Urticaria and Angioedema

Introduction to urticaria and angioedema Urticaria and angioedema (urticariaandangioedema), also known as rubella and angioedema, can occur separately or simultaneously; manifested as non-indentation edema of the skin, sometimes involving the upper respiratory tract or gastrointestinal mucosa. Urticaria only damages the surface of the skin. It is characterized by a red smear edge and a pale lumps of lumps in the center. Sometimes it can be fused into a huge wheal. The lesions of angioedema involve the deep layers of the skin (including subcutaneous tissue), and easily recognized edema. These manifestations can appear and disappear rapidly at one time. Those who have repeated episodes of no more than 6 weeks are acute and the response is chronic. basic knowledge The proportion of illness: multiple in spring and summer, the incidence rate is about 0.02%-0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: pruritus

Causes of urticaria and angioedema

Causes:

Without urticaria, angioedema deficient in C1 esterase inhibitor (C1INH) may be congenital autosomal dominant or acquired; both are classified as type 1 and non-functional lacking C1INH Type 2 of C1INH, the patient's C1 esterase activity is uncontrolled, C4, C2 and other components are consumed in large quantities, and the cleavage products are significantly increased, and vasoactive peptides such as vasoactive peptides such as bradykinin are activated, resulting in angioedema, accompanied by serum. Urticaria and angioedema that occur in disease or idiopathic cutaneous necrotic vasculitis are associated with immune complex activation of the complement system. Some of the substances listed in the non-immune class enter the body to stimulate the release of histamine from mast cells, or the release of acetylcholine and histamine due to factors such as mood, exercise and heat.

The pathological feature of urticaria is dermal edema, while angioedema is edema of both the dermis and subcutaneous tissue. The collagen bundles in the affected area are widely separated, the capillaries are dilated, and there may be lymphocytes, eosinophils and neutrophils around the blood vessels. Polymorphic infiltration. This disease, which is caused by both IgG-mediated IgE-dependent and IgA-deficient patients, is a rapid allergic reaction. Most chronic urticaria is special.

Urticaria and angioedema prevention

Daily taboos:

1. Don't catch it: Most people's intuitive response to skin itching is to grab it with your hands, but you may not know that this action can not only stop itching, but also the more itching, the main reason is because when you catch the part When itching, it will increase the local temperature and cause the blood to release more histamine (allergen), which will worsen.

2. Do not apply heat: Some people will want to use hot compresses when they itch. Although heat can make local itch feel less sensitive, it is actually another kind of stimulation, because heat will cause blood vessels to expand and release more allergens. For example, immersing in an overheated hot spring or bath, or wrapping in a thick quilt to maintain a warm transition is likely to cause hives.

3. Avoid eating foods containing artificial additives, eat more fresh fruits and vegetables, fried, fried or spicy foods that are less likely to cause heat reactions in the body.

Urticaria and angioedema complications Complications pruritus

Complications 1. Laryngitis that can cause complications. Chronic urticaria is more common with bronchitis and often involves laryngitis in the throat. General laryngitis is caused by secondary bacterial infections. When the symptoms of laryngitis are severe, it may even cause suffocation. It can be seen that the harm of chronic urticaria is still relatively large.

Complications 2, chronic urticaria can affect the cardiovascular system and bring cardiovascular system complications. Mainly manifested as fever, headache, shortness of breath, weakness of the limbs and other symptoms, sometimes suddenly subsided and then the liver increased dramatically. Some patients develop myocarditis.

Complications 3, rapid emergence of rubella lesions, local symptoms of itching or fever. Some patients have systemic symptoms such as poor diet or migraine in the rubella. Rubella flat redness or pale edematous spot lesions are also often referred to as graphic urticaria. Sometimes, hemorrhagic urticaria or bleeding often occurs in the initial onset. Blisters in the rubella block can be converted into vesicular urticaria. Sometimes, blisters or bullae occur in seemingly normal superficial skin, but blushing often occurs, and such rubella can easily induce children.

Urticaria and angioedema symptoms Common symptoms Wind group traveler edema palm hard edema itchy angioedema red hail pimples fatigue chills

It can occur at any age, and is more common in young and middle-aged people. Urticaria is characterized by a sudden wheal on the skin, which can be resolved after a few minutes or hours. Generally, it does not exceed 24 hours, occurs in batches, and sometimes occurs repeatedly in one day. Second, it is bright red and light yellow, red blood vessels are exuded lightly, white is caused by a wide range of exudation and compression of capillaries to produce anemia, the size of the wind block is not equal, the larger one can reach 10cm diameter or larger, sometimes Blisters can appear on the surface, scattered and arranged, adjacent damage can be fused to each other to form a special circular, circular, ground pattern, etc., can spread the whole body, leaving no trace after disappearing, itching, burning or irritating pain, general acute type Several days to 1 to 2 weeks of stop, there are repeated episodes, the course of lingering for more than 1 to 2 months, and some years of continuous, chronic, angioedema, subcutaneous tissue than the pine or mucous membranes, a limited transient Severe swollen, unclear edges, no itching, usually involving the eyelids, lips, tongue, external genitals, hands and feet, often with urticaria, if the upper respiratory tract is involved, it may block the throat and endanger life If the gastrointestinal tract is involved, abdominal pain may occur, and some may be accompanied by nausea and vomiting, so that unnecessary surgical exploration is performed, and usually disappears after 2 to 3 days.

In addition, some types of urticaria-angioedema have some special clinical manifestations.

1. Cold urticaria is divided into two types: hereditary and acquired. The former starts from the baby, and the symptoms are relieved with age. It often lasts for a lifetime, and the rash occurs several hours after the whole body is cold. The damage is erythema with a diameter of no more than 2 cm. Pimples, which can be associated with fever, chills, joint pain, myalgia and headache, last for 48 hours; the latter often occur from childhood, after the skin is exposed to cold, the disease can occur, inhaling cold air or eating cold food or drink occasionally mucous membranes Swelling occurs, except for the occurrence of wind block at the exposed site, the patient may develop systemic symptoms, such as sensation loss after sneak into cold water, or even drowning, the symptoms disappear in a few months, but there are also persistent unhealed.

2. Cholinergic urticaria occurs after stress, exercise and heat. The damage is 1~2cm, and the outside is surrounded by a large blush. Sometimes it is only itching and no wheal, which can be accompanied by salivation, sweating, abdominal pain and Diarrhea lasts for months to years.

3. Solar urticaria: a few minutes after exposure to sunlight, limited to the exposed area, lasting 1 to 2 hours.

4. Peptone urticaria: In the case of deafness, mental agitation or simultaneous drinking, the protein protein decomposed by the protein is absorbed by the intestinal mucosa and causes disease, which is characterized by redness and congestion of the skin, accompanied by headache, in 1-4 It disappears within hours, sometimes for 1 to 2 days.

Examination of urticaria and angioedema

Increased blood eosinophils, IgE can be increased, cold urticaria can detect cold globulin or cold fibrinogen, serum circulating urticaria patients with increased circulating immune complex, complement C2 level and total complement activity Decreased, C1 esterase-deficient angioedema patients lack serum C1INH or only inactive C1INH, may also be associated with abnormal levels of complement components (C1, C4, C2) in the anterior segment of the complement system.

Diagnosis and identification of urticaria and angioedema

diagnosis

According to the skin lesions, the wind is rapid and the regression is rapid. According to the characteristics of each type, it is not difficult to diagnose. After the diagnosis is established, the relevant pathogenic factors should be sought.

Differential diagnosis

The disease needs to be differentiated from papular urticaria and erythema multiforme.

1. Acute urticaria is often an acute attack, generalized itching wind rash, may be associated with high fever, severe blood pressure drop or even shock, the course of natural recovery within 1 to 2 weeks should be actively treated.

2. Chronic urticaria continues to cause turf skin lesions for 1 to 3 months or years. The severity of the disease and the incidence can vary from person to person. There are great differences, sometimes with artificial urticaria. Belts and other places are exposed. The wheal caused by contact with cold water or cold wind is called cold urticaria. It is mostly a bluff of paroxysmal small pieces. It has redness and can spread the whole body. These patients are sensitive to acetylcholine. 0.01mg of acetylmethylcholine can be used for intradermal test. After 10 minutes of injection, wheals with a diameter of 1 to 1.5 cm can be found, which is positive, and the course can vary from several months to several years.

3. Angioedema, also known as giant urticaria, is caused by the decrease or inactivity of C1 esterase inhibitors in blood and tissues. It is involved in small blood vessels in deep and subcutaneous tissues of the dermis, and histamine and other mediators cause vasodilation. The permeability is increased, and the exudate forms a localized edema from the blood vessel into the loose tissue. It has the characteristics of paroxysmal, repetitive and non-depressed. It is generally not itchy and can be single-shot, suddenly in the lips, face or limbs. Swelling of normal skin color or severe swelling, compressing the superficial capillaries of the skin and causing white swelling and damage, the edges are unclear, local tension is felt, and the general itching is not obvious. This type of damage can naturally resolve within a few days, but It can happen again. Some patients can also have more than two lesions. Generally, there is no systemic symptoms. A small number of patients may cause suffocation due to the occurrence of pharyngeal isthmus. If not treated in time, it may lead to death.

4. Pimples-like urticaria is a common skin disease in children. It can also be seen in adults. It occurs repeatedly in spring and autumn. This disease is a disease named after the symptoms. In fact, some patients in this disease are insect bites, especially in the limbs. The exogenous allergic reaction caused by animal bites is a delayed response that takes about 10 days. The bite causes the rash to occur, and desensitization occurs after repeated bites.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.