, and rehabilitation measures are carried out using physiotherapeutic techniques.

Why us

Advantages of visiting our medical center:

• Doctors. We welcome specialists of the highest qualification category, holders of academic degrees, with extensive experience in leading Russian clinics.
• Individual approach. The doctor will develop an individual treatment plan for each patient in accordance with the cause of development and clinical picture of the disease.
• Complexity. Effective treatment of edema and the diseases that cause them is possible thanks to the close cooperation of our clinic’s specialists - therapist, cardiologist, allergist, endocrinologist, urologist, etc.
• Expert equipment. All studies are carried out using modern equipment and are highly accurate.
• Comfort. All consultations, studies and treatment are carried out within our hospital, which allows our patients to save money.

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