Chronic (recurrent) urticaria. Chronic urticaria treatment Chronic urticaria diagnosis

Urticaria is a pathological condition of the skin that occurs against the background of an allergic reaction. The disease is characterized by the presence of pronounced symptoms and requires timely treatment.

The chronic form of the disease proceeds for a rather long period. In order to avoid recurrence of the disease, patients are advised to completely exclude allergens.

Chronic urticaria is characterized by the presence of pronounced symptoms that do not go away within a month and a half. During the course of the disease on the patient's skin are observed:

• papules;
• Rash;
• Scarring;
• puffiness;
• Plaques.

Most patients during the development of the pathological process complain of itching. The rash with the disease manifests itself in the form of pink or red blisters. The place of their dislocation can be the neck, face, arms, legs, back.

The cause of scarring on the skin is an allergic reaction. They are characterized by different sizes and shapes. Quite often, scars can disappear and reappear.

Some patients develop papular chronic urticaria. In this case, papules with a white center appear on the patient's skin. Around them there is an inflammatory process on the skin.

During the development of this disease, patients complain of itching, the intensification of which is observed in the evening. During the development of an allergic reaction in patients, swelling may occur on the skin.

A fairly common symptom of the chronic form of the disease is Quincke's edema.

In places where edema appears, stretching and peeling of the skin are observed. Symptoms of the disease are not always pronounced.

In some cases, the symptoms of the disease disappear, and after a certain time they reappear. That is why, when the first symptoms of the disease occur, patients are advised to immediately seek help from a doctor.

Causes of the disease

The main reason for the appearance of the pathological process is the impact on the body of a provoking factor. Against this background, the production of a special substance, histamine, is observed.

During the period of release of this protein, the capacity of the capillaries increases, which leads to leakage of fluid through them. As a result of this, the development of blisters and swelling of the skin is observed.

The disease is autoimmune in nature. When exposed to an allergen, specific antibodies are released and activated, which leads to an allergic reaction.

Causes of chronic urticaria and how to treat it, see this video:

There are a huge number of provoking factors of the disease. Most often, it is diagnosed against the background of violations in the performance of the kidneys. With rheumatoid arthritis, the risk of pathology is significantly increased.

Urticaria can be diagnosed in patients with malignant neoplasms.

If diseases of the gallbladder occur against the background of infectious processes, then this can be the cause. The disease is often diagnosed in patients with Sjögren's syndrome.

With diabetes, a person is at risk of developing a chronic form of the disease. With lupus or lymphogranulomatosis, the development of the disease can be observed.

It is also diagnosed against the background of various diseases of the thyroid gland. The occurrence of pathology is diagnosed in patients with certain chronic diseases - caries, viral hepatitis, hypothyroidism, hyperthyroidism.

Pathology in the fairer sex can appear with inflammation of the appendages. Urticaria of a certain group of patients develops against the background of caries.

Chronic urticaria can be observed when exposed to a variety of provoking factors. That is why a patient with a tendency to allergic reactions needs to closely monitor their health.

How is chronic urticaria diagnosed?

To ensure an effective chronic form of the disease, it is necessary to correctly diagnose it. Initially, the doctor examines the patient, and also collects an anamnesis.

In order to confirm a preliminary diagnosis, it is necessary to conduct appropriate tests. In this case, the patient's body is tested:

These factors are allergy triggers, with the help of which the type is established. For a correct diagnosis, an instrumental examination is recommended.

In the period of exacerbation of the disease, it is much easier to diagnose it. That is why patients are advised to seek help from a doctor when the first signs of the disease appear.

Providing first aid

The first group of medications should be taken in the evening. Most often, experts recommend the use of Claritin, Tavegil, Suprastin.

When to see a doctor

In some cases, patients manage to eliminate the manifestations of the chronic form of urticaria on their own. If the disease leads to the development of edema or anaphylactic shock, then the patient must urgently seek help from a doctor.

Principles of treatment of pathology

Therapy of urticaria is carried out with the use of medications. Most often, patients are recommended the use of antihistamines, as well as leukotriene receptor antagonists.

With the help of the first group of drugs, itching and other symptoms of an allergic reaction are eliminated. Medication should be taken twice a day. The duration of the use of drugs is 3-12 months.

If the patient has rhinitis or bronchial spasms, then it is necessary to take the second group of drugs. Most often, patients are recommended to use Singular.

If a person has pain with urticaria, then he is recommended to use painkillers.

In order to avoid the occurrence of complications, the use of antimicrobial drugs is necessary. They are recommended for patients who have impaired stomach function. The most commonly used drugs are Dapsone or Colchicine.

If the patient's body does not respond to antihistamines, then he is recommended to take Prednisolone. To combat the manifestations of the disease, the use of:

• Prednisolone;
• Nezulin;
• Fenistila;
• Sinaflan etc.

Medicines are produced in the form of an ointment and are intended for topical use. The dosage and frequency of use of the drug should be determined by the doctor in accordance with the individual characteristics of the patient.

What is chronic urticaria, this video will tell:

To combat the manifestations of recurrent urticaria, the use of traditional medicine is recommended. The most effective of them include:

It is quite a serious and responsible process. That is why it requires an integrated approach and constant monitoring of the doctor.

diet therapy

To ensure the most effective therapy for urticaria, patients are advised to follow a diet. In this case, patients are strictly forbidden to eat spicy, salty and peppery dishes.

Also, do not eat hard cheese, mustard, mayonnaise. It is not recommended to use seafood, nuts and honey for urticaria for cooking. The intake of alcoholic beverages during the period of treatment of the disease by patients is strictly prohibited.

The patient should refrain from drinking hot sauce and coffee. Baking, chocolate and lollipops are not recommended for hives.

the diet should not include citrus fruits and strawberries.

When compiling a diet, preference is given to products whose action is aimed at increasing the concentration of histamine in the blood. It is recommended to cook dishes from poultry.

The chronic form of urticaria is a rather unpleasant disease that can occur for various reasons. At the first manifestations of the disease, it is recommended to treat it.

For this, drug therapy is used, as well as folk remedies. To ensure the highest possible effectiveness of treatment, the patient is advised to follow a diet.

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Diagnosis, tests and examinations for urticaria

The main complaint of a patient with urticaria is the presence of an itchy rash on the skin and mucous membranes. The rash is represented by small vesicles filled with a clear liquid. When pressed, the bubbles turn pale. The rash can migrate from one area of ​​the body to another. A special characteristic of the rash is its inconstancy - the rash can then reappear, then disappear during the day. The patient, as a rule, describes all these complaints at the doctor's appointment.

Which doctor treats hives? Which doctor should I contact for urticaria?

There are the following questions that the doctor asks during the examination:

• how long the patient has been bothered by rashes and itching on the skin;
• on which part of the body, and under what circumstances, the rash arose for the first time;
• whether the patient comes into contact with potential allergens ( chemicals, pollen, animal hair);
• whether the person is taking any medications, vitamins, or dietary supplements;
• Have you made any changes to your usual diet?
• Does the patient suffer from any chronic diseases?
• whether there are persons suffering from urticaria among the patient's relatives.

If urticaria occurs in an adult or child against the background of an existing disease of the collagenosis group (for example, rheumatoid arthritis, rheumatism, systemic lupus erythematosus, systemic scleroderma, periarteritis nodosa, dermatomyositis), then the treatment of urticaria is not so much allergist (make an appointment) or dermatologist (make an appointment), how many rheumatologist (make an appointment), since in such a situation the skin symptom is a manifestation of another, systemic disease. Accordingly, success in the treatment of urticaria is determined by the effectiveness of therapy for the underlying pathology of the collagenosis group. This means that with urticaria against the background of diseases of the group of collagenoses, one should contact a rheumatologist, a dermatologist or an allergist, and doctors of these specialties will lead the patient collegially.

In addition, if urticaria is combined with a disease of the gastrointestinal tract (for example, gastritis, celiac disease, ulcerative colitis, etc.) or malnutrition, then, in addition to a dermatologist or allergist, you should contact gastroenterologist (make an appointment) which deals with the treatment of the digestive tract. It is necessary to consult doctors of two specialties, since the success of the treatment of urticaria also depends on the effective and properly selected therapy for diseases of the digestive tract.

In Russia, application tests are widespread, during which the allergen is applied to the patient's skin in liquid form. So, a drop of the allergen is applied to the skin of the patient's forearm and after a while the reaction is determined. The formation of a large red spot at the site of application of the allergen indicates that the patient has an allergy. Up to ten allergens can be tested at the same time.

In the diagnosis of allergies, blood tests are no less informative. As a rule, a general blood test is performed to determine the number of eosinophils, as well as tests to determine the level of immunoglobulins.

Tests performed for hives

What research can a doctor prescribe for urticaria?

During anaphylactic shock, swelling of the soft tissues occurs, including the tissues of the respiratory tract. Therefore, the main danger in this case is shortness of breath due to swelling of the larynx. Air in this case ceases to enter the respiratory tract and acute respiratory failure develops. Also under the influence of histamine ( main mediator of allergic reactions) there is a fall ( scientific collapse) vessels. As a result, blood pressure drops sharply and blood circulation is disturbed. This further exacerbates hypoxia ( oxygen starvation) organism. A disorder of cardiac and respiratory activity develops sharply, the patient's consciousness becomes cloudy and fainting occurs.

The stages of first aid include:

• Call an ambulance- anaphylactic shock is an emergency condition requiring immediate assistance, therefore, as soon as the patient has the first signs of anaphylaxis ( he blushed, began to choke), call an ambulance.
• Ensuring oxygen access to the respiratory tract- during anaphylactic shock, swelling of the airways occurs, as a result of which their lumen narrows and creates an obstacle to the penetration of air. Before the arrival of the ambulance, it is necessary to lay the patient horizontally and straighten the neck to restore airway patency. It is also necessary to check the oral cavity for the presence of chewing gum or other objects that can block the airways.
• Providing blood pressure support- for this, it is necessary to give a horizontal position to the patient with raised legs in order to increase the flow of venous blood.
• Injection of adrenaline and other drugs. As a rule, people prone to allergic reactions carry the necessary medicines with them. Most often, this is a disposable syringe with epinephrine or dexamethasone. Adrenaline is injected intramuscularly into the upper third of the thigh. If you do not have the necessary drugs with you, you must wait for the arrival of an ambulance.

Adrenaline, prednisolone, and other medicines used in first aid for hives

Injections used in first aid for hives

Urticaria treatment

The following treatments are relevant for urticaria:

• taking pharmacological agents injections, pills);
• use of topical drugs ointments and creams);
• diet therapy;
• physiotherapy procedures.

Pills and injections for hives

The injections prescribed for urticaria are:

• Adrenalin- is put exclusively as first aid for urticaria, which is a manifestation of anaphylactic shock. One milliliter intramuscularly, can be repeated after 5 to 10 minutes.
• Diphenhydramine- used both as first aid and as prolonged ( prolonged) treatment. It is administered intramuscularly in one ampoule, usually in the evening. It has such side effects as drowsiness, a sedative effect on the central nervous system. Despite the fact that it is only the first generation antihistamine, it has a pronounced antiallergic effect.
• Suprastin- is prescribed, as a rule, in the subacute period of the disease. The recommended dose is one milliliter intramuscularly two to three times a day.
• Fenkarol- recommended for urticaria, Quincke's edema and other allergic reactions. It is prescribed two milliliters twice a day for 5 days.

Tablets prescribed for urticaria are:

• tavegil- one tablet by mouth three times a day;
• diazolin- one tablet two to three times a day ( depending on the severity of the symptoms);
• claritin- once, inside, one tablet a day;
• zyrtec- one tablet per day, once;
• trexil- one tablet twice a day.

Diphenhydramine, zyrtec, claritin and other antihistamines for urticaria

To date, there are three generations of antihistamines that differ in their spectrum of action. The oldest representative of this group of drugs is diphenhydramine. It has a pronounced anti-allergic effect, but, unfortunately, provokes great drowsiness.

Generations of antihistamines

Antibiotics for hives

That is why antibiotics are prescribed with great care to people with a predisposition to allergies. In cases where urticaria is a concomitant symptom of a bacterial disease, the choice of antibiotic should be made very carefully. Under all circumstances, penicillin and sulfa drugs should be avoided. In this case, antibiotics can aggravate the course of urticaria and stimulate the development of anaphylactic shock.

Vitamins for hives

Vitamins prescribed for hives include:

• beta carotene or vitamin A- 25,000 IU each ( international units) of this vitamin daily ( what is the daily norm) will help reduce the symptoms of hives. Vitamin A is available in capsules.
• Vitamin PP ( nicotinamide) - prevents the release of histamine, which, in turn, determines the symptoms of urticaria. The daily norm is 100 milligrams. As a rule, this vitamin is always contained in a complex of vitamins.
• Vitamin C- reduces the permeability of capillaries and, thereby, reduces the development of edema. The average daily dose is 500 milligrams, and with profuse rashes with urticaria, the dose can be increased to 1000 milligrams.
• Magnesium- the lack of this element in the body can provoke the development of urticaria. Therefore, it is recommended to take magnesium at 250 milligrams daily.
• Vitamin B12- prevents the release of histamine. Reduces the symptoms of hives, dermatitis and other types of allergies. It is prescribed one ampoule intramuscularly for a month.

Polysorb, activated charcoal and other drugs used in the treatment of chronic urticaria

Chronic urticaria significantly reduces the quality of life of patients, as itching causes severe discomfort, especially at night. Skin rashes are a visible cosmetic defect that provokes a violation of the emotional background and various psychological problems. The lack of proper rest, combined with emotional disorders, leads to the fact that patients become irritable, complain of headaches, and their ability to work decreases. All this as a result leads to the progression of the disease, so some patients are prescribed antidepressants and other drugs to normalize the functioning of the nervous system.

Omalizumab ( xolair) with urticaria

Advantan, akriderm ( diprospan) and other ointments used in the treatment of urticaria

There are the following types of hormonal ointments for the treatment of urticaria:

• prednisolone;
• akriderm ( another name for diprospan);
• flucinar;
• histane-N;
• lorinden s.

The second group includes non-hormonal products that contain various components to moisturize and nourish damaged skin. An important role in the treatment of urticaria is played by zinc-based ointments, which have an antimicrobial and drying effect.

• salicylic-zinc ointment;
• skin cap ( zinc based);
• nezulin;
• la cree.

Diet therapy for hives

There are the following schemes for the development of cross-allergy:

• cow's milk- soy, veal and beef;
• chicken eggs- poultry meat ( chickens, ducks, quails), eggs of other birds;
• strawberry- currant, raspberry;
• hazelnuts- sesame, poppy, oatmeal and buckwheat flour;
• peanut- potatoes, soybeans, plums, peaches.

There are the following provisions of the hypoallergenic diet:

• limited intake of traditional allergens ( milk, eggs, seafood, honey);
• refusal of exotic products ( shellfish, meat of rare animals, fruits such as guava, lychee);
• minimal consumption of food colors, flavor enhancers, flavorings ( found in large quantities in semi-finished products, products of bright color with a pronounced aroma);
• reduction in salt intake present in large quantities in chips, saltine crackers, dry beer snacks);
• refusal of canned vegetables of home or industrial production;
• the use of such cooking methods as boiling, baking;
• drinking at least 2 liters of water per day.

Physiotherapeutic procedures for urticaria

In chronic urticaria, the following physiotherapy is indicated:

• electrophoresis with various drugs;
• exposure to ultrasound on areas with rashes;
• darsonvalization ( exposure to weak currents);
• therapeutic baths ( based on sulfide and radon);
• ultraviolet irradiation.

Diet for hives

Exclusive ( elimination) diet for hives

General Elimination Diet Rules
The principle of the elimination diet is that for a certain time the patient completely refuses food or removes traditional allergen foods from the menu. Then food products are gradually introduced into the diet, and the patient's task is to monitor the body's reaction to the foods consumed. To do this, you need to keep a food diary, which records data on the composition of the diet and possible reactions of the body.

The list of data to be entered in the diary includes the following items:

• meal time;
• foods that were eaten;
• heat treatment method;
• the amount of food eaten;
• body's reaction rash, itching) if it appears.

In addition to the food diary, there are a number of provisions that are mandatory for compliance with the elimination diet. The system of eating should be fractional, which implies at least 5 meals a day. Portions should be small, otherwise a large load is created on the digestive system. All dishes are prepared with a minimum amount of salt and spices. Products prepared by frying, smoking, drying are prohibited. Out-of-season vegetables and fruits, as well as foodstuffs of exotic origin, are not allowed.

The elimination diet continues until the body's reaction to all the foods that make up the human diet is established. After that, the patient is transferred to a hypoallergenic diet, in which the products established as allergens for this patient are completely excluded.

Strict Elimination Diet Rules
A strict diet begins with fasting, which should last from 3 to 5 days. Therefore, resorting to this type of elimination diet is allowed only for adults who have undergone a comprehensive examination. In most cases, a strict diet is prescribed to patients who are in the hospital and all rules are followed under the guidance of medical personnel.

Foods for hives

Products are entered in the following sequence:

• vegetables ( zucchini, carrots, potatoes);
• dairy products ( cottage cheese, kefir, yogurt);
• porridge ( oatmeal, buckwheat, rice);
• low-fat varieties of fish;
• lean meats;
• eggs;
• milk and products from it.

The order in which products are not included in the list is determined by the patient. But at the same time, it is necessary to continue to adhere to the rule that a new product can be tried every 2 days. After fasting is completed, the patient must begin to keep a food diary, in which the body's reaction to each new food eaten should be displayed. Compliance with all the rules of a strict elimination diet allows you to identify food allergens and draw up a basic menu, which the patient with urticaria must subsequently adhere to.

The rules of a gentle elimination diet
A sparing elimination diet is relevant for young children, as well as for patients who, for health reasons or for other reasons, cannot follow a strict diet. First, from the patient's menu, it is necessary to exclude all products that modern medicine refers to the group of traditional allergens.

There are the following food allergens:

• milk and products made from it butter, cheese, ryazhenka, cream);
• cereal crops ( wheat, rye, barley);
• legumes ( peas, chickpeas, lentils);
• eggs ( chicken, goose, duck);
• all kinds of sea fish salmon, flounder, salmon);
• all kinds of seafood shrimps, mussels, caviar);
• meat ( beef and veal, chicken, meat of wild animals and birds);
• vegetables ( tomatoes, bell peppers, celery, eggplant);
• fruits ( all citrus fruits, peaches, red apples);
• berries ( strawberries, raspberries, red and black currants);
• nuts ( peanuts, walnuts, almonds, hazelnuts);
• chocolate and any of its derivatives ( cocoa, icing);
• sauces and salad dressings vinegar, soy sauce, mayonnaise, mustard, ketchup);
• any food that contains yeast ( yeast bread and other forms of baking);
• honey and other bee products ( propolis, royal jelly).

There are the following permitted foods with an elimination diet:

• dairy products with low fat content ( kefir, yogurt, cottage cheese);
• cereal crops ( corn, oats, millet);
• vegetables ( broccoli, cucumbers, zucchini, carrots, potatoes);
• meat ( turkey, rabbit, low fat pork);
• low-fat varieties of river fish ( walleye, pike, trout);
• fruits ( green apples and pears);
• berries ( white cherries and currants).

Hypoallergenic diet for urticaria in adults

There are the following provisions of the hypoallergenic diet for urticaria:

• the feeling of overeating should not be allowed, therefore, no more than 300 grams of food should be consumed at one time;
• the number of daily meals - at least 5;
• the temperature of the food consumed is moderate;
• at least 300 - 400 grams of vegetables and fruits should be consumed per day;
• the diet should contain a lot of fiber, which is found in cereals, vegetable and fruit dishes;
• sweets, cereals, meat and dairy products with high fat content should be consumed in the morning;
• after dinner, preference should be given to low-fat dairy products, vegetables, lean meat and fish;
• At least one and a half liters of liquid should be consumed per day.

There are the following categories of foods that contribute to the release of histamine:

• any exotic food products ( those that are not part of the patient's standard diet);
• all berries, fruits and vegetables are red and purple;
• any berries, fruits and vegetables in canned form ( jams, preserves, pickles);
• all varieties of citrus crops;
• honey and bee products;
• whole cow's milk, hard cheeses, cheese;
• chicken eggs, egg powder;
• any varieties of meat and fish that are prepared by smoking or drying;
• meat and fish canned food;
• any kind of seafood;
• chocolate and all products in which it is contained;
• coffee and caffeinated drinks;
• carbonated drinks.

Treatment of urticaria with folk remedies

How to treat hives with folk remedies?

There are the following rules for the collection and preparation of raw materials for herbal medicine:

• do not collect plants that are wet from rain or dew;
• collection should be carried out in areas that are at a sufficient distance from highways and industrial enterprises;
• dry raw materials should be in the sun or in the oven;
• dried plants must be crushed using a coffee grinder or other similar equipment;
• raw materials are not recommended to be stored in plastic or metal containers; it is best to use ceramic or glass containers for this.

Duration and dosage in herbal medicine
The positive effect of taking phytopreparations occurs, as a rule, after 2-3 weeks. This does not mean that treatment should be stopped, since for a sustainable result, it is necessary to take folk remedies for at least 3-4 months. At the same time, periods of constant medication should be alternated with pauses, which should be every month and last 7 to 10 days. Subsequently, after the completion of the course of treatment, for preventive purposes, 2 times a year, herbal remedies should be taken for 4 to 6 weeks.

It is necessary to start treatment of urticaria with those funds, which include 1 - 2 components. If no allergic reactions are noted within 5 to 7 days, you can switch to drugs with a more complex composition ( multi-component fees). The daily volume of drugs for oral administration is 200 milliliters, which should be divided into 2 to 3 doses. When using topical preparations, the amount is determined by the area of ​​\u200b\u200bthe skin on which rashes are present.

Forms of herbal remedies
Depending on the method of manufacture and subsequent use, there are several forms of folk remedies.

There are the following types of herbal medicines:

• Decoction. Indicated for internal use and is prepared from soft plant fragments ( leaves, inflorescences). For the daily norm of the medicine, a tablespoon of raw materials is steamed with a glass of water of 70 - 80 degrees and infused for half an hour.
• Infusion. It is also intended for oral administration, but differs from the decoction in that it is prepared from the hard segments of the plant ( roots, bark). In order for the raw materials to fully “give away” their beneficial substances, the infusion must be kept in a water bath for at least 20 minutes. To prepare the daily norm, a tablespoon of dry ingredients per glass of water is used.
• The juice. It is prepared from fresh plants and is taken at 50 - 100 milliliters per day. Drink the drink should be within 1 - 2 hours after its preparation, as then it significantly loses its healing effect.
• Concentrated decoction. This form of phytopreparation is used for therapeutic baths. A decoction of high concentration is prepared from 6 - 7 tablespoons of raw materials ( soft and/or hard plant parts) and 2 glasses of water 70 - 80 degrees. Water-herbal suspension must be kept in a water bath for about 20 minutes.
• Solutions. They are used for lotions and are prepared as a concentrated decoction of plants that have a drying effect. Also, other components with antipruritic action can be added to the solution. It could be salt a teaspoon per glass of broth), vinegar/lemon juice ( a tablespoon per glass of broth).
• Oil substances. Used for compresses, which are applied to those areas of the skin where blisters are present. Such preparations are prepared on the basis of natural oils ( castor, olive, burdock) and dry raw materials. To make the substance, you should combine a glass of oil with a glass of chopped herbs, and then infuse the suspension for 2-3 weeks. A tablespoon of some emollient component can be added to the real filtered oil ( glycerin, lanolin).
• Ointments. Designed for application to areas of the skin that are affected by a rash. They are prepared from dry plants and a fatty base, which can be used as butter, unsalted pork lard. First, the fat base should be melted, vegetable raw materials should be added and simmered in the oven for 2-3 hours at a low temperature. Then, depending on the recipe, various components with a drying effect can be added to the fat base. It can be birch tar, white clay, talc. Ingredients with a drying effect are added at the rate of a tablespoon per glass of the finished fat base.

Nettle and other folk remedies in the treatment of urticaria

There are the following groups of phytopreparations:

• bath products;
• drugs for internal use;
• preparations for external use.

Means for external use for urticaria

Medicines for internal use
This group includes decoctions, infusions and juices that must be taken orally. Before you start taking herbal remedies, the patient should consult a doctor. This requirement is mandatory, since with urticaria many remedies made on the basis of medicinal herbs may be contraindicated.
and chamomile ( 1 part).

Juices

Celery.

Fuck honey.

Beet ( not recommended if hives are due to a food allergy).

Urticaria - causes, symptoms, what to do and what will help? - Video

One of the options for an allergic reaction is hives. According to statistics, every third inhabitant of the planet has at least once encountered this pathology. Most often, urticaria is not an independent disease, but a symptom of other autoimmune diseases. In this case, the disease becomes chronic.

• cold (Duncan test);
• thermal (water compress);
• provocation by pressure, tension (test with a spatula, tourniquet).

They also do tests for food, household allergens, reactions to plants and animal hair.

The reaction to food allergens is detected using two types of diets:

• Elimination. It consists in the gradual exclusion from the diet of foods that, presumably, caused allergies. The patient keeps a food diary, recording their response to withdrawal.
• Provocative. In this case, on the contrary, the amount of allergenic foods in the diet is increased.

With the help of diets, it is possible to determine the allergen in only 50% of cases. The remaining cases are recognized as idiopathic.

Treatment

Chronic treatment begins with the elimination of the allergen. Basic principles of treatment of urticaria:

• elimination of the provoking factor;
• relief of the patient's condition with the help;
• drawing up a treatment algorithm;
• therapy of the disease that caused;
• relapse prevention.

The drugs used for treatment are shown in the table:

Diet

Diet for chronic urticaria is an effective method of therapy. Exclusion from the diet of products of increased allergenicity leads to a decrease in the symptoms of the disease and the achievement of a long period of remission.

With nettle fever, you can not eat the following foods:

• sweets (chocolate, honey, sweets, soda);
• nuts;
• sausages;
• canned foods;
• chicken eggs;
• red vegetables and fruits (tomatoes, apricots, citrus fruits, peaches, persimmons, grapes); berries (strawberries, raspberries);
• smoked meat, lard, fish;
• mayonnaise, ketchup and other store-bought sauces;
• sweet yoghurts, whole milk;
• white bread, muffin;
• chips, crackers and other products with a lot of preservatives;
• alcohol.

Allowed products:

• lean meat (chicken, rabbit, turkey);
• fermented milk products (cottage cheese, kefir, fermented baked milk, unsweetened yogurt);
• cereals (buckwheat, oatmeal, rice, barley);
• whole grain bread;
• baking hypoallergenic;
• green vegetables and fruits (cucumbers, zucchini, eggplant, cabbage);
• fresh greens;
• boiled potatoes;
• vegetable and butter;
• rosehip broth, dried fruit compote without sugar.

The way food is prepared is also important. It is preferable to cook by steaming or by stewing and baking. Fried foods are best avoided.

ethnoscience

Some folk remedies have been successfully used to treat chronic urticaria. Decoctions of herbs can be used inside, in the form of lotions and trays. Usually use such herbs: succession, coltsfoot, plantain. They have anti-inflammatory and anti-allergic effects.

• A decoction of bay leaf is drunk and applied to the affected areas. It relieves itching and inflammation well.
• Drink celery juice before meals. It removes toxins well, improves digestion, improves immunity.
• Alcoholic infusion of nettle and yarrow. Take 30 drops before meals. The tool strengthens the immune system, reduces inflammation.
• Lotions are made from a decoction of celandine. You can take a bath, but make sure that water does not get into your mouth.

Before using folk remedies, you should consult your doctor.

Chronic urticaria and the army

Chronic urticaria is a life-threatening disease. It belongs to the category of skin diseases. According to the Law on Military Service, a conscript with skin diseases (Section 62) is considered partially fit for military service.

He is issued a military ID with category B, the young man is deducted into the reserve.

Prevention and prognosis

Chronic urticaria, unfortunately, cannot be completely cured. If all medical prescriptions are followed, a long-term remission can be achieved. However, contact with an allergen can cause a relapse at any time.

In order to avoid relapse, the patient must observe the following preventive measures:

• Stick to a hypoallergenic diet.
• Avoid contact with allergens.
• Use cosmetics and household chemicals with a natural composition.
• Treat all infectious diseases promptly.
• Strengthen immunity with the help of tempering procedures and physical exercises.
• During epidemics of influenza and SARS, do not visit public places.
• Avoid prolonged stress.
• To refuse from bad habits.

Chronic urticaria is an incurable disease. In order to prevent the transition of allergies to the chronic stage, it is necessary to seek medical help at the first sign of the disease. Timely detection of the allergen and adequate treatment are a guarantee of recovery.

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What is hives?

As a rule, urticaria is more a symptom than an independent disease. For example, it can be a skin manifestation of allergic shock, bronchial asthma, some kind of autoimmune disease. Very rarely, urticaria is an independent allergic reaction, without accompanying symptoms.
According to statistics, every third inhabitant of the planet suffered at least one episode of urticaria, more than 15 percent of people suffered this episode twice. The peak incidence occurs between the ages of 20 and 40, and it is predominantly female who suffers from this disease.

Causes of hives

Conditions in which the balance of hormones changes include:

• taking oral contraceptives.

There are the following causes of chronic urticaria:

• infectious diseases;
• immune system disorders;
• Food;
• physical factors;
• dermatitis;

infections

Immune system disorders ( autoimmune urticaria)

Food ( allergic urticaria)

Physical factors ( sun, cold)

There are the following physical factors that can cause hives:

• The sun. In some patients ( most often women) due to exposure to sunlight, blisters characteristic of this pathology appear on the skin. The rash appears on those parts of the body that are not covered by clothing ( shoulders, face). Solar urticaria develops a few minutes after exposure to sunlight.
• Cold. In this case, cold water or air can provoke hives. In some people, symptoms of the disease appear when eating too cold food. Blisters with cold urticaria do not appear on chilled areas of the skin, but around them.
• Water. The reaction of the body to contact with water, as a result of which an itchy rash appears on the skin, is called aquagenic urticaria. In some cases, the rash is absent or almost invisible, and only itching is present as a symptom.
• Vibrations. In this case, the rash appears as a result of vibration exposure. Vibration urticaria most often affects people whose work involves the use of certain equipment ( e.g. a jackhammer).
• Allergens. Dust, plant pollen, animal dander, and other traditional allergens that come into contact with the skin cause a rash. Symptoms of contact urticaria disappear after contact with the allergen is interrupted.
• A sharp increase in body temperature. Body temperature may change due to excessive emotional or physical exertion, eating too hot and / or spicy food, visiting a steam room. Experts call this type of disease cholinergic urticaria. This form of the disease is characterized by the appearance of small blisters of a pale shade, which are located on the upper body.
• mechanical irritation. Most often, skin is irritated by tight clothing, a too tight belt, and digging buttons. For the onset of symptoms, as a rule, long-term exposure to a mechanical factor is necessary. This disease is called dermographic urticaria. Blisters in this disease have a linear shape and appear on the skin not together with itching, but after a while.

Urticaria and dermatitis

Urticaria and diabetes

Against the background of reduced immunity and low resistance ( sustainability) of the skin often develop dermatitis, rarely urticaria. A favorite place for rashes in diabetes is the feet, ankles, palms. This is explained by the fact that these parts of the body are the most distal, that is, located on the periphery. In them, blood circulation is the worst, which is the basis for the development of a rash. A manifestation of urticaria in diabetes mellitus, as in other diseases, is a small, blistering rash.

Urticaria and hepatitis

Urticaria and gastritis

Urticaria and herpes

Urticaria and leukemia

What does urticaria look like on the face, arms, legs, back and other parts of the body?

Symptoms of acute urticaria in adults

Rash with hives

A feature of urticaria in adults is that it quickly and suddenly appears and also quickly disappears.

Itching with hives

Quincke's edema and other manifestations of urticaria

With the aggravation of the severity of the disease, a giant urticaria can develop, which is called Quincke's edema. This condition is characterized by severe edema, which involves not only the skin, but also the subcutaneous tissue with mucous tissues. Quincke's edema ( also called angioedema) refers to one of the most dangerous manifestations of urticaria, since in the absence of timely medical intervention it can cause death.

The first sign that indicates angioedema is the rapid swelling of the skin, due to which the part of the affected body part increases in size. The shade of the skin remains natural, and the itching is replaced by pain and severe burning. Quincke's edema most often develops in the area of ​​the cheeks, lips, mouth, genitals and other places rich in subcutaneous tissue. The most dangerous is edema, which affects the mucous tissues of the respiratory tract, as this creates an obstacle to normal breathing.

There are the following signs of Quincke's edema of the respiratory tract:

• hoarse voice;
• wheezing labored breathing;
• bluish skin tone in the area of ​​the lips and nose;
• bouts of severe coughing, which resembles barking;
• the skin on the face turns red and then quickly becomes pale.

Is hives contagious?

Is it possible to swim with hives?

There are the following rules of water procedures for urticaria:

• The water temperature should not exceed 35 degrees. Higher temperature water increases the permeability of blood vessels, as a result of which, after a bath or shower, the rash may increase in size.
• Do not use hard washcloths, detergents with abrasive particles, or any other devices that can injure the skin. The best option are soft sponges made of foam rubber.
• During water procedures, you should not use products that are bright in color and / or have a pronounced aroma, as they contain fragrances and other chemicals that irritate the skin. It is best to use special hypoallergenic products for hives.
• The duration of any water procedure should not exceed 15 minutes. In acute urticaria, the bathing time should be reduced to 5 minutes.
• After hygiene procedures, you should blot moisture from the skin with a soft natural towel, and then apply a healing ointment or other external agent that the patient uses.
• If there are manifestations of a secondary bacterial infection on the skin ( abscesses) bathing is prohibited. The patient in this case should take a quick shower, trying not to affect the area with abscesses.

How long does hives last?

In adult patients, the acute form of urticaria, as a rule, has a longer course, and skin changes can persist for up to one and a half months. The fact is that in adults it is quite difficult to identify the cause of the pathology and therefore there are difficulties in eliminating the factor that provokes the disease.
If the symptoms of the disease do not go away after a month and a half, the disease is defined as chronic, which can last from several months to 5 ( and sometimes more) years. The duration of the chronic form depends on the state of the patient's immune function, the lifestyle he leads, and other general factors.

Complications and consequences of urticaria

There are the following consequences that urticaria can lead to:

• Quincke's edema. The most dangerous consequence of this pathology is Quincke's edema, which affects the larynx, since in this case there is an obstacle to the respiratory process. In the absence of timely medical assistance, edema can be fatal.
• bacterial infection. A common consequence of hives is a bacterial infection that develops on the skin affected by the rash. Most often, this complication develops in acute forms of the disease, when pronounced large blisters appear on the patient's body. Due to the addition of a bacterial process, abscesses and boils appear on the patient's skin, which can be painful.
• Depression. Emotional disorders are observed in approximately 15 percent of adult patients who suffer from chronic urticaria. The cause of depression is poor sleep, as the patient is prevented from getting enough sleep by severe nighttime itching. In addition, blisters are a cosmetic defect, which negatively affects the patient's self-esteem and entails emotional experiences.

Urticaria in children

As a rule, acute urticaria occurs in children with atopy ( predisposition to allergic reactions). Studies have shown that one in five children who are hospitalized with acute urticaria also suffer from atopic dermatitis. More than half of hospitalized children have other allergic reactions.

Symptoms of hives in children

Features of skin changes in urticaria
Skin rashes in children with urticaria occur suddenly and are not accompanied by any preliminary symptoms. Blisters appear on the child's body, rising above the skin, which can be a pronounced pink or red hue. Most often, the elements of the rash appear in the skin folds or areas where the skin comes into contact with clothing. Also, blisters can appear on the buttocks, on the inside of the elbows and knees, and on other parts of the body. With weak pressure, a dense white nodule appears in the center of the blister. A characteristic feature of the rash with urticaria is severe itching, due to which the child begins to scratch the skin. This leads to the fact that the blisters begin to increase in size, and red crusts form on their surface.

There are the following distinctive signs of a rash with urticaria in children:

• a rash on the skin appears suddenly and also disappears abruptly;
• on a specific area of ​​the body, blisters last no more than 2 hours ( in rare cases up to 2 days), after which they may appear elsewhere;
• with strong scratching, the elements of the rash can merge, forming large continuous blisters;
• swellings have an irregular shape, but their edges are clearly defined;
• after the rash disappears, there is no scarring, pigmentation or any other marks left on the skin.

Urticaria in the chest

Causes of hives in infants
In most cases, the appearance of a rash characteristic of urticaria in children is associated with exposure to a food allergen, which is the food included in the diet of a child or a nursing mother. A common concomitant factor is various infectious diseases, which occur in about 60 percent of infants suffering from urticaria. There are other reasons that can provoke this disease in children under the age of one year.

There are the following causes of urticaria in infants:

• physical factors (warm or cold, dry air, synthetic fabrics, diaper friction);
• chemical substances (cosmetics and care products for children's skin, washing powders and rinses for clothes);
• medicines (antibiotics, anti-inflammatory agents, vitamins);
• air components (dust, pollen, tobacco smoke, fluff);
• insect bites (mosquitoes, bedbugs, bees).

In addition to skin changes and itching, hives in infants may be accompanied by other signs. In children, appetite deteriorates, the skin becomes dry, diarrhea or vomiting may develop. Due to itching, the child becomes restless and tearful, does not sleep well, looks apathetic and lethargic.

Treatment of urticaria in infants
Urticaria in infants rarely becomes chronic and usually disappears after 2 to 3 days. Treatment of this pathology involves the elimination of the factor that initiates the appearance of a rash. Means can also be prescribed to reduce itching and strengthen the general condition of the child.

Therapy for urticaria in infants includes the following provisions:

• Allergen elimination. If any food product is a provocateur of the disease, it must be excluded from the diet of the child and mother ( if she is breastfeeding). You should also remove foods that can cause cross-allergies. If the cause of urticaria is a non-food allergen, the child must be provided with conditions that will prevent contact with this substance / factor.
• Body cleansing. Sometimes, in cases where hives are the result of a food allergy, a cleansing enema is given to the child. This is necessary in order to speed up the process of removing the provocateur of the disease from the body.
• The use of medicines. With urticaria, non-hormonal ointments are shown that reduce itching, soften and nourish children's skin. With profuse rashes that are characteristic of a severe form of the disease, antihistamines may be prescribed ( usually taken at bedtime to ensure a comfortable night's rest for the child). Some children are shown taking sorbents and / or drugs intended to normalize bowel function.
• Dieting. A special diet is indicated for all children with urticaria ( and mothers if their child is breastfed) regardless of which factor is the cause of the disease. Diet can reduce the amount of histamine released in the body, resulting in less symptoms of the disease.

Types of urticaria

Types of hives include:

• solar urticaria;
• cold urticaria;
• aquatic urticaria;
• food urticaria;
• dermographic urticaria;
• urticaria on the background of stress;
• cholinergic urticaria.

solar urticaria

Symptoms of solar urticaria
Signs of urticaria appear after a person prone to this disease has been exposed to sunlight for 15 to 20 minutes. Less prolonged exposure generally does not cause a rash. The longer the patient has been under the sun, the more pronounced the symptoms. The blisters characteristic of solar urticaria are small in size and, most often, do not exceed a few millimeters in diameter. In rare cases, when the patient has been under the sun for a long time, individual elements of the rash can increase up to 1 - 2 centimeters.

Solar urticaria blisters are pink in color and have a red line around the edges. As with other forms of this disease, the rash is accompanied by severe itching. These elements appear on the skin a few minutes after exposure to the sun and disappear after a few hours, after cessation of contact with the sun's rays. The localization zone of the rash is those parts of the body that are not protected by clothing. Also, skin symptoms of solar urticaria can appear on those areas of the skin that are covered with thin tissues such as chiffon.
In addition to the rash, this pathology may be accompanied by other symptoms that do not develop so often.

There are the following symptoms of solar urticaria:

• temperature increase;
• feeling short of breath;
• nausea, vomiting;
• general malaise.

External factors include various chemical components that are present in the composition of cosmetic, therapeutic and care products that are applied to the skin. These can be deodorants against sweat, creams with a moisturizing or nourishing effect, products for problem skin. Some types of perfume products can also cause solar urticaria ( especially those containing lavender, vanilla or sandalwood essential oil). The difference between a rash that occurs due to external factors is its clear outline.

The internal causes of solar urticaria include toxic substances that are formed in the body due to dysfunction of certain organs. This pathology can be caused by diseases of organs such as the kidneys, liver, thyroid gland. Drugs are another category of internal causes of solar urticaria.

There are the following medications that can cause solar urticaria:

• non-steroidal anti-inflammatory drugs;
• tetracycline antibiotics;
• oral contraceptives;

Cold urticaria

Symptoms of cold urticaria
The key symptom of cold urticaria is an itchy rash. Depending on the time of appearance of skin changes, there are immediate and delayed forms of cold urticaria. With immediate urticaria, the rash appears almost immediately after exposure to cold. With a delayed type of illness, blisters appear 9 to 10 hours after the action of the cold factor.

The size of the formations can be different - from small flat bubbles to solid spots covering large areas of the skin. As with other forms of urticaria, skin changes are accompanied by severe itching. Elements of a rash appear on those areas of the skin that are in contact with a cold stimulus ( cheeks, hands, neck). In addition, blisters can occur under the knees, on the inside of the thighs, on the calves. If large areas of the skin have been exposed to cold or contact with cold has been prolonged, other symptoms may appear in addition to the rash.

Causes of cold urticaria
Modern medicine currently does not have specific facts regarding the causes that provoke cold urticaria. One of the most common versions is the assumption that the disease develops due to a hereditary anomaly in the structure of the proteins of the human body. Due to a defect, under the influence of cold, the protein forms a certain structure, which the immune system begins to perceive as a foreign body. Due to the response of the immune system, cold urticaria develops.

Aquagenic urticaria

Causes of Aquagenic Urticaria
The cause of aquagenic urticaria is various forms of moisture that get on the skin or mucous membranes of a person. It should be noted that it is not water that provokes the pathological reaction, but the chemical compounds present in it. Rashes may appear after contact with tap or sea water, rain, snow. There are cases when the cause of aquagenic urticaria was the patient's own sweat. The provocateur of the disease can be either a separate type of liquid or any form of water, which significantly reduces the patient's quality of life. At the moment, experts identify several factors that may be the cause of an inadequate reaction of the body to water.

There are the following causes of aquagenic urticaria:

• weakened immune system most often due to the use of drugs that suppress immune function);
• diseases of the liver and / or kidneys of a chronic type;
• deficiency in the body of immunoglobulin class E.

food urticaria

Symptoms of food urticaria
In children, food urticaria is manifested by bright red blisters of small size, which are very itchy. Food urticaria more often than all other forms of this disease is accompanied by Quincke's edema, which in most cases develops in adult patients. As a rule, the patient's lips, larynx, cheeks swell.
A common manifestation of food urticaria is gastrointestinal dysfunction, which is equally common in both children and adults. Patients complain of discomfort in the abdomen ( sometimes severe pain), diarrhea, vomiting, and nausea may occur.

Causes of food urticaria
In modern medical practice, there are a number of food products that belong to the group of obligate ( traditional) allergens, that is, those products that most often provoke food urticaria. The patient may have an allergic reaction to one particular food or to several different foods.

There are the following traditional food allergens:

• whole cow's milk;
• chicken eggs;
• honey and bee products;
• nuts;
• citrus;
• berries, fruits, red vegetables ( strawberries, apples, tomatoes, bell peppers).

Dermographic urticaria

Symptoms of dermographic urticaria
The main sign of dermographism is linear blisters that appear after any mechanical impact has been exerted on the patient's skin. Wardrobe elements most often act as an irritant ( tight collar of a shirt, buckle of a tightly tightened belt). Depending on the time of occurrence of blisters, there are immediate and delayed dermographism. In the first type of hives, the blisters appear immediately after pressure has been applied to the skin. In delayed dermographism, skin symptoms only occur after prolonged skin irritation.

The blisters that occur with dermographic urticaria are light in color, and the color of the skin around them can vary from pink to dark red. There is also a form of dermographism that appears exclusively as white lines on the skin, with no signs of redness. Linear blisters swell and therefore rise significantly above the surface of the skin.

An invariable symptom for all forms of dermographic urticaria is severe itching, which increases with the onset of night. In most cases, with an increase in body temperature or the environment, itching and other symptoms of dermographic urticaria appear more intensely. Deterioration of the general condition and symptoms from other organs with this dermographism are extremely rare.

Causes of dermographic urticaria
At the moment, there are no specific factors that can be indicated as the causes of dermographic urticaria. At the same time, experts note that there are a number of circumstances that increase the likelihood of developing this pathology.

There are the following factors contributing to dermographism:

• heredity;
• thyroid pathology;
• ulcerative lesions of the digestive tract;
• emotional and/or physical exhaustion.

Urticaria due to stress

Symptoms of neurogenic urticaria
Psychogenic urticaria is characterized by large blisters that merge with each other, covering large areas of the body. Separate elements of the rash have an oval or rounded shape, but when they are combined, the formations acquire even polygonal outlines. The color of the blisters can vary from white to pink, and in some cases the blisters can be bicolor ( white in the center and pink around the edges). An obligatory symptom of neurogenic urticaria is intense itching.

In some cases, some time after the onset of the rash, patients develop angioedema, which most often affects the larynx or the mucous membrane of the digestive tract. With swelling of the larynx, the patient is disturbed by pain in the throat, it is difficult for him to breathe, speak and swallow food. If the edema spreads to the organs of the digestive tract, the patient experiences the urge to vomit, nausea, pain in the navel and lateral parts of the abdomen. There may also be stool disorders in the form of diarrhea.

Causes of psychogenic urticaria
When a person is in a state of stress, the body begins to distort the perception of impulses that the nervous system produces. Under the influence of irritating factors, the blood vessels expand, and the permeability of their walls increases, and a lot of fluid begins to flow into the tissues. All this leads to the formation of blisters on the skin, which are accompanied by severe itching.
Most often, neurogenic urticaria is diagnosed in women and adolescent patients.

People who are prone to this pathology have some common character traits. So, such patients are characterized by irritability and irascibility, emotional instability and often are in a state of nervous exhaustion. The appearance of symptoms of psychogenic urticaria is facilitated by such external factors as excessive physical or mental stress, conflicts in the family or at work, intrapersonal problems ( especially for teenagers). The high-risk group includes people who have impaired functionality of the digestive tract, genital organs, and the cardiovascular system.
In the treatment of neurogenic urticaria, the elimination of factors that act as provocateurs of stress plays an important role. In the absence of competent medical care, this disease becomes chronic ( most common in adult patients).

Cholinergic urticaria

The development of this urticaria is based on the increased sensitivity of the body to acetylcholine ( hence the name urticaria - cholinergic). Acetylcholine is the main mediator of the parasympathetic nervous system, which is involved in neuromuscular transmission. A sharp release of a large amount of acetylcholine into the blood leads to the appearance of itchy spots and bubbles on the skin, which is a manifestation of cholinergic urticaria. Synonymous with chronic urticaria is the term pruritic dermatosis.

Cases where increased production of acetylcholine is observed include:

• stress;
• emotional load ( fright, fear);
• prolonged stay in the sauna, steam room or in the sun.

Manifestations of cholinergic urticaria
The main symptom of this type of urticaria is a skin rash. As a rule, it is represented by small itchy vesicles that appear 5 to 10 minutes after exposure to a traumatic factor. The rash first appears on the neck, upper chest, and arms. The duration of the rash is very variable - it can last only a few minutes and quickly disappear. But it can also last for several hours. Sometimes the rash may not appear at all or be so small that the patient may not notice it. In this case, the main symptom is severe itching that appears after taking a hot shower or after visiting the sauna.

Cholinergic urticaria is typical for people with a predisposition to allergies. It also often accompanies diseases such as gastritis, hepatitis and other pathologies of the gastrointestinal tract. In these diseases, there is an increased sensitivity to acetylcholine, which determines the pathogenesis ( formation mechanism) urticaria.

Chronic ( idiopathic) urticaria

Depending on the regularity of the rash, there are permanent and recurrent forms of chronic urticaria. With a constant type of disease, blisters practically do not disappear from the skin, while recurrent ones are characterized by periods of remission ( the time when the rash completely disappears).

Symptoms of chronic urticaria

There are the following features of the rash in chronic urticaria:

• chronic urticaria is not characterized by such a profuse rash as in the acute form of the disease;
• blisters rise above the surface of the skin, have a flat shape and well-defined edges;
• visually, the elements of the rash are similar to insect bite marks, and their diameter can vary from a millimeter to several centimeters;
• initially, the blisters are pink or red, but become lighter over time;
• rashes on the skin are itchy and can form large continuous formations;
• a rash appears spontaneously, for no apparent reason;
• in some cases, the occurrence of blisters is preceded by factors such as climate change, various colds, stress.

Urticaria during pregnancy, after childbirth and during lactation

Symptoms of hives during pregnancy or after childbirth

Many women are interested in whether urticaria during childbearing presents any danger to the fetus. This pathology does not pose a direct threat to the child. Violations of the nervous system can negatively affect the development of the embryo ( nervousness, irritability) that accompany urticaria.

Treatment of urticaria during pregnancy and after childbirth

Urticaria is a disease that is most often allergic in nature. It is accompanied by skin rashes caused by severe itching.

The size of the rashes can be from a few millimeters to up to two or three centimeters. Itchy spots can move around the body, merge into one continuous spot.

According to the duration of manifestation, the disease is divided into:

• acute form, which is allergic in nature. It flows both in a few days, and can drag on for two or three weeks;
• chronic form - lasts more than six weeks or many years, but there are periods of relapse.

Itchy patches are flat blisters with well-defined borders. Rashes can constantly be located in one place, or move throughout the body.

The period of exacerbation of the disease may be accompanied by headache, nausea and vomiting, sometimes fever may occur.

Causes

If the cause of acute urticaria is an allergic reaction, then the causes of chronic urticaria are most often diseases. It can manifest itself as concomitant with acute infectious, viral and autoimmune disorders.

At certain moments, the main role of a provocateur is played by a bacterial agent, which manifests itself against the background of chronic diseases.

They can be diseases of the gastrointestinal tract, liver, disorders in the biliary tract. Sometimes even dental or oral problems can be harmful.

The presence of a focus of chronic inflammation in the body leads to the accumulation of active substances in the blood. However, the role of provocateurs is performed by external, non-infectious allergens. They can be pollen, food, dust, drugs.

There is a version that the cause of the chronic form of the disease can be preservatives, dyes and food additives, which are actively used in the food industry.

Video: Dermatologist consultation

Pathogenesis

The pathogenesis of this problem is not well understood. A few years ago, doctors diagnosed almost all patients with idiopathic urticaria.

But recently, the pathogenesis has been revised by specialists, and the diagnosis of "chronic urticaria" is increasingly being made.

The main element of the rash is a blister. It is formed due to swelling of the papillary dermis. The appearance of blisters is due to a local increase in the permeability of the vascular wall, followed by the release of fluid from the vascular bed into the intercellular space.

Edema occurs when mast cells are activated, and histamine is released, which directly increases the permeability of the vascular wall, various small venules.

Types of chronic urticaria - myth or reality

The chronic form of the disease is divided into:

• chronic constant (persistent) - with it there is a daily change of rashes;
• chronic relapsing - in the period of the disease there are long periods of remission.

Until now, there is no clear classification of urticaria in medicine. It can only be conditionally divided into the following forms, depending on the development and etiological factors.

The idiopathic form of the disease is classified as chronic, since it lasts at least six weeks.

Also, this diagnosis is established to the patient in the case when it is impossible to identify and accurately establish the cause that provoked the disease.

The appearance of the idiopathic form can be triggered by the following diseases:

• violation of the functionality of the kidneys;
• arthritis;
• malignant neoplasms;
• diabetes;
• thyroid disease.

Its possible manifestation is also with alcohol and drug intoxication, as well as in violation of the metabolic process in the body.

Recently, doctors have a theory that idiopathic urticaria can provoke the development of diseases such as leukemia, myeloma and lymphoma.

The result of this disease is that the patient's body begins to produce antibodies that destroy the immune system.

recurrent

If relapses appear in the chronic form, then we can talk about a more complex disease - chronic recurrent urticaria. Periods of exacerbations alternate with moments of remission.

During the period of exacerbation, severe itching does not allow the human body to fully function, rest, which causes the patient's irritability. All this can lead to nervous breakdowns and depression.

If the patient has this diagnosis, then doctors forbid visiting baths and saunas, taking hot baths.

Symptoms of manifestation

Rashes can appear due to climate change, stress suffered by SARS. They can be cyclical, for example, during the menstrual cycle, during the change of seasons.

Most often, the chronic form of the disease is accompanied by the following symptoms:

• spontaneous manifestation of rashes, for no apparent reason;
• watery blisters with well-defined edges;
• severe itching;
• swelling of the skin;
• if the edema has spread to the mucous membranes of the stomach and intestines, then nausea, vomiting, and stool disorders are likely.

Diagnostic methods

Diagnosis of the disease is as follows:

• exclusion of other types of urticaria;
• allergen detection;

If it is not possible to establish the cause of the disease, then doctors diagnose chronic urticaria. That is, in fact, only the factor that provoked the appearance of the rash is revealed, but not the cause.

If the cause is not identified, the results of the tests did not show the full picture, then you may need to contact specialized specialists - a dermatologist, urologist, gastroenterologist.

Treatment Methods

Treatment of chronic urticaria consists of a complex of actions. It includes:

1. establishing the cause of the disease, its elimination;
2. relief during exacerbations of manifestations with the help of antihistamines;
3. preparation of a course of treatment;
4. in case the disease is provoked by the disease, treatment of the provocative disease;
5. prevention.

As you can see, the treatment of the disease also includes drug treatment aimed at eliminating symptoms, improving the body, as well as eliminating the allergen.

Treatment can be carried out with drugs or traditional medicine. Medical treatment includes the use of:

• antihistamines;
• sorbents;
• ointments that contain glucocorticosteroids;
• enzymes for digestion;
• sedatives.

Why Diet Matters

A prerequisite for the treatment of the disease is diet, that is, the exclusion from food of all foods that can provoke an exacerbation.

However, it is quite difficult to independently identify the allergen in the diet. It is advisable to consult with a specialist.

You may need to test for food allergens. Most likely, the doctor will prescribe keeping a food diary.

When dieting, the following types of foods should be removed from the diet:

• fatty, fried, salty, spicy;
• limit dairy products, exclude completely fresh milk;
• flour and bakery products;
• chicken
• red fruits and vegetables;
• grape;
• sweet;
• alcohol, carbonated drinks;
• products containing a large amount of dyes, preservatives, additives;
• chocolate, cocoa.

Prevention

It is almost impossible to cure this disease completely.

In this regard, patients with a chronic form are required to constantly observe and implement preventive measures, which include:

• avoid contact with the allergen if it is external;
• exclude from the diet those foods that can provoke the acute phase of the disease;
• general control over the state of the body;
• prevent diseases of internal organs;
• the use of hypoallergenic cosmetics;
• it is recommended to replace household chemicals with natural ones - baking soda, mustard;
• carry out procedures for hardening the body. This will help strengthen the immune system, the body will become less susceptible to allergens;
• during the period of exacerbation of seasonal infectious diseases, avoid visiting public places.

The most important thing is to prevent the development of the chronic phase of the disease. Therefore, at the slightest sign, you should consult a doctor.

It is almost impossible to independently identify the allergen and establish the category of the disease.

If you are an opponent of drug treatment, then for the treatment of this problem there are many proven traditional medicine that will help to cope with the disease.