Recurrent urticaria is a complication of the acute stage of the disease. Hives. Diagnosis and treatment. Diet for urticaria. Treatment of urticaria with folk remedies Chronic urticaria is considered to be the symptoms of which occur

Urticaria, regardless of its form and type, causes a lot of inconvenience to a person. While the acute form lasts only a few days, chronic urticaria can last a long time and last up to 6 weeks. Relapses of the disease sometimes haunt a person for years.

Classification

A feature of urticaria is a rash on the body, similar to blisters that occur after exposure to nettles on human skin. There are two forms:

  1. Chronic recurrent urticaria. The disease appears in waves - periods of exacerbation and remission alternate.
  2. Constant (persistent). The symptoms do not go away, the elements of the rash replace each other day after day.

According to the medical classification of diseases of the 10th revision, urticaria has a code from L50.0 to L50.9, which distinguishes the disease by type. The ICD 10 code is set depending on the symptoms and clinical picture.

WHO identifies the following types of urticaria in ICD 10:

Causes

In most cases, it is very difficult to establish the true cause of the pathology. The disease can be provoked by both external (exogenous) and internal (endogenous) factors.

Internal ones indicate the presence of chronic diseases in a person. Provocative factors include:

  • inflammatory processes in internal organs;
  • diseases of the liver, kidneys and gastrointestinal tract;
  • endocrine diseases;
  • infectious pathologies;
  • malignant tumors;
  • helminthic infestations.

In addition, the cause of the appearance may be heredity, malfunctions of the immune system, physical factors (vibration, friction, insect bites), and various irritants. The main allergic substances include:

  • food;
  • medications;
  • household chemicals;
  • plant pollen;
  • UV radiation;
  • warm or cold.

In most cases, the chronic form of urticaria occurs for an unknown reason or as a consequence of an allergy (40-90%). Physical factors provoke the development of the disease in 20-30 cases out of 100. Infectious diseases and allergies to food or medications account for less than 9% of all cases.

Symptoms

With chronic urticaria, as with acute urticaria, there is a main symptom - a rash. The rash appears as blisters of different types and sizes.

In the chronic course of the disease, the rash is characterized by some features:

  1. The rash elements are not as pronounced as in the acute form, and not as extensive.
  2. The color of the rash is bright red at first, but lightens over time.
  3. With each exacerbation, the lesion can be localized in different parts of the body, occupying large areas. The size of the bubbles varies significantly.
  4. The itching is not as intense as in the acute form.
  5. Around the blisters, the skin becomes rough and swollen. After a relapse, the lesion goes away without leaving any traces.
  6. As a rule, the rash appears unexpectedly. Sometimes it is preceded by ARVI, a change in climate zone, or stress. The disease can also worsen cyclically (for example, every menstruation or season change).

In addition to the rash, urticaria may present other signs: fever, gastrointestinal problems, general malaise, headache, neurotic disorders due to constant itching.

The photo below shows that the rash can appear as single blisters or merge into one large spot.

Diagnostics

To make a diagnosis it is necessary to undergo a visual examination. To determine the type of disease and exclude other pathologies, the following studies may be prescribed:

  • complete blood count to determine the level of eosinophils;
  • blood test for RW and HIV;
  • coprogram;
  • general urine analysis;
  • blood chemistry;
  • skin biopsy for antibodies to allergens;
  • provocative tests for stimuli;
  • rheumatological tests (for idiopathic, dermographic urticaria);
  • chest x-ray;
  • Ultrasound of the gastrointestinal tract;
  • other tests to detect chronic infection.

Examinations are carried out by an allergist, dermatologist, immunologist, ENT specialist, neurologist.

Therapy

The main rule in the treatment of any type of urticaria is the elimination of the pathogenic factor influencing the occurrence of the disease. It is necessary to eliminate allergens from life, cure chronic infections and other provoking diseases. At the same time, symptoms are relieved using pharmaceutical and folk remedies, and then preventive therapy is prescribed.

Medicines to relieve symptoms

Folk remedies

Treatment of symptoms using traditional methods is also used as an additional therapy. Decoctions, solutions, infusions, compresses, baths and ointments relieve itching and swelling, accelerate skin healing, and improve immunity.

To help cure chronic urticaria:

Diet

Throughout treatment, as well as for prevention, patients must follow a hypoallergenic diet. Products that promote the release of histamine are allowed to be consumed no more than once a week.

These include:

  • exotic food;
  • conservation;
  • citrus;
  • milk;
  • chicken eggs;
  • nuts;
  • seafood;
  • smoked, dried food;
  • chocolate;
  • products with preservatives.

To find out what exactly triggers the recurrence of rashes, the patient is recommended to go on a strict diet. First, a person fasts for 3 days, and then gradually introduces one product into the diet and observes the body’s reaction. This way it is possible to identify the allergen.

The prognosis for chronic urticaria is favorable. Despite the fact that the course of therapy can be long (up to 6 months), if all principles of complex treatment are followed, a long-awaited recovery occurs. But it is worth remembering that the result is also influenced by a person’s diet, regimen and lifestyle.

Urticaria is a skin condition that is often pruritic and presents with erythematous (red, pink), painless, blistering rashes that resolve within 24 hours and leave behind clear skin. It is one of the 20 most common skin diseases, and is dealt with not only by allergists and dermatologists, but also by therapists, pediatricians and doctors of other specialties.

Depending on the duration, urticaria is usually divided into two forms: acute (AC) and chronic (CC). The latter is characterized by daily or frequent symptoms (blister rash, itching, angioedema (AO)) for 6 weeks or more. Over the course of a lifetime, 0.5-1% of the entire human population suffers from CC. Moreover, if OK is usually associated with the action of exogenous factors and allergens (food, medications, insect bites, etc.), then the cause of chronic in many cases is another disease or condition (for example, rheumatoid arthritis, infection, etc.) and urticaria acts only as a “symptom” of this disease or its cause is not identified at all (chronic idiopathic urticaria (CIU)). At the same time, diagnosing the primary cause of chronic urticaria often causes certain difficulties not only among therapists, but even among some specialized specialists (allergists, dermatologists). Many doctors do not know by what mechanisms urticaria can occur, what conditions, factors and conditions lead to its development, and as a result, patient consultation is reduced to prescribing symptomatic treatment and/or conducting various kinds of expensive studies, usually not justified by the course, form and clinical picture of the disease.

Thus, the purpose of this review is a brief description of the currently known or suspected etiological factors of CU, which will allow doctors of various specialties to optimize diagnosis and treatment in such patients.

It is important to remember that with typical chronic urticaria, rashes often appear spontaneously, that is, without apparent cause or connection with specific triggers. Therefore, the term “chronic urticaria” is synonymous with the term “chronic spontaneous urticaria” (CSU); it is sometimes also called "chronic vulgaris urticaria". The last two terms make it possible to distinguish CU from other long-term forms of urticaria with known provoking factors (for example, from various types of physical urticaria).

Pathogenesis

It is believed that the symptoms of CU are primarily related to the activation of mast cells (MCs) in the skin. The mechanism by which skin cells in urticaria are forced to release histamine and other mediators has long remained a mystery to researchers. The discovery and characterization of “reaginic” IgE by Ishizaka scientists made it possible to explain the development of acute and episodic allergic urticaria according to the immediate type of reactions (type I reactions according to Gell and Coombs), accompanied by the binding of IgE to skin mast cells and specific allergens, which leads to the release of mediators.

In recent years, works have appeared that emphasize the possible role of blood coagulation in the pathophysiology of the disease. It is known that upon activation of the coagulation cascade, vasoactive substances such as thrombin are formed, leading to an increase in vascular permeability due to stimulation of the endothelium. Activation of the coagulation cascade due to the action of tissue factor, which is expressed by eosinophils infiltrating skin rashes, has been found in patients with CU.

Currently, many studies have already been published confirming the role of autoreactivity and autoantibodies (anti-IgE and anti-FcεRIα) in autoimmune urticaria. It is believed that the binding of these functional autoantibodies to IgE or high-affinity IgE receptors on mast cells can lead to degranulation of the latter and the release of mediators. Autoimmune urticaria is described in more detail below.

At the end of 2011, Bossi et al. published interesting results from a study of serum from patients with chronic urticaria. Scientists assessed the role of mediators of mast and endothelial cells in increasing the permeability of the vascular wall. It was found that in many patients, mast cell degranulation is not associated with stimulation of high-affinity IgE receptors and occurs by IgE- and IgG-unrelated mechanisms. This finding opens up additional opportunities for understanding the pathogenesis of CU and the discovery of new histamine-releasing factors, especially in patients without autoreactivity and circulating autoantibodies.

Etiology

The main etiological factors of urticaria and the frequency of their occurrence are indicated in the table. Each of the reasons is discussed in more detail below.

1. Infectious diseases

The role of infection in various forms of urticaria has been discussed for over 100 years and is mentioned in most scientific reviews. It is assumed that the occurrence of urticaria during infections is associated with the participation of mast cells in protection against infectious agents. However, the exact mechanism is still unclear. In addition, it is difficult to establish a causal relationship between urticaria and infection, since it is not yet possible to perform a challenge test with the suspected pathogen.

Despite the fact that to date the connection between CU and many infectious diseases has not been fully proven, there is a fairly large number of scientific studies, observations and reports that have demonstrated an improvement in the course or onset of remission of CU after eradication of the infectious process.

Bacterial infection and foci of chronic infection. From 1940 to 2011, there were only a few references to cases of infectious diseases allegedly associated with the occurrence of urticaria in adult patients: dental abscess (9 cases), sinusitis (3 cases), cholecystitis (3 cases), prostatitis, rectal abscess (1 each). case) and genitourinary tract infections (2 cases). In other studies, this relationship was less reliable. For example, in a 1964 study, radiographic examination of 32 of 59 patients with CU showed sinusitis, and 29 of 45 had dental infection. In many patients, the infectious process was asymptomatic.

A retrospective study of 14 adult patients with chronic tonsillitis and streptococcal tonsillitis, published in October 2011, suggested a causal relationship between the two diseases. Most patients had high titres of antistreptolysin-O and circulating immune complexes, and resolution of urticaria symptoms after antibiotic therapy or tonsillectomy, leading the study authors to conclude that tonsillitis could be the primary cause of urticaria. In a study published in 1967, 15 of 16 children with CU had recurrent upper respiratory tract infections, pharyngitis, tonsillitis, sinusitis, and otitis media, often due to streptococcal or staphylococcal infections.

Some doctors believe that the cause-and-effect relationship between local bacterial infections and urticaria is more likely to be random than constant, moreover, the international recommendations for the treatment of urticaria EAACI/GA2LEN/EDF/WAO do not give precise indications of the role of bacterial infection in the development of urticaria. Nevertheless, many experts consider it necessary, after excluding other causes of CU, to conduct tests for infections and prescribe antibiotics if they are detected.

Helicobacter pylori. Participation in the development of CC of a new infectious agent - H. pylori— was considered by scientists back in the 1980s. This was due to its ubiquity and frequent detection in patients with CU. It is believed that infection H. pylori is detected in approximately 50% of people in the general population in most countries of the world and in at least 30% of patients with CIC.

H. pylori is a spiral-shaped gram-negative bacterium that infects various areas of the stomach and duodenum. It is assumed that many cases of gastric and duodenal ulcers, gastritis, duodenitis and possibly some cases of lymphoma and gastric cancer are etiologically associated with infection H. pylori. However, most infected H. pylori carriers do not show any symptoms of disease.

Some studies have shown that in a number of patients with chronic urticaria and peptic ulcer disease caused by H. pylori, treatment of infection with antibiotics led not only to the healing of ulcers, but also to the disappearance of urticaria; in others, there was no positive relationship between the eradication of the microorganism and CU. However, it is worth noting that after eradication H. pylori Some patients without peptic ulcers also experienced remission of urticaria or improvement in its course.

According to the systematic review Urticaria and Infections (2009), there are 13 well-designed and conducted studies that demonstrated a clear and statistically significant effect of eradication H. pylori(carried out in 322 patients) on the course of CC, and 9 studies in which such an effect was not noted (eradication was carried out in 164 patients). Taking all studies together (both pros and cons), the rate of urticaria remission after H. pylori eradication was observed in 61.5% (257/447) of patients compared with 33.6% (43/128) when eradication was not carried out. At the same time, the frequency of remission in the control group of patients with CC and without infection H. pylori was 29.7% (36/121). The review authors concluded that remission of urticaria after eradication of H. pylori was observed almost 2 times more often, indicating a clear benefit from such treatment for patients with urticaria (p< 0,001).

Thus, although the role H. pylori As the etiological factor of urticaria has not yet been definitively confirmed, the authors of the systematic review recommend that all clinicians, after excluding other causes of urticaria:

1) order testing to identify H. pylori;
2) treat with appropriate antibiotics if infection is detected;
3) it is imperative to obtain confirmation that eradication of the infection was successful.

Viral infection. In separate studies, scientists have suggested a connection between CU and certain viral infections, such as hepatitis viruses (A, B, C), Epstein-Barr, herpes simplex (recurrent genital herpes), norovirus and HIV infection. It is believed that hepatitis B and C are more likely to be combined with urticarial vasculitis than with CC. Sometimes, at the beginning of some acute infectious diseases, including hepatitis and infectious mononucleosis, the appearance of rapidly passing urticarial rashes is noted, usually not progressing to CU. Moreover, in a review examining a possible link between hepatitis viruses and CC, scientists concluded that there is no convincing evidence for such an association yet.

Fungal infection. Intestinal infection with yeast fungi of the genus Candida albicans was studied as a possible cause of CU, but after eradication therapy this was not confirmed. A Turkish study suggested a role for microsporidia in the development of AC and CU. The authors recommended taking this type of infection into account in patients with CIC. However, there is no convincing evidence yet that fungal infection may be etiologically associated with the development of CU.

2. Autoimmune urticaria

Indirect evidence that CU may be autoimmune in nature has existed for many years. Back in 1983, Leznof et al. discovered a connection between autoimmune thyroiditis and CC/AO, and in 1989 the same authors identified a combined syndrome - autoimmune thyroid disease + CC/AO - in 15% of patients with antithyroid antibodies (antimicrosomal and antithyroglobulin), which supported assumptions about the possible role autoimmunity in this disease.

It was also believed that the formation of blisters in CU is associated with the release of histamine and other mediators from skin MCs, so it was hypothesized that CU may be the result of the action of histamine-releasing factors circulating in the blood, in particular autoantibodies. The assumption of the causative role of antibodies in CSU appeared back in 1962, when the Swedish dermatologist Rorsman reported severe basopenia (a decrease in the number of basophils in the blood less than 0.01 × 10 9 / L) in some patients with CSU and its absence in physical urticaria. He also clarified that such basopenia may be associated with possible antigen-antibody reactions, accompanied by degranulation of basophilic leukocytes. Grattan et al. in 1986 an important observation was made. The authors were the first to describe the appearance of a “wheal-hyperemia-itch” reaction with intradermal injection of serum from some (but not all) patients with chronic urticaria into unaffected areas of the skin. Scientists found a positive response in 7 out of 12 patients and noted that such a result can only be obtained in the active phase of urticaria. Early studies of this reaction suggested an association with histamine-releasing autoantibodies with anti-IgE characteristics. In patients with a positive response to autologous serum, the appearance of blisters is believed to have occurred due to the ability of these autoantibodies to cross-react with IgE associated with skin MCs, thereby causing MC activation and the release of histamine and other bioactive substances.

Indirect evidence of the involvement of class G antibodies to FcεRI receptors of mast cells in the pathogenesis of CC, observed with positive passive transfer and testing with autologous serum, supported the opinion that these antibodies cause the formation of blisters and itching in those patients in whom they are detected in the blood.

Taking into account the above scientific data, the term “autoimmune urticaria” has increasingly begun to be used, describing some forms of urticaria as an autoimmune disease.

Features of autoimmune urticaria:

  • more severe course;
  • long duration of the disease;
  • absence or poor response to treatment with antihistamines;
  • Carrying out an intradermal test with autologous serum and a test for the release of histamine from donor basophils under the influence of the patient’s serum is considered the “gold standard” for diagnosing autoimmune urticaria.

CU associated with autoimmune reactions is often prone to a long-term chronic course compared to other forms of CU. In addition, other autoimmune diseases are sometimes found in patients with autoimmune urticaria, such as autoimmune thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, vitiligo, pernicious anemia, celiac disease, insulin-dependent diabetes mellitus, etc. Frequency of these diseases and identification of characteristic autoimmune markers higher in patients with confirmed presence of histamine-releasing autoantibodies than in those without. Autoimmune thyroiditis and CU often coexist, but there is no evidence yet that thyroid autoantibodies are of primary importance in the mechanism of development of CU. The importance of the connection between these two diseases lies in a separate autoimmune mechanism that is present in both conditions and which remains to be studied. There is also currently no convincing evidence that treatment of thyroid dysfunction can change the course of concomitant urticaria.

3. Urticaria associated with food and drug intolerance

Patients often visit their doctor because they suspect that their symptoms of chronic urticaria are related to the food they eat. Currently, most experts are inclined to believe that “true food allergy is extremely rarely the cause of chronic urticaria or angioedema,” however, there is some evidence that food pseudoallergens can lead to exacerbation of CU. Several studies have shown that in 1 in 3 patients with pseudoallergic reactions, prescribing a diet without food additives improves urticaria. It is believed that this phenomenon is associated with changes in the permeability of the gastroduodenal mucous membranes.

As for medications, as in the case of food, some of them are usually regarded not as causative agents, but as provoking agents of CC (for example, aspirin and other non-steroidal anti-inflammatory drugs), leading to an exacerbation of the disease through non-immune mechanisms.

4. Physical urticaria

There are quite a large number of physical forms of urticaria, which some experts classify as urticaria, while others classify it as a separate group. These are diseases such as symptomatic dermographism (dermographic urticaria), cold, cholinergic, delayed pressure, thermal, vibration, adrenergic, etc. (discussed in detail in other publications). The causative factor is the effect of a physical stimulus on the patient's skin. Many types of physical urticaria can occur together with CSU in the same patient.

5. Other reasons

Hormonal disorders. It is believed that CU occurs approximately 2 times more often in women than in men, which can be predisposed to various disorders associated with sex hormones. Thus, urticaria may be associated with several diseases and conditions that involve hormonal imbalances, including endocrinopathy, the menstrual cycle, pregnancy, menopause, and the use of oral contraceptives or hormone replacement therapy. Hypersensitivity reactions to endogenous or exogenous female sex hormones have been described in the form of estrogen-associated urticaria (estrogen dermatitis) and autoimmune progesterone dermatitis.

Oncological diseases. There are isolated reports in the scientific literature of various malignant diseases, such as chronic lymphocytic leukemia, occurring in patients with urticaria. However, a large Swedish retrospective epidemiological study did not find a clear association between urticaria and cancer, and a recent Taiwanese study, on the contrary, confirmed a tendency for an increased incidence of cancer, especially hematological malignancies, in patients with CU.

Diseases of the gastrointestinal tract and hepatobiliary system. The role of diseases of the gastrointestinal tract and hepatobiliary system in the development of CU is discussed. According to a summary published in the World Allergy Organization Journal (January 2012), chronic inflammatory processes such as gastritis, ulcerative and gastroesophageal reflux diseases, inflammation of the bile ducts and gallbladder should be considered as possible causative factors of urticaria, for which appropriate treatment should be prescribed. treatment.

Autoinflammatory syndromes. Suspicion of autoinflammatory syndrome should arise when persistent urticaria and fever appear in a child during the neonatal period. In these syndromes, there is an increase in the level of interleukin IL-1, so the IL-1 antagonist anakinra is often used to treat the disease.

Common variable immunodeficiency. In a study published in 2002, in 6 adult patients with combined variable immunodeficiency, the first manifestation of the disease was CU with or without AO. 4 of them had a history of recurrent infections and a decrease in the total level of IgM, while the rest had a decrease in the total level of IgG and IgA. 4 patients were treated with intravenous immunoglobulin, after which their urticaria symptoms significantly decreased.

Schnitzler's syndrome. This syndrome was first described by Schnitzler in 1972, and since then many cases of this disease have been mentioned in the scientific literature. In addition to CC, it is characterized by fever, bone pain, increased ESR and macroglobulinemia. Most patients with Schnitzler syndrome have a favorable prognosis, although in some patients it can later transform into a lymphoproliferative disease.

6. Chronic idiopathic urticaria

Urticaria is defined as idiopathic if no cause is found after careful review of the history, physical examination, and laboratory and other test results. It is believed that about 90% of cases of CU are idiopathic. Some studies suggested an autoimmune nature of the disease in 40-60% of patients with CIC, confirmed by the introduction of autologous serum and using in vitro tests. In other cases of idiopathic urticaria, the cause remains unclear, although a number of such patients may actually also have autoimmune urticaria, the diagnosis of which is not confirmed due to false negative results or lack of sensitivity of the tests. Nevertheless, in the majority of patients with CIC, the disease still occurs through other, as yet unknown mechanisms.

Conclusion

To date, the etiology and pathogenesis of CIC remain unclear. In this regard, a large number of questions remain that remain to be answered. For example, how can degranulation of skin mast cells occur for no apparent reason, by an unknown mechanism, and without an obvious trigger? Many attempts have been made to link the mechanism of degranulation and the appearance of symptoms of CU with the use of certain foods and supplements, and chronic infections. However, none of these assumptions has yet been clearly confirmed in clinical studies, and expanding our understanding of the etiology of the disease is a task for further study.

The format of the scientific article did not allow us to present all the supposed causes of HC. Therefore, when writing the review, the goal was to highlight the main causative factors of the disease that are most often encountered in clinical practice. For a deeper study of the problem, it is advisable to refer to other publications.

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P. V. Kolkhir, Candidate of Medical Sciences

Research Center GBOU VPO First Moscow State Medical University named after. I. M. Sechenov Ministry of Health and Social Development of Russia, Moscow

is an allergic skin reaction that manifests itself in the form of an itchy, inflamed rash.

Chronic urticaria becomes when its duration exceeds 6 weeks.

Recurrent - if it is accompanied by long periods of remission.

What is chronic idiopathic urticaria? This is a disease whose causes remain unknown.

Chronic urticaria ( ICD10 code – L50.1 Idiopathic, L50.8 Chronic) is widespread.

Symptoms and manifestations

Signs of chronic urticaria persist on the skin for more than 6 weeks (as opposed to the acute form, which lasts less than 6 weeks).

Characteristic symptoms chronic (recurrent) urticaria include:

  1. Rash in the form of red (or pale pink) blisters, usually on the face, back, abdomen, arms or legs, décolleté or neck. The rash can be localized (up to 10 cm), or can spread to large areas of the body (generalized urticaria).
  2. Appearance of scars, which vary in size, change shape, disappear, and then reappear.
  3. The appearance of papules and plaques with a white center surrounded by red, inflamed skin (chronic papular urticaria).
  4. Itching(less severe than in the acute form of urticaria), worsening at night, causing insomnia, neurotic disorders.
  5. Edema, causing pain and burning (angioneurotic, Quincke's edema), especially in the throat and around the eyes, on the cheeks, lips, rarely on the arms, legs and, very rarely, on the genitals. At the site of swelling, skin tension is often observed, it begins to peel off, and cracks appear.

Attention! Rash and inflammation are often accompanied general malaise, weakness, nausea, fatigue, arthralgia (joint pain), less commonly: diarrhea and fever.

Signs and symptoms of chronic urticaria tend to flare up when exposed to triggers such as heat/cold, sunlight, exercise, stress.

Symptoms quiet down for long periods time (1-6 months), and then come back. The duration of chronic recurrent urticaria is not limited by time. It can last throughout the patient's life.

Causes

Chronic (recurrent) idiopathic urticaria is the most common type of the disease.

If recurrent urticaria appears on the skin, the causes are: body reaction to allergen, against which the body produces a protein called histamine.

When histamine is released from cells (called mast cells), fluid begins to leak through the capillaries, which accumulates in the skin and causes hives.

Mechanism chronic (idiopathic) urticaria autoimmune, Patients with this form of the disease have special IgG antibodies(most likely due to an autoimmune disease accompanying urticaria), which activate and awaken even those sleeping mast cells in the skin, causing them to attack healthy cells in the body, causing an increased allergic reaction.

Chronic urticaria, causes accompanying disease: thyroid disease, systemic lupus erythematosus (the body's immune system attacks the joints), Sjögren's syndrome (damage to the lacrimal/salivary glands), rheumatoid arthritis, celiac disease (digestive disorder) and diabetes.

Reference! Disease affects men and women equally, more often she manifests itself in adolescent children during puberty.

Climax and chronic urticaria are closely related, since the former causes the development of the latter.

Chronic urticaria is often the result other chronic disease and infection:

Chronic (recurrent idiopathic) urticaria may provoke some triggers (allergens):

  • stress, constant worries, emotional disorders;
  • alcohol;
  • caffeine;
  • increase/decrease in temperature;
  • constant pressure on the skin (wearing tight clothes);
  • medications – painkillers, aspirin, opiates;
  • some food additives - salicylates, which are found in tomatoes, orange juice, food coloring;
  • insect bites;
  • exposure to water;
  • Taking ACE inhibitors (used to treat hypertension) can cause angioedema.

Photo of the disease

Chronic (idiopathic) urticaria appeared on the hands, photo:

Chronic (papular) urticaria, photo:

Diagnostics

If chronic recurrent urticaria is suspected it is important to see a doctor as soon as possible.

The disease is not life-threatening, but constant relapses cause considerable discomfort to patients.

A specialist will help you choose the right course of treatment, which will significantly prolong the period of remission.

For consultation and diagnosis should contact therapist, allergist or dermatologist.

Reference! Diagnosis during the period of exacerbation of the chronic form is not difficult and includes a routine examination of the patient’s skin. The diagnosis during remission of chronic urticaria is more difficult to make.

Allergist prescribes provocative tests and short-term exposure to provoking factors (ice cube test for, test against the background of physical activity - for, light irradiation of a skin area - for, exposure to pressure on the skin - contact dermatitis, placing limbs in a container with water - for aquagenic urticaria).

Besides(during remission and exacerbation) for the diagnosis of chronic (idiopathic) urticaria the doctor prescribes:

For a person with chronic urticaria, treatment prescribe a comprehensive: drug therapy in combination with diet and light maintenance therapy using traditional medicine.

First aid

Let's find out what should be done if chronic urticaria appears and how to treat it:

  • elimination of allergen(if you were able to identify it);
  • one-time reception any antihistamine at night (Tavegil, Suprastin, Claritin) before going to the doctor;
  • one-time taking a sedative(motherwort extract, peony tincture);
  • when Quincke's edema, anaphylactic shock - immediately call an ambulance.

Drug therapy

In addition to the treatment of concomitant conditions (diseases of the thyroid gland, stomach), which are prescribed by the doctor, the following drugs can be used in treatment chronic (recurrent) urticaria:

  1. Antihistamines 1st and 2nd generations: they reduce the intensity of itching. 2nd generation drugs: Zyrtec, Allegra, Claritin, Alavert, Clarinex, Xyzal.

    1st generation drugs: Vistaril, Benadryl, Suprastin, Tavegil, Cetirizine have a mild sedative effect.

    Any antihistamine for chronic urticaria is prescribed 2 times a day for 3-12 months, depending on the severity of the symptoms.

  2. Leukotriene receptor antagonists: in the presence of bronchial spasms and allergic rhinitis, the drug Singulair is prescribed.
  3. If there is no response to antihistamines and there is a concomitant stomach disease, the specialist may prescribe Colchicine and Dapsone, this antimicrobial, painkillers.
  4. Systemic corticosteroids: effective in combating chronic urticaria when antihistamines do not help (Prednisolone).
  5. Cyclosporine(Sandimmune-Neoral) and Methotrexate: prescribed against the background of autoimmune urticaria, when antihistamines do not help, used against severe forms of dermatitis, accompanied by severe itching, inflammation and swelling.
  6. Levothyroxine(Levothroid): Prescribed for some patients with chronic hives associated with thyroid disease.

If you are concerned about chronic (recurrent) urticaria, treatment soothing creams and ointments will help relieve swelling and inflammation:

  • Fenistil-gel is a universal drug;
  • Nezulin and La-Cri anti-itch cream;
  • Advantan - will reduce pain and swelling;
  • Prednisolone ointment – ​​similar to Hydrocortisone;
  • Sinaflan is a glucocorticosteroid ointment for itching.

Attention! All of the above drugs (dosage, duration of use) must be prescribed by the attending physician.

ethnoscience

Used as maintenance therapy.

    1. Frozen chamomile cubes. Chamomile in bags can be purchased at any pharmacy. Fill 4 bags with boiling water (300 ml), use molds to make ice, place in the freezer. When the chamomile decoction freezes, wrap the cube in gauze or a napkin and apply it to damaged skin, this will relieve swelling and inflammation.

Attention! This method not suitable for patients with aquagenic/cold urticaria.

Diet

From the daily diet should be excluded allergenic products:

  • spicy, fried, salty foods seasoned with pepper, mustard, mayonnaise or fatty sauce;
  • chocolate, cookies, lollipops, cakes, pastries, crackers, bagels;
  • citrus fruits (especially strawberries, oranges);
  • coffee, alcohol;
  • seafood;
  • nuts;
  • all hard cheeses, with mold;

Instead, go on a diet need to add products that lower histamine levels:

  1. Domestic bird.
  2. Brown rice, buckwheat, oatmeal, quinoa, bulgur.
  3. Fresh fruits - pears, apples, melons, watermelons, bananas, grapes.
  4. Fresh vegetables (except tomatoes, spinach, eggplants).
  5. Rice, hemp, almond milk.
  6. Olive and coconut oil.
  7. Herbal teas.

Remember! Chronic (idiopathic) urticaria requires an integrated approach to treatment and compliance with all preventive measures (diet, use of hypoallergenic drugs).

Seeking medical help for this form of the disease inevitably. With the right approach, the disease quickly turns into long-term remission stage.

A practicing dermatologist in the following video talked about the causes and recurrence of chronic urticaria, as well as methods of treating and preventing the disease.

Hives appear on the skin and do not go away for at least six weeks. Symptoms appear as:

Hives rashes are red or pinkish blisters that cover the face, neck, back, abdomen, limbs, neck. The affected areas can be located either in small spots with a diameter of up to 10 cm, or in large areas.

Scars on the skin occur due to an allergic reaction. They can have different sizes and shapes. They often disappear and reappear elsewhere. Papular urticaria may appear.

It is characterized by the appearance of papules, which have a white center, surrounded on all sides by dry, inflamed skin. The itching of the chronic form of the disease differs from the acute form in its severity. In case of illness with code L50.8, it is less pronounced, but intensifies at night, preventing the person from sleeping and leading to neurotic disorders.

Swelling often accompanies allergic reactions. With urticaria, severe angioedema or angioedema may occur in the throat, eye area, cheeks, lips or limbs. They cause severe pain. The skin at the sites of swelling becomes tense and peels, and cracks may occur. All symptoms appear in outbreaks when a person comes into contact with the catalysts of the disease:

  • high temperatures;
  • cold;
  • light;
  • food;
  • medications;
  • alcohol;
  • insect bites;
  • ACE inhibitors;
  • caffeine;
  • friction or pressure on the skin;
  • food additives;
  • stress.

Signs of urticaria may appear immediately and not subside for a month and a half, and then fade for six months and return again. The duration of the disease is not limited in time and can last throughout a person’s life.

Important: The disease is often accompanied by weakness, severe fatigue, fever, joint discomfort, nausea and other symptoms.

What does the disease look like in the photo?





Causes of this disease

Urticaria is quite widespread. The reasons for its occurrence are the effects of certain allergens on the body, during which a special substance is produced in the body - histamine.

When released, this protein provokes an increase in the capacity of the capillaries and liquid leaks through them.

It accumulates in the skin and forms blisters, rashes, and other symptoms of hives.

The disease is autoimmune in nature and the patient’s blood contains special antibodies, which, when exposed to an allergen, are released and activated, thereby causing an allergic reaction.

The causes of the chronic form of the disease are often diseases of some internal organs:

  1. kidney dysfunction;
  2. rheumatoid arthritis;
  3. malignant neoplasms;
  4. gallbladder dysfunction caused by infections;
  5. Sjögren's syndrome;
  6. diabetes;
  7. disorders of the thyroid gland;
  8. lymphogranulomatosis;
  9. lupus.

The disease can manifest itself in people who experience alcohol intoxication or drug intoxication. Some chronic diseases can also cause the development of idiopathic urticaria:

Important: Idiopathic urticaria most often occurs in adolescents during puberty.

When should you see a doctor and what tests are needed for diagnosis?

It is necessary to consult a doctor as early as possible, when the first symptoms appear..

The disease is not considered dangerous, but the regular manifestation of symptoms has a very negative impact on a person, bringing him discomfort.

Only a specialist can select the necessary and effective course of treatment and establish an accurate diagnosis (by identifying the cause), thereby increasing the duration of remission.

An allergist helps identify urticaria. He primarily prescribes tests for:

  • cold;
  • physical exercise;
  • light;
  • pressure;
  • water.

These are allergy triggers. Based on the reaction, the type of urticaria is determined. In addition to samples, the doctor prescribes tests:

Important: Urticaria is diagnosed much faster during an exacerbation than during remission.

Treatment of recurrent urticaria

So, how to treat such urticaria? Treatment must be carried out comprehensively:

  • identify the cause and ways to eliminate the allergen;
  • relieve symptoms during exacerbation;
  • undergo basic treatment;
  • take preventive measures to eliminate relapses.

In addition, treatment must be supported by medication and diet, as well as management of associated conditions.

When using folk remedies, you must first consult a doctor..

What should you do first?

When treating, it is first necessary to eliminate the allergen, if it can be accurately identified. The following should be taken before visiting a doctor:

  • antihistamines;
  • sedatives.

Antihistamines are taken at night. This could be Tavegil, Suprastin or Claritin. If the disease manifests itself in an acute form and causes swelling or anaphylactic shock, then you must immediately call an ambulance.

What medications can I take? Tablets and ointments

Medicines for the treatment of chronic urticaria are prescribed strictly in consultation with a doctor.

  • antihistamines;
  • leukotriene receptor antagonists;
  • antimicrobial;
  • painkillers;
  • corticosteroids;
  • Cyclosporine and Methotrexate;
  • Levothyroxine.

Antihistamines can reduce itching and reduce allergy symptoms.

These drugs are prescribed twice a day for a course of three months to a year.

Leukotriene receptor antagonists are used for rhinitis and bronchial spasms. The most popular remedy is Singulair.

Antimicrobial and painkillers are prescribed in cases where a reaction to allergy medications does not manifest itself, and in case of concomitant stomach problems, Colchicine and Dapsone are used.

Prednisolone (corticosteroid) is also prescribed if the patient’s body does not respond to antihistamines. You can soothe inflammation on the skin in chronic forms of urticaria using creams or ointments:

  1. Fenistil-gel;
  2. Nezulin;
  3. La Cree;
  4. Advantin;
  5. Hydrocortisone;
  6. Prednisol ointment;
  7. Sinaflan.

All ointments help eliminate itching, relieve swelling and pain.

How can folk remedies help?

The use of methods and means of traditional medicine for this disease is indicated only as maintenance therapy to relieve symptoms of itching, swelling, as well as to relieve the patient from stress, which could provoke a relapse.

You can use frozen cubes of chamomile infusion.

But this remedy is contraindicated in aquagenic or cold forms of the disease.

To prepare the cubes you will need 4 bags of dried plant. They are poured with boiling water (300 ml) and brewed.

The resulting infusion is cooled, filtered and frozen in small molds.

When urticaria worsens, ice is wrapped in gauze or a napkin and applied to the affected areas of the skin. Cold and chamomile decoction help relieve swelling and inflammation, and also slightly soothe the itching. If a relapse of urticaria is accompanied by fever and stress, you can prepare a raspberry decoction. you will need 50 grams of plant roots.

They are poured with 200 ml of boiling water and cooked over low heat for a third of an hour. The resulting broth is infused for another hour and filtered. The resulting product should be taken up to 5 times a day for 3 months..

For severe skin lesions, you can take baths with herbs.

You will need a teaspoon of dried:

  • St. John's wort;
  • sequences;
  • celandine;
  • sage;
  • chamomile;
  • valerian.

All components are mixed. Five teaspoons of the mixture are poured with warm boiled water and left for 5 hours. The resulting infusion is filtered and poured into a pre-drawn warm bath. The water temperature should not exceed 38 degrees. The duration of stay in water can be from 10 to 20 minutes.

Course of treatment – ​​twice a week for two months.For an antimicrobial effect in case of hives, you can take a mint drink. To prepare it you will need dried mint (2 teaspoons), which is poured with boiling water (200 ml).

The mixture is infused for half an hour, and then taken 50-70 ml three times a day.

An herbal mixture with a soothing and antimicrobial effect is also used for urticaria.

You will need a teaspoon:

  • lemon balm;
  • hop cones;
  • valerian rhizomes.

Two large spoons of the mixture must be poured with boiling water in a volume of 200 ml and left for two hours and filtered to remove pieces of plants. The resulting infusion is cooled and taken orally, a third of a glass daily, three times a month.

Diet: what should you give up and what should you give preference to?

In case of a chronic disease, it is necessary to follow a special diet, since some deviations from it can lead to relapses. It is necessary to completely exclude from the diet or minimize consumption of:

  • spicy dishes;
  • salty food;
  • peppery food;
  • mustard;
  • mayonnaise;
  • fatty sauces;
  • chocolate;
  • lollipops;
  • baking;
  • citrus fruits;
  • strawberries;
  • coffee;
  • alcohol;
  • seafood;
  • nuts;
  • hard cheeses and blue cheeses;
  • honey

In addition, you should increase your intake of foods that increase the concentration of histamine in the blood. This:


Important: The diet is used to prevent urticaria.

Conclusion

Diet and appropriate treatment of chronic idiopathic urticaria does not make it possible to completely cure the disease, but allows it to be transferred to a long-term stage of remission.

Why does it occur?

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, the following are observed on the patient’s skin:

  • Papules;
  • Rash;
  • Scarring;
  • Swelling;
  • Plaques.

Most patients during the development of the pathological process complain of itching. The rash of the disease appears as pink or red blisters. Their location can be the neck, face, arms, legs, back.

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

During the development of this disease, patients complain of itching, which intensifies in the evening. During the development of an allergic reaction, patients may experience swelling on the skin.

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

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

The incidence of urticaria in the population is quite high, which, accordingly, defines it as a common disease. Moreover, at least once in their lives, about 10 to 35% of the population has encountered its manifestation.

The most unfavorable course of this disease is chronic urticaria, the duration of which is about 5-7 weeks.

Urticaria is a skin disease predominantly of allergic origin, which is characterized by the rapid appearance of itchy blisters, similar in appearance to blisters upon contact with nettles.

Hives can be an independent (usually allergic) reaction or one of the manifestations of certain diseases.

Main causes and mechanisms of disease development

The development of blisters and tissue swelling is based on an increase in the permeability of the vascular wall, caused by an increase in the content of histamine, serotonin and a number of other biologically active substances in the blood.

Chronic urticariaChronic urticaria most often develops in children under 3 years of age. Acute urticaria becomes chronic if the rash persists for more than 6 weeks. Chronic recurrent urticaria is characterized by periods of remission (at this time there is no rash) and exacerbation (the appearance of rashes).

The main reasons for the development of chronic urticaria include:

  1. Prolonged contact with the allergen. Chronic recurrent urticaria develops with frequent “meetings” with an allergen. Anything can be an allergen. Food, insects, cosmetics, washing powders, pet hair, dust, etc.
  2. Lack of treatment for the disease in the acute period. If no attention is paid to the child’s health and no attempt is made to cure the rash, it will persist for a long time.
  3. Autoimmune processes in the body.
  4. Long-term use of medications to which the child is allergic.
  5. Infectious diseases. The long-term presence of a chronic infectious source of inflammation can cause the development of rashes. The most common causes in children are:
  • helminthic infestation;
  • caries;
  • chronic purulent lesions in the area of ​​the nose and head;
  • mycosis.

Reasons for development

Factors that cause disease are divided according to their nature into two categories:

  • endogenous - causes associated with organ diseases:
    • inflammatory problems in teeth and gums;
    • liver disease,
    • pancreatitis,
    • gastritis;
    • helminths.
  • exogenous – the appearance of blisters is influenced by external factors:
    • chemical (reaction to certain substances),
    • temperature (heat, cold),
    • mechanical (friction, vibration).

Provoking factors can be sunlight, cold, stressful situations, food or medications.

The true cause of this disease lies much deeper. Its appearance can be provoked by the following diseases of internal organs and systems:

  • renal dysfunction;
  • rheumatoid arthritis;
  • malignant formations;
  • infectious gallbladder disease;
  • Sjögren's syndrome;
  • diabetes;
  • thyroid diseases;
  • lymphogranulomatosis;
  • lupus.

It should be noted that chronic is called urticaria, the symptoms of which persist for more than 6 weeks or continuously recur. There are many classifications of this disease.

According to the flow, mild, moderate and severe forms of the process are distinguished. Depending on the location, urticaria can be focal or generalized. Classification according to causal factors includes the following points:

  • immunological;
  • anaphylactoid;
  • physical (temperature, mechanical, solar, contact, vibration, cholinergic);
  • other types (infectious; caused by tumor processes in other organs; endocrine, psychogenic, pigmentary, papular, idiopathic, hereditary).

Symptoms of urticaria on the legs An examination of the body is carried out to make a diagnosis and identify the cause of the development of rashes. Without its definition, it is impossible to carry out accurate and effective treatment.

The examination regimen is prescribed by an allergist and immunologist. Diagnosis of chronic urticaria includes the following examination methods:

  1. General blood test with a detailed leukocyte formula. With allergies, the level of eosinophils in the blood increases. When a bacterial infection is attached, the erythrocyte sedimentation rate (ESR), the level of neutrophils increases, and the leukocyte formula shifts to the left.
  2. Analysis of stool for worm eggs.
  3. Blood tests for various allergens.
  4. Skin biopsy in the area of ​​the rash. The biopsy is examined for the presence of immunoglobulins and specific antibodies.
  5. Examination of the body for the presence of a chronic source of infection. Consultations with an ENT specialist, infectious disease specialist, dentist, or dermatologist may be required.

Chronic (recurrent) idiopathic urticaria is the most common type of the disease.

Scientists believe that hives are just a symptom of another disease. The causes of chronic urticaria are foci of infection, for example, adnexitis, caries, tonsillitis, etc.

In addition, diseases of the stomach, pancreas, liver, rheumatic and autoimmune diseases and tumors provoke the development of the disease. 30-50% of diseases are autoimmune in nature.

This may be a disease of the thyroid gland - autoimmune thyroiditis. But most often the cause of recurrent urticaria cannot be determined.

In this case, a diagnosis of chronic idiopathic urticaria is made.

In general, the causes contributing to the development of urticaria can be defined as endogenous and exogenous. Temperature, chemical, physical, mechanical, as well as pharmacological (especially various serums and antibiotics) products and food products are defined as exogenous causes.

As for endogenous causes, these include various pathologies that are relevant to internal organs. In particular, in this case, pathologies of the gastrointestinal tract, nervous system and liver are highlighted.

Again, insect bites (blood-sucking, in particular mosquitoes, midges, mosquitoes, fleas, etc.) are identified as the cause of the development of the disease in question. Due to their bites, chemically active substances similar to histamine enter the body with saliva.

In addition to the above reasons, helminthic infestations also play a significant role.

The main reason for the appearance of skin inflammatory manifestations of this type is considered to be a peculiar reaction to an allergen. Chronic idiopathic urticaria can be an independent disease or a manifestation of one of the symptoms of some other disease.

Provoking factors can be sunlight, cold, stressful situations, food or medications.

Chronic inflammatory processes in organs initiate bacterial infection. The body's response may be chronic urticaria.

Chronic urticaria is a disease that is difficult to treat. It requires an integrated approach and detailed diagnostics.

The disease is not caused by an allergen, but by internal inflammatory processes, infectious or viral blood poisoning, and autoimmune diseases. The appearance of chronic urticaria in children is rare.

Young children suffer from an acute form of the disease, and chronic manifestations are diagnosed in adults.

It is almost impossible to identify the original cause of the disease. The appearance of chronic urticaria is associated with a complex of causes affecting the human body. In general, it is noted that attacks can be triggered by:

  • immune system failures;
  • diseases of the endocrine system;
  • gastrointestinal problems;
  • viral and bacterial infection;
  • problems with the thyroid gland;
  • tendency to allergic reactions;
  • increased sensitivity to external factors;
  • arthritis and systemic lupus;
  • presence of malignant tumors
  • insect bites.

Central to the pathogenesis of urticaria is mast cell destabilization. Immunological and non-immune provocateurs (both various chemical substances and physical factors) can act as activators of mast cells.

Mast cells, or mast cells, are highly specific connective tissue cells containing granules with biologically active substances, inflammatory mediators: histamine, leukotrienes, prostaglandins, platelet activating factor, etc.

They also carry specialized receptors for immunoglobulin E on their surface. Mast cells play one of the determining roles in the development of immediate allergic reactions.

When mast cells are activated, a massive release of the mediators they contain into the blood occurs, which leads to a whole cascade of pathological changes in the body:

  • bronchospasm;
  • increased permeability of vascular walls;
  • swelling of the mucous membranes, skin microstructures;
  • increased mucus production by glandular cells of the bronchial tree;
  • spastic contractions of smooth muscle tissue of the gastrointestinal tract;
  • decreased vascular tone;
  • platelet aggregation;
  • skin rashes.

The causes of urticaria in children can be divided into two main groups: allergic and non-allergic.

Causes of non-allergic urticaria in children:

  • exposure to low temperatures, ultraviolet radiation, vibration;
  • contact with water;
  • prolonged compression of soft tissues;
  • excessive physical or psycho-emotional stress.

In addition to the manifestation of urticaria in children as an independent disease, in some cases it can be one of the symptoms of the underlying pathology:

Risk factors for developing urticaria in children:

  • presence of allergic diseases;
  • episodes of urticaria in the past (even one-time episodes);
  • burdened hereditary allergy history;
  • severe concomitant chronic diseases.

Chronic urticaria in children, unlike acute urticaria, in most cases is non-allergic; immune mechanisms cannot be identified in the majority of patients.

A characteristic feature identified during the research is information about artificial feeding during the neonatal period in most children with urticaria.

Classification

The manifestation of urticaria is divided into groups of conditions according to the pathogenetic mechanisms that provoke rashes on the skin surface:

  • The idiopathic form is a manifestation of the disease that characterizes chronic urticaria, but the causes that caused the disorder cannot be determined.
  • Autoimmune form - the disease is long-lasting and severe. The diagnosis is confirmed by the lack of response to antihistamines.
  • Papular form - rashes appear as the body’s response to an insect bite.
  • Spontaneous form - the appearance of rashes without any connection with any reasons, the disease is also called ordinary urticaria (chronic);
  • Physical form:
    • cholinergic variety - rashes with signs of urticaria appear after rubbing areas of the skin or physical contact;
    • cold variety - blisters appear due to changes in temperature (heat or cold);
    • psychogenic type - a skin reaction in the form of blistering is initiated by an emotional reaction to some event;
    • contact type - the body’s reaction in the form of urticaria to contact with substances that are allergens for the patient.
  • Hereditary variety - the patient inherited a reaction to some factors (cold, insect bites, contact with certain substances) with skin rashes with signs of chronic urticaria.

Chronic urticaria can have different forms of the process:

  • recurrent form - a cyclical course of chronic urticaria, when periods of exacerbation are followed by short breaks (several days);
  • persistent form - the rash is continuously renewed throughout the disease.

Contact urticaria develops in direct contact with an irritating factor, temperature urticaria - from exposure to low or high temperatures, vibration urticaria - from mechanical vibration.

Urticaria can manifest itself in several varieties, each of which is characterized by its own course and symptoms. In particular, the following main varieties are distinguished, determined based on the characteristics of the flow:

  • acute urticaria (this also includes Quincke's edema in an acute limited form of manifestation);
  • chronic recurrent;
  • chronic papular persistent.

There are several types of urticaria; in addition, there are conditions that were previously also considered types of urticaria, but have now begun to be classified as separate diseases. These include urticarial vasculitis, cutaneous mastocidosis (urticaria pigmentosa) and some other manifestations.

Urticaria occurs in different forms, including:

  • Immunologically caused form of urticaria:
  1. cytotoxic type;
  2. anaphylactic type;
  3. immunocomplex type.
  • Anaphylactoid form of urticaria:
  1. aspirin dependent;
  2. caused by mediator-releasing agents.
  • Physical form of urticaria:
  1. temperature (cold and heat);
  2. dermographic (mechanical);
  3. cholinergic;
  4. contact;
  5. solar;
  6. vibration
  1. papular;
  2. idiopathic;
  3. pigmented;
  4. infectious urticaria;
  5. systemic mastocytosis;
  6. cutaneous form of vasculitis and other systemic diseases;
  7. endocrine;
  8. caused by neoplastic processes;
  9. psychogenic.
  • Hereditary forms of urticaria:
  1. hereditary syndrome characterized by urticaria, amyloidosis, deafness;
  2. hereditary angioedema;
  3. violation of protoporphyrin metabolism 9;
  4. caused by deficiency of SZv-inactivator;
  5. hereditary cold urticaria.

Urticaria and pregnancy

It happens that urticaria develops in women who are in an interesting position. In these cases, its development can be triggered by the body’s reaction to both medications, food, and external irritants and some diseases.

The most common cause of the disease in this case is complicated toxicosis (preeclampsia), this is due to the production of a large amount of pregnancy hormones in the body of a pregnant woman.

During this period, urticaria often takes a chronic course and can accompany the woman throughout pregnancy. This condition is complicated by the fact that it is often not possible to choose an antihistamine that is suitable and safe for the fetus to relieve symptoms, so you have to rely more on traditional medicine recipes and local remedies, which is not very effective.

The most common complication is Quincke's edema. The pathology causes swelling of the larynx and mucous membranes, difficulty breathing, and suffocation may occur if the patient is not given timely assistance.

Chronic urticaria, the treatment of which is carried out according to doctor’s prescriptions, goes away within 3–5 years, sometimes can persist up to 10 years, and have a progressive course. Patients often suffer from nervous disorders and are prone to depression.

The prognosis for the treatment of chronic urticaria depends on the severity of the manifestations of the disease and the reasons that caused its development. If the pathological condition is observed in patients suffering from cancer, the prognosis is significantly worse.

Prevention of concomitant systemic diseases and maintenance therapy reduce the number of relapses of urticaria and ease its course.

This situation poses a threat to the child's life. Therefore, it is necessary to promptly refuse food that causes an allergic reaction and treat chronic urticaria.

Complications of urticaria in children can include:

  • obstruction of the upper respiratory tract (including angioedema of the larynx);
  • generalization of the process (spread of urticaria over the entire surface of the body);
  • dyspeptic disorders.

The most serious complication of the disease may be the development of edema of the deep layers of the skin and fatty tissue (Quincke's edema or angioedema).

Prevention of urticaria

To avoid pathology, you should strive to observe:

  • load mode - rest,
  • develop a friendly outlook on the world, try to avoid stressful situations;
  • consume natural products,
  • prevent chronic inflammatory processes, treat inflammation in a timely manner.

Chronic urticaria has such a feature that it is very difficult to cure it 100%. To prevent its reappearance, certain measures must be taken. In addition, they will reduce the frequency of attacks of the disease.

Basic preventive measures:

  • following a diet that excludes allergenic foods;
  • avoiding any contact with the allergen
  • timely and complete treatment of chronic and infectious diseases;
  • maintaining a healthy lifestyle;
  • use of hypoallergenic household chemicals and cosmetics.
  • restriction, and in some cases a complete ban on visiting bathhouses and swimming pools.

Prevention of recurrent urticaria is the timely treatment of foci of chronic infection, diseases of the gastrointestinal tract and nervous system.

To summarize, we can say that recurrent urticaria is not life-threatening. Determining the cause of the disease is very difficult, since it may be related to the condition of the internal organs and the presence of infection.

Therefore, it is better to prevent the disease by paying close attention to your health.

Exacerbation and complications of chronic urticaria are discussed below.

Chronic recurrent urticaria requires constant preventive procedures. They should be started as soon as the acute symptoms of the disease are relieved.

Prevention consists of maintaining proper nutrition, a healthy lifestyle and maximally blocking all factors that can cause a relapse of the disease.

Experts advise taking raspberry and mint decoctions in courses. The course lasts from 1 to 3 months.

Raspberry roots have antipyretic, tonic and calming effects. Mint has a positive effect on the nervous system.

Sedatives help normalize the functioning of the nervous system, relieve tension and stress, which stimulate the formation of hives.

When preventing the disease, it is important to maintain proper nutrition. It excludes all allergenic products.

Spicy, fried, fatty foods, the use of spices and sauces should be excluded. The diet should be free of sweet, flour products, sugar, chocolate, and citrus fruits.

Consumption of alcoholic and carbonated drinks is prohibited.

The products that make up the diet should be aimed at normalizing the functioning of the gastrointestinal tract. These are lean varieties of meat and poultry, a large amount of vegetables and fruits, herbal teas, and cereal porridges.

In addition to proper nutrition, you should limit contact with allergens at the household level and use special cosmetics. It is important to pay attention to hardening procedures. Walking in the fresh air, dousing with cold water, and contrast showers help strengthen the body.

It is important to monitor your general health and promptly treat respiratory viral and chronic diseases. Every year it is recommended to go to a sanatorium for treatment and recovery. If you follow all preventive measures, the symptoms of the disease go into remission for a long time.

Basic preventive measures:

  • preventive prescription of antihistamines;
  • avoiding contact with allergens;
  • creating a hypoallergenic environment at home.

In cases of known hypersensitivity, contact with the allergen should be avoided. It is important to promptly treat gastrointestinal pathologies and liver diseases, foci of chronic infection, maintain a daily routine and a healthy diet.

Diet

If the allergen has not been identified, it would be advisable to prescribe a special hypoallergenic diet with the exclusion of all products that can lead to the development of allergies. In the future, as the symptoms disappear, restrictions can be gradually lifted, but you need to monitor the skin and try to understand the relationship between the manifestations of the disease and food intake.

The diet may contain the following dishes and products:

  • meat:
  • dairy products:
  • vegetables:
    • potatoes are healthy, but they should be soaked first;
    • salad,
    • zucchini,
    • broccoli,
    • dill;
  • sugar: fructose,
  • porridge:
    • corn,
    • rice,
    • buckwheat;
  • bakery products:
    • hypoallergenic cookies,
    • yeast-free bread
  • oil (small amount):

Menu for urticaria Treatment of chronic urticaria is impossible without a hypoallergenic diet. If the disease develops in a child who is breastfed, the mother must follow the diet.

If your child takes formula for artificial feeding, replace it with hypoallergenic ones. When choosing a mixture, consult your pediatrician. Do not take mixtures with flavor enhancers and preservatives.

It is necessary to exclude from the diet all foods that can cause allergic reactions.

The most allergenic foods include:

  • fish;
  • seafood;
  • nuts;
  • cocoa, chocolate;
  • fruits and vegetables of bright red or orange color, all citrus fruits;
  • store-bought juices;
  • sweet carbonated drinks;
  • products in the preparation of which preservatives, dyes, and flavor enhancers were used.

If the allergen has not been identified, it would be advisable to prescribe a special hypoallergenic diet with the exclusion of all products that can lead to the development of allergies.

In the future, as the symptoms disappear, restrictions can be gradually lifted, but you need to monitor the skin and try to understand the relationship between the manifestations of the disease and food intake.

If necessary, additional laboratory tests may be performed to identify the allergen.

The consumption of alcoholic beverages is strictly prohibited, as they provoke an exacerbation of the disease.

When searching for the cause of the disease, a specialist may prescribe a special diet. This method is also used when it is known that the problem was caused by a food allergen.

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