Hives ( Urticaria )

The typical lesion of urticaria is wheal. It usually has a pale center and should disappear after 24 hours, without leaving a mark. When an urticaria leaves a mark at the site of the lesion, it is usually vasculitic type urticaria.

Angioedema: Affects not only the epidermis such as urticaria, but also affects dermis and deeper layers of the skin.

Chronic urticaria: Lasts more than 6 weeks. If the urticaria has less time, it is acute.

Inducible urticaria: It appears and disappears, it can be drug, food, cold or heat or infections.

80% of hives have an infectious cause. Reason why a patient in emergency who presents urticaria frequently has a fever or a history of it.

Treatment:

1. Second generation antihistamines such as cetirizine, loratadine, desloratadine. (Do not use the first generation as atarax or fendramin) And use every 24 hours. (Once a day)

2. Steroids. Add them as 2nd option.

Scheme for treatment of chronic urticaria

1. Second generation antihistamines

2. Antileukotrienes

3. Steroids

4. Combine anti h1 and h2

5. Immunomodulators

Topical medication: Not recommended

Emergency Management

1. Fendramin

2. Steroids

In cases of Dysphonia or Dyspnea, take into account glottis edema, use deep intramuscular adrenaline. The use of subcutaneous adrenaline is of little use.

Admission: ONLY in patients with dyspnea or dysphonia.

Always remember to calm the parents, THE HABONES WILL NOT DISAPPEAR immediately.

Conference notes that I attended from Dra. Rojas, Pediatrician-Allergist