These are rashes on the skin that can be of different sizes, slightly raised, and quite itchy (Picture-1).
This name is given because its appearance resembles the itchy rash that occurs as a result of contact with stinging nettle (Urtica urens). Urticaria plaques usually appear suddenly and usually disappear within an hour or two. Sometimes they occur in clusters and disappear in one part of the body and new ones may appear in another. (Picture-2).
Urticaria, known as “hives” among the people, is a very common ailment and it is estimated that 20% of people have an attack of urticaria at some point in their lives.
What causes urticaria?
Urticaria usually occurs due to special foods eaten or drugs used. The main foods that cause urticaria are milk and dairy products, eggs, nuts (hazelnuts, peanuts, walnuts), strawberries, tomatoes, fish and shellfish (lobster, shrimp, hermit crab). The main drugs that can cause urticaria are penicillin group antibiotics, sulfonamides, aspirin and epilepsy drugs.
What are other possible causes of urticaria?
Dermographism, which is a special form of urticaria, is a form of urticaria that occurs following the scratching or rubbing of the skin with a hard object, or where clothes and laundry squeeze the body. It is seen in 5% of the society (Picture-3).
Cholinergic urticaria is small pinhead-like urticaria plaques with redness around it, which appear after activities that increase body temperature. Exercise, hot baths, sauna, high fever or psychological stress can cause cholinergic urticaria. It constitutes 5-7% of patients with urticaria.
Cold urticaria occurs after contact with cold air or cold water. Usually the arms and legs are affected. Contact with cold air or drinking cold water can also cause urticaria on the lips and mouth.
Solar urticaria is a type of urticaria caused by sunlight in susceptible individuals. Lesions appear a few minutes after exposure to the sun.
What does chronic urticaria mean?
Sometimes urticaria may recur, although no obvious cause can be found. If the attacks last longer than six weeks, it is called chronic urticaria.
In a patient with chronic urticaria, first of all, it should be investigated whether there is another underlying disease. Because some infections, intestinal parasites, vascular inflammation, rheumatic diseases, thyroid gland diseases, cancers and lymphatic tissue tumors can cause chronic urticaria. In the absence of such an underlying disease, it is called idiopathic urticaria, and signs and symptoms are suppressed by using various drugs. Chronic urticaria is a condition that does not usually last a lifetime and resolves within a few months to a few years.
What is angioedema?
Although urticaria involves the skin surface, angioedema is characterized by swelling in the deeper layers of the skin. It is most commonly seen on the lips, eyelids, hands and feet. If it is in the throat, emergency treatment measures should be taken as the airways can be blocked. However, this is an extremely rare condition. Angioedema attacks usually cause swelling of the eyelids and lips, last for a day or two, and may recur at any time with or without urticaria.
Hereditary angioedema is a rare hereditary disease and may be fatal in some cases. Therefore, it should be differentiated from other chronic angioedema types. Angioedema, or swelling, can affect the face, arms, and legs, as well as the airways such as the windpipe, tongue, and larynx. In fact, sometimes severe pain caused by angioedema in the abdomen may lead patients to be operated on with a mistaken diagnosis of appendicitis. It is known that the deficiency of a special protein in the blood leads to this hereditary disease.
How is urticaria-angioedema treated?
The basic principle of treatment is to avoid triggering factors such as foods, food additives, drugs and psychological stresses that may cause urticaria as much as possible. A group of drugs called antihistamines are most commonly used to treat attacks. If urticaria attacks cannot be controlled with antihistamines, short-term use of cortisone-containing drugs (corticosteroids) together with antihistamines may be necessary.
The vast majority of patients benefit from corticosteroid therapy; however, long-term and uncontrolled use of these drugs should be avoided due to their potential side effects. In acute and severe angioedema cases, adrenaline injections may sometimes be required to correct the edema. Hereditary angioedema can be treated with some special medications. It should not be forgotten that all these drugs must be used in accordance with the recommendations of an allergist.
