Summary about Disease
. Wheals, also known as hives or urticaria, are raised, itchy welts that appear on the skin. They are usually red or skin-colored and can vary in size and shape. Wheals are a common skin reaction, often triggered by an allergic reaction, infection, or other underlying condition. They are typically temporary, resolving within a few hours to days. Angioedema, which is swelling in deeper skin layers, can sometimes accompany hives.
Symptoms
Raised, itchy welts (wheals) on the skin.
Welts that are red or skin-colored.
Welts that can vary in size and shape, from small dots to large patches.
Itching (pruritus), which can be mild to severe.
Welts that may appear and disappear quickly, sometimes within hours.
Angioedema (swelling) in deeper skin layers (lips, eyelids, tongue, throat) may occur, causing pain or discomfort.
Causes
Allergic reactions: Foods (nuts, shellfish, eggs), medications (antibiotics, NSAIDs), insect stings or bites, latex.
Infections: Viral (common cold, flu), bacterial (strep throat), fungal.
Physical stimuli: Pressure, cold, heat, sunlight, exercise, vibration.
Underlying medical conditions: Autoimmune diseases (lupus, thyroid disease), certain cancers.
Medications: Some medications can directly cause wheals.
Stress: Emotional stress can sometimes trigger or worsen hives.
Contact with irritants: Certain chemicals or plants.
Idiopathic: In many cases, the cause is unknown (chronic idiopathic urticaria).
Medicine Used
4. Medicine used
Antihistamines: First-generation (diphenhydramine) and second-generation (cetirizine, loratadine, fexofenadine) antihistamines to relieve itching and reduce the size of welts.
H2 Antihistamines: Ranitidine or famotidine can be combined with H1 antihistamines for added benefit.
Corticosteroids: Oral or topical corticosteroids (prednisone, hydrocortisone cream) may be prescribed for severe cases to reduce inflammation, but long-term use is generally avoided due to side effects.
Epinephrine: An epinephrine auto-injector (EpiPen) is used for severe allergic reactions with angioedema or difficulty breathing.
Omalizumab: For chronic idiopathic urticaria, omalizumab (Xolair), a monoclonal antibody, can be used.
Doxepin: A tricyclic antidepressant with antihistamine properties, used for chronic urticaria, especially when itching is severe.
Is Communicable
No, wheals (hives) themselves are not communicable. They are a reaction within an individual's body and cannot be spread from person to person. However, if the hives are caused by an underlying infectious disease (like a viral infection), that infection could be communicable.
Precautions
Identify and avoid triggers: If you know what causes your hives, avoid those substances or situations.
Avoid scratching: Scratching can worsen itching and increase the risk of skin infection.
Use cool compresses or take cool baths: To help relieve itching.
Wear loose-fitting clothing: To avoid irritating the skin.
Avoid hot showers or baths: Hot water can worsen itching.
Use mild, fragrance-free soaps and detergents: Avoid products that can irritate the skin.
Manage stress: Stress can sometimes trigger or worsen hives.
Keep a food diary: To help identify potential food triggers.
Consult a doctor: If hives are severe, persistent, or accompanied by other symptoms like difficulty breathing or swelling of the face, seek medical attention immediately.
How long does an outbreak last?
Acute urticaria: Usually lasts less than six weeks, with individual wheals typically disappearing within 24 hours.
Chronic urticaria: Lasts longer than six weeks, with hives appearing frequently or continuously over months or even years. Individual welts may still disappear within 24 hours, but new ones keep forming.
How is it diagnosed?
Physical examination: A doctor will examine the skin and ask about the patient's medical history and symptoms.
Allergy testing: Skin prick tests or blood tests (RAST or ImmunoCAP) may be performed to identify specific allergens.
Blood tests: Complete blood count (CBC), erythrocyte sedimentation rate (ESR), or C-reactive protein (CRP) to look for signs of infection or inflammation.
Thyroid function tests: To rule out thyroid disease as a cause.
Skin biopsy: In rare cases, a skin biopsy may be performed to rule out other skin conditions.
Detailed history: The doctor will ask about potential triggers, such as foods, medications, insect stings, or recent illnesses.
Physical challenge tests: In some cases, a doctor may perform a physical challenge test (e.g., applying pressure or cold to the skin) to see if it triggers hives.
Timeline of Symptoms
9. Timeline of symptoms The timeline of symptoms can vary significantly:
Immediate: Symptoms may appear within minutes of exposure to an allergen or trigger.
Delayed: Symptoms may appear hours or even days after exposure.
Acute urticaria: Wheals appear suddenly, typically resolving within hours to days (less than six weeks total duration).
Chronic urticaria: Wheals appear frequently or continuously for more than six weeks. Individual wheals may resolve within 24 hours, but new ones continue to develop. Symptoms may fluctuate in severity over time.
Important Considerations
Anaphylaxis: Be aware of the signs of anaphylaxis (difficulty breathing, wheezing, swelling of the face, throat, or tongue, dizziness, loss of consciousness) and seek immediate medical attention if they occur.
Chronic Idiopathic Urticaria (CIU): Many cases of chronic urticaria have no identifiable cause. Management focuses on symptom control.
Angioedema: Angioedema can be life-threatening if it affects the airway. Seek immediate medical attention if you experience swelling of the tongue, throat, or difficulty breathing.
Medication Side Effects: Be aware of the potential side effects of medications used to treat hives.
Underlying Conditions: Hives can sometimes be a sign of an underlying medical condition. It is important to work with a doctor to identify and treat any underlying causes.
Pregnancy and Breastfeeding: Certain medications for hives are not safe during pregnancy or breastfeeding. Consult a doctor about safe treatment options.