Seven most frequently asked questions on Urticaria

The most common skin condition that I come across, during my everyday dermatology practice in my clinic, is Urticaria. My patients usually feel defeated and distressed due to this particular skin condition and its problematic nature. I would like to share some views and provide answers to certain frequently asked questions related to this mysterious skin condition.

1) What is Urticaria?
The skin of a person affected with Urticaria appears with spontaneous patches in pale red colour along with pink-coloured swellings called 'hives'. The patches and hives can be present for less than 6 weeks in case of acute conditions. Prolonged state of these patches on the skin can be diagnosed as chronic conditions. The condition usually retreats in a few minutes to a few hours but appears on a different part of the skin.

2) What are the symptoms of Urticaria?
Itching or a stinging sensation on the 'hives' are usually reported by patients suffering from Urticaria. Sometimes it could be even painful if the 'hives' appear at a deeper level of the skin. A small number of patients also mention having felt dizzy, headaches and nauseous. Some of them even suffer from diarrhoea or shortness of breath.

3) What causes Urticaria?
A cell that resides next to the nerves and the small blood cells of the skin, called the “Mast cell” is the central cause of Urticaria. The “Mast cell” secretes a chemical called 'Histamine' when activated. In some patients, the number of “Mast cells” is more, while in some other, more amount of histamine is secreted by the cells. The histamine dilates the blood vessels that causes the swellings in the affected areas.

4) What triggers these cells to release histamine – Can I avoid that?
The histamine chemical is secreted by the “Mast cells” when the cells gets activated by certain foreign factors like bacteria, viral or hepatitis infections, particular drugs or medicines, food etc. In some chronic cases, the swellings can occur when the “autoantibodies” of the affected person start attacking the own immune system of the body. Patients with high autoantibodies may have to risk longer courses of the skin condition and it might take more time to zero-down on any particular treatment.

5) How do I know whether I have autoimmune chronic urticaria?
The condition can only be determined after certain tests such as ASST available mostly in highly sophisticated research centers. However, certain clues present in a patient's medical history can help us deduce whether such condition is present. Personal or a family history with members suffering from other autoimmune diseases such as thyroid, Diabetes mellitus type I or Rheumatoid arthritis are usually seen. Premenstrual flares and exacerbation during menses in women are also common symptoms of Urticaria. Another observation to determine this is the non-responsive nature of the patient towards typical treatment methods for long-term conditions.

6) What are the things I can avoid to prevent an attack?
Recording each and every event before an attack, should by done by the patient so that it can be discussed in detail with the doctor during the next visit. Although the food items that trigger an attack are usually hard to categorize, some of the known food items could be non-vegetarian food, seafood, mushrooms, yam, jack-fruit, avocados, cheese and peanuts. Infections like a sore throat or diarrhea and even undiagnosed conditions like a thyroid disorder may trigger an attack too. Sometimes even stress and physical exertions could act as triggers. However, in some patients, even after a detailed inspection, it can be really hard to shortlist the triggering causes.

7) In how much time will I get rid of this disease?
The course of urticaria, an annoying condition rather than a disease, becomes difficult to predict in some patients. In 99% of acute cases, the conditions usually resolve in 3-4 weeks while chronic conditions would take a few months to years to be resolved. However, a good command over the quality of life style could certainly help in bringing the conditions under control. Keeping track of all the events of the progress of your condition would also be helpful.

An article by Dr. Divya Sharma

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