Treatment of allergic urticaria: symptoms and causes

The body reacts to environmental stimuli in completely different ways. The ambiguity and variety of effects can even confuse a person.

Urticaria is a large group of allergic diseases with similar symptoms. It is not contagious and affects a significant part of the world's population. Characterized by spontaneous eruption of blisters, redness, or angioedema1. symptoms of allergic urticaria and causes

Urticaria appears quickly and clearly, so it can be diagnosed using the following parameters:

• at the first manifestation of an allergy, the skin becomes blistered;
• the rash is accompanied by burning and itching;
• Externally, the affected area of ​​the epithelium looks as if it were a burn from contact with nettles, hence the name.

The mechanism of allergy development is based on immediate hypersensitivity. Upon repeated contact with even a small dose of the allergen, the response appears quickly.

Experts identify several of the most common causes of the disease:

• stress;
• infections;
• use of medications;
• parasitic infestations;
• insect bites;
• prolonged exposure to the sun;
• ultra-violet rays;
• flower pollen;
• dust indoors and outdoors;
• some types of sweets;
• citrus.

There are two main types of illness:

• urticaria of an immune nature;
• non-immune urticaria.

In the acute form, fever always has an immunological basis for the manifestation of rashes. The chronic form is different and has a wider list of activation mechanisms:

• exogenous factors (influence of processes from outside);
• endogenous factors (the influence of processes occurring inside the body).

Food provocateurs, along with drugs and temperature, are considered exogenous factors. The second group is diseases of a somatic nature and associated with various internal pathological processes. These include:

• gout (a chronic disease characterized by metabolic disorders of certain substances);
• diabetes;
• lupus erythematosus;
• chronic cholecystitis (inflammation of the gallbladder, which is characterized by a violation of its motor function, accompanied by changes in the physical and chemical properties of bile);
• pancreatitis (inflammatory processes in the pancreas), etc.2,3

The rapid spread of an itchy rash, which occurs at the slightest interaction with the substance that caused the allergy, is characteristic of acute urticaria. Externally, the rash looks like many bubbles of different sizes with a clear border of bright color. The rash is often local in nature. The rashes are concentrated on the skin, but there are cases when they appear on the mucous membranes. As usual, symptoms that appear up to 6 weeks characterize spontaneous urticaria; if the blisters do not go away for more than 6 weeks, we are talking about a chronic form of the disease4.

The recurrent (chronic) form of urticaria is an allergic-type disease, which is characterized by the appearance of a rash in the form of papules and itchy blisters. This allergic reaction lasts over 6 weeks. Occurs in 25% of patients. After a long period of remission, repeated manifestations of the rash are possible. Such symptoms are more common in women.

There are two types of chronic urticaria:

• persistent - there is a constant renewal of the rash;
• recurrent – ​​periodic exacerbations of the disease occur.

Pseudo-form is a symptom indicating disorders in the digestive system. It appears when:

• hepatitis;
• helminthiasis;
• chronic gastritis;
• poisoning;
• infectious diseases.

However, there is no relationship between the immune system and the appearance of the pseudo-form5.

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Hives are a condition characterized by a reddish, itchy rash on the skin that is caused by an allergic reaction. It is not contagious and is most often caused by a specific allergen, but in some cases the cause is unknown.

An allergic reaction to hives is fraught with serious complications that require urgent medical attention and are life-threatening. Therefore, you should not endure unpleasant attacks, but contact an allergist and find out how to treat urticaria in your particular case.

Causes of urticaria

The cause of allergic urticaria is a malfunction of the immune system. In allergic urticaria, the body reacts to an objectively neutral substance (allergen) as if it were harmful and releases a protein called histamine. When histamine is released, the tiny blood vessels on the surface of the skin (capillaries) become inflamed. Fluid accumulates underneath them, causing blisters.

Why allergies occur with urticaria (substances and provoking conditions):

• medications, including some antibiotics and non-steroidal anti-inflammatory drugs (including aspirin);
• foods that are known to cause histamine production (spinach, fish, yogurt, tomatoes, meat, chocolate, nuts, shellfish, eggs, strawberries);
• alcohol abuse;
• infections including influenza, colds, mononucleosis and hepatitis;
• intestinal parasites;
• sudden change in air temperature;
• high body temperature;
• pet hair;
• dust mites;
• insects;
• latex;
• pollen;
• some chemicals;
• thyroid diseases;
• lupus;
• exposure to sunlight;
• severe stress.

In some cases, doctors do not find the exact cause of the allergy in the form of hives.

Allergic urticaria in children

Children are very susceptible to skin rashes, and this is the most common reaction in the case of allergies. Children under 3 years of age most often suffer from manifestations of nettle fever. But older children can also experience trouble in the form of itchy rashes.

The location of blisters is similar to adults - on the extremities (most often in folds and places of close contact with clothing), around the mouth or eyes.

The mechanism of manifestation of the rash is the formation of a large amount of histamine due to the penetration of an allergen substance into the body. The surface of the skin becomes swollen and blisters form. The skin lesion disappears quite quickly and without a trace if the child does not scratch the sore spot. But then it can appear again, in another part of the body.

The doctor can quickly diagnose the cause that provoked the hives if the parents determine the time and place of the first appearance of the spots. Accurate diagnosis involves taking the following samples: skin scraping and blood test.

Symptoms of urticaria

With hives, itchy blisters appear on the body - pink or red, oval or round in shape. They can vary from a few millimeters to several centimeters in size. Hives blisters usually appear in batches, often on the face and extremities (urticaria on the arms and legs). Allergic urticaria may appear on only one part of the body, or the rash may cover most of the body.

The blisters usually disappear on their own within 24 hours, but new ones may form afterwards. In some cases, hives may remain on the skin for several days. For people with chronic urticaria, symptoms of allergic urticaria may last for months or years.

In some cases, it is recommended to call an ambulance, as serious complications of allergies due to urticaria are possible - anaphylaxis, Quincke's edema, myocarditis.

Dangerous symptoms, in addition to allergy manifestations of urticaria on the body:

• chills,
• elevated temperature,
• abdominal pain,
• nausea, vomiting,
• cardiopalmus,
• swelling of the mucous membrane of the mouth, tongue, lips,
• weakness and dizziness.

Allergic urticaria in adults

The disease has a number of features when it occurs in an adult. Fever may present as follows:

• Spicy. Rashes appear on the body and limbs, they are accompanied by itching, which increases in warmth. Redness occurs 15-20 minutes after contact with the allergen substance. The blisters disappear quickly and leave no marks or scars.
• Quincke's edema. It is characterized by swelling and larger rashes, appearing on the face near the eyes or mouth. A rash appears on the nasal mucosa and on the conjunctiva of the eyes. In exceptional cases, it is accompanied by swelling of the genitals and limbs. It often causes difficulty breathing and can even be life-threatening.
• Persistent papular. It develops due to long-term treatment of any type of disease and is characterized by the formation of papular blisters (nodules that are located above the skin level). The blisters are noticeably raised above the skin. The patient has to fight the disease for a long time – up to several months. The entire period is accompanied by itching.
• Chronic. It is characterized by wave-like increases and decreases in the level of severity of symptoms. Periods of recovery are followed by exacerbations with severe itching. The time period of the disease is calculated in decades. In rare cases, skin lesions become papular. This form of urticaria is characterized by the manifestation of Quincke's edema. When scratching itchy areas, the disease may be accompanied by an infection, which significantly complicates the course of the disease.
• Solar. The main cause is UV radiation, but the development of allergies is also associated with chronic diseases (for example, chronic liver disease). The appearance of urticaria lesions varies among patients. The rash can be mild or severe; the size of the lesion and blisters, color saturation, shape and location will differ. The severity of the disease is determined by the severity of itching. The most severe form is accompanied by the development of neurotic disorder and insomnia6,7.

Types of allergic urticaria

Hives can be acute or chronic.

Acute allergy with urticaria is the most common type. Symptoms last less than 6 weeks and usually occur in allergic urticaria on the face and neck, fingers and toes. In the acute type, the allergen is usually immediately clear.

Chronic urticaria in adults lasts more than 6 weeks. Most often, it is an idiopathic form of urticaria of unknown origin that can last for months or years. On the skin, allergies with this type of urticaria occur in completely different places.

How is allergic urticaria treated?

First of all, when allergic urticaria develops, the effect of the allergen should be eliminated. In case of contact allergies, remove the irritating substance from the surface of the skin; in case of an insect bite, remove the sting, stop eating or taking medication, take enterosorbent (activated carbon, Enterosgel), and, if possible, rinse the stomach.

Before seeking medical help, you can take an antihistamine and use an ointment that does not contain hormones. There is no need to try to treat yourself; further prescriptions should be made by a doctor, since uncontrolled use of hormonal and other potent drugs can lead to negative consequences.

Medical care consists of a more precise selection of allergy medications that have minimal side effects, the prescription (in severe cases, with chronic urticaria) of systemic corticosteroids, and in some cases, immunosuppressants. Source: Modern principles of treatment of acute and chronic urticaria. Skorokhodkina O.V., Klyucharova A.R. Practical medicine No. 7, 2012. p. 45-49.

Emergency care for a patient with allergic urticaria is required when Quincke's edema develops. If it occurs, you should immediately call an ambulance. In order to alleviate the patient’s condition before the ambulance arrives, you need to calm him down, provide an influx of fresh air, and unfasten clothing that is restricting breathing. To relieve swelling, doctors provide the necessary assistance on site, including adrenaline injections and tracheal intubation, then the patient is taken to the hospital, where further treatment is carried out.

Treatment of urticaria

Acute allergic urticaria is treated mainly with antihistamines (cetirizine, fexofenadine). They need to be taken regularly over several weeks. The principle of their action is to block the action of histamines, due to which the rash is reduced and the itching of allergies in urticaria stops. Some antihistamines cause drowsiness. Some of them are not suitable during pregnancy unless prescribed by a doctor. Such drugs should not be self-prescribed for allergic urticaria in any case.

The chronic form causes long-term discomfort, and in this case, the symptoms of urticaria are treated. Antibiotics may be prescribed to reduce redness, swelling and other symptoms if the cause is identified.

Physiotherapy provides good help for allergic urticaria.

At the Ear, Nose and Throat Clinic we provide effective treatment for urticaria in adults and children - identifying the root cause and prescribing effective therapy, including physiotherapeutic methods.

What does allergic urticaria look like?

The main symptom of an allergy type of urticaria is an urticarial rash. These are blisters that look like nettle burns. They are of different sizes, more often have a rounded shape, less often - irregularly elongated, convex, can merge with each other, are surrounded by a fuzzy pink border along the periphery, and turn pale when pressed. The rash is painless and accompanied by severe itching. The rash can be located anywhere, including on the scalp, palms and soles. In the head and neck area, rashes and itching are characterized by greater intensity. The appearance of blisters is preceded by itching and redness of the skin.

In the generalized form of allergic urticaria (a large area of ​​rashes merging with each other), general symptoms appear - weakness, fever, chills, gastrointestinal upset. Source: Characteristics of patients with chronic urticaria at the stage of outpatient examination. Skorokhodkina O.V., Klyucharova A.R. Practical medicine No. 4, 2015. p. 131-135.

Quincke's edema is characterized by the sudden development of limited swelling of the skin, mucous membranes, and subcutaneous fat. The skin at the site of swelling is pale and cold. Edema can occur in the mucous membranes of different organs and systems - respiratory, digestive, urinary, nervous, with symptoms corresponding to damage to each of them. Laryngeal edema is especially dangerous, as it can lead to stenosis and asphyxia. The onset of laryngeal edema is characterized by hoarseness and difficulty breathing.

Allergic urticaria: recommendations to avoid

If the allergy trigger for hives is known, patients should avoid exposure to it as much as possible.

If you know that you are susceptible to spontaneous allergy symptoms due to hives, follow these guidelines:

• abstain from alcohol or reduce its consumption;
• do not prescribe any medications for yourself;
• avoid stress as much as possible;
• use anti-allergenic soaps, skin creams and cleansers;
• Avoid foods that trigger the production of histamine (they are listed in the “Causes of urticaria” section).

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