Urticaria Symptoms and Treatment

Urticaria, commonly known as wind rash, is a skin condition characterized by self-limiting edematous reactions that appear on the body and typically resolve within 2 to 24 hours, with potential for recurrent episodes. The primary manifestation is the emergence of wheals on the skin, often preceded by itching. These wheals can be bright red, pale, or skin-colored, and in some cases, patients may also experience edematous erythema. Relief from symptoms can be achieved through a combination of general and pharmacological treatments.

Symptoms of Urticaria

Urticaria, colloquially referred to as wind rash and as "wind丹" in Traditional Chinese Medicine, is a localized edematous reaction resulting from dilation and increased permeability of small blood vessels in the skin and mucosa. These reactions typically resolve within 2 to 24 hours but may recur repeatedly, with illness duration varying from a few days to several months. Clinically, it is a relatively common condition characterized by the appearance of wheals on the skin, often preceded by itching. The wheals vary in size and shape, with unpredictable onset times. As they spread and merge, a depression may be visible at the epidermal hair follicle due to edema of the dermal papillae. Wheals last from minutes to hours, with some persisting for several days before resolving without traces. Rashes tend to occur in batches, particularly in the evening, and can be widespread or localized. In some cases, they may be accompanied by angioedema or the formation of large blisters. Patients may also experience symptoms such as nausea, vomiting, headache, abdominal pain, diarrhea, and in severe cases, chest tightness, discomfort, pallor, tachycardia, weak pulse, hypotension, and shortness of breath.

Treatment of Urticaria

1. General Treatment:

Due to the diverse causes of urticaria, treatment effectiveness may vary. Specific measures include:

• Identifying and avoiding causative factors: It is crucial to identify and avoid triggers for each patient. If the condition is caused by an infection, the infected area should be actively treated. If medication is the cause, the offending drug should be discontinued. For food allergies, the patient should avoid the offending food.
• Avoiding triggering factors: For example, patients with cold urticaria should stay warm, while those with cholinergic urticaria should reduce exercise, sweating, and emotional fluctuations. Patients with contact urticaria should minimize exposure to the causative agent.

2. Pharmacological Treatment:

• Antihistamines: H1 receptor antagonists exhibit strong antihistaminic and anti-inflammatory effects, making them effective in treating various types of urticaria. Commonly used H1 receptor antagonists include diphenhydramine, cyproheptadine, chlorpheniramine, among others. Other options include avastin, cetirizine, mizolastine, loratadine, ebastine, nazolastine, and desloratadine. If monotherapy is ineffective, a combination of two different types of H1 receptor antagonists or a combination of H1 and H2 receptor antagonists can be considered. Commonly used H2 receptor antagonists include cimetidine, ranitidine, and famotidine.