Urticaria is the most common skin condition. As a result of allergies or other factors, blood vessels dilate, increasing their permeability, causing swelling of the dermis.
It is estimated that about 50% of the population has had a cutaneous allergic reaction in their lifetime. Urticaria is divided according to the duration of symptoms – into acute urticaria, which occurs in 2/3 of cases and lasts up to 6 weeks, and chronic urticaria, which lasts more than 6 weeks.
Symptoms
The characteristic symptom of urticaria is a lesion on the skin in the form of an urticarial wheal that is painful on pressure, often accompanied by swelling.
These blisters can appear anywhere on the skin depending on the triggering factor of the symptoms and disappear, usually within 24 hours. Swelling, on the other hand, can persist for up to 72 hours.
Burning skin and intense itching are also associated symptoms.
Urticaria can cause other symptoms that aren’t directly related to the skin. The main ones include dizziness, weakness, feeling of heat, hoarseness, drop in blood pressure or nausea and vomiting.
Causes and risk factors
Looking at urticaria in terms of triggering factors, we can divide it into spontaneous and induced urticaria.
Spontaneous urticaria is a chronic disease that in many ways resembles an allergic skin reaction with histamine-dependent symptoms, but with unknown triggering factors.
Induced urticaria is usually caused by a physical (friction, ambient temperature, pressure, UV light) or other factor (elevation of body temperature, contact with water, or chemicals).
Other types of urticaria are:
Diagnosis and treatment
In the treatment of urticaria, the key is to identify the causative agent of symptoms, so that treatment can be targeted and relapses can be prevented. If there is chronic urticaria (lasting more than 6 weeks), an effective method should be to rule out other disease entities and discover the factors that aggravate symptoms.
In the case of allergic urticaria, symptoms occur extremely quickly. Even minutes after contact with an allergen, a wheal becomes visible, which can help identify the triggering factor.
The primary diagnostic tests for urticaria are provocation tests to determine the triggering agent and typical laboratory tests including blood count, acute phase protein (CRP) and red blood cell sedimentation rate (ESR).
Patients suffering from food urticaria are put on an appropriate elimination diet depending on the patient. The use of a food diary can help detect the allergic factor. The primary treatment for acute and chronic urticaria is second-generation antihistamines. If treatment after increasing the dose isn’t effective, systemic corticosteroids are suggested, but treatment cannot be used long-term due to side effects. Clinical trials are also an attractive option, especially when basic treatment doesn’t have a positive effect.