Hives (urticaria): Triggers and treatment
Urticaria, commonly known as hives, is a condition where red, raised patches (sometimes called weals or welts) appear on the skin, often accompanied by an unpleasant itchiness. Urticaria is one of the most common skin rashes and affects one in every four to five people at some point in their life. The first World Urticaria Day was held on 1 October 2014 with the objective of raising awareness of the symptoms around the world. Read on to find out more about the various forms, potential triggers and the treatments available for hives.
Symptoms of hives
Hives is a very common skin condition that can take a range of different forms. Around one in every four to five adults will experience an outbreak of hives at least once in their life. The primary symptom of urticaria is a rash of red, raised patches. The skin rash is different for each form of the condition and may be isolated, widespread or appear across the entire body. The size of the rash also differs from one patient to the next: in some cases, the rash comprises spots of just a few millimetres across, while other people develop patches of several centimetres in diameter. The rash is accompanied by extreme itchiness. A burning sensation and extreme sensitivity are also possible in the affected areas. Some patients also develop swollen skin, known as angioedema, in their face and extremities.
Forms of hives
A basic distinction is made between two forms of the condition: acute and chronic. The term acute urticaria denotes symptoms or complaints that appear once for a few days or weeks before receding gradually of their own accord. For the most part, the symptoms of this form of the condition can be managed quite effectively. Chronic urticaria, on the other hand, is a considerably more complex skin condition that is also more difficult to treat. Chronic urticaria is diagnosed when the symptoms persist for longer than six weeks. While the individual raised patches may not remain in one place for more than 24 hours, they may reappear on other parts of the body. Chronic urticaria is further divided into chronic inducible urticaria (where a trigger can be identified) and chronic spontaneous urticaria (where the trigger remains unclear).
Trigger factors of hives (urticaria)
Depending on the form and sub-form of the condition, hives can be triggered and exacerbated by various internal and external factors:
- Acute urticaria: Though it is not always the case, acute urticaria is very often triggered by an allergy. The potential causes of acute urticaria include food allergies and intolerances, infections, medication intolerances (such as an intolerance to certain antibiotics, such as penicillin, sulfonamide, etc.), antipyretic painkillers (e.g. ibuprofen, diclofenac, etc.) and medication for high blood pressure or heart conditions (e.g. beta blockers, diuretics, etc.).
- Chronic urticaria: In contrast to acute urticaria, chronic urticaria (both inducible and spontaneous forms) is almost never caused by an allergy.
- Chronic inducible urticaria (physical urticaria): Chronic inducible urticaria is usually triggered by physical stimuli and – depending on the physical trigger – can be divided into:
- Cold urticaria: Cold urticaria is one of the most common forms of physical urticaria. In this form, the typical symptoms of the condition are caused by contact with cold (e.g. cold air, cold water, cold items, sweat, etc.). The skin alterations appear on the parts of the body that come into contact with the cold, which is why uncovered areas of skin such as the hands and face are usually affected.
- Heat-induced urticaria: Heat-induced urticaria is less common than other forms of the condition. The cause of heat-induced urticaria is localised heat (e.g. taking a hot shower or bath, using a hairdryer, eating hot food, etc.).
- Solar urticaria: The trigger for solar urticaria is visible light or ultraviolet radiation. This form is most common among young adults, with women on average more likely to suffer from it than men. Sunlight in particular causes the characteristic raised red patches to appear on the skin, along with an unpleasant itchiness. However, the mechanism that connects light radiation to a breakout of hives is not yet fully understood.
- Pressure urticaria: Heat-induced urticaria is less common than other forms of the condition. Pressure urticaria denotes a condition where the symptoms are triggered by applying pressure to skin. Pressing on the skin or impacting on something can cause swelling which, in many cases, can also be painful.
- Dermatographia: The trigger of dermatographia (also known as dermatographic urticaria) is so-called shear forces which can be caused, for example, through rubbing, chafing or scratching. The reaction develops on the skin shortly after the skin has been irritated. However, only the areas of skin which have been rubbed, chafed or scratched are affected. For some patients, even lightly stroking the skin is enough to cause an outbreak of raised patches; other patients might only develop symptoms after more firm or intense scratching or rubbing.
All sub-forms of chronic individual urticaria can appear either on their own or together with other sub-forms.
- Chronic spontaneous urticaria: The exact triggers of chronic spontaneous urticaria remain unclear. It is generally assumed that the possible causes are infections, autoimmunity and reactions to intolerances (e.g. to medications, food additives and preservatives). As its name suggests, chronic spontaneous urticaria is characterised by its spontaneous onset. The red, raised patches appear repeatedly for a period of more than six weeks.
Underlying causes of hives
While the triggers of the individual forms of urticaria may vary, the processes that ultimately lead to skin alterations and complaints are the same for every form and sub-form. Following specific irritation, the body’s mast cells (mastocytes) emit various biochemical messengers, including histamine.
Mast cells are the cells in our immune systems that are crucial, among other things, in defending the body against pathogens and healing wounds. In addition, mast cells also play an important role when it comes to allergies, primarily through immediate allergic reactions. As soon as an irritant activates the mast cells, the cells begin to release specific messengers into the interstitium (the spaces between cells, tissue or organs).
Histamine is a so-called tissue hormone. It appears almost everywhere in the body, including in the skin. Histamine plays in important role in numerous physiological processes. When histamine is released, it causes blood vessels to dilate and thereby allow fluid to permeate tissue. This is what causes the redness and raised patches on the skin. At the same time, histamine causes the itchy sensation at nerve endings.
Diagnosis of hives
A doctor usually recognises the red, raised patches at first sight. If the patient visits a doctor at a point in time when no skin rash is present, the patient providing a detailed description of their complaints and symptoms can be decisive in diagnosing the condition. In any case, a comprehensive discussion of the patient’s medical history is important. As well as providing essential information, it is a valuable diagnostic tool in identifying or ruling out potential triggers (cold, heat, light, pressure, shear forces, medications, foods, infections, etc.) at an early stage and also makes it possible to determine whether the patient has an acute or chronic form of urticaria.
Important differential diagnosis in the event the case of suspected urticaria include urticaria vasculitis and autoinflammatory syndromes (cryopyrin-associated periodic syndrome, Schnitzler syndrome) – these conditions present with similar symptoms to chronic spontaneous urticaria and must be excluded before treatment can begin.
After discussing the patient’s medical history, the doctor may conduct a range of examinations and tests in order to identify the cause of the hives. The tests detailed below may not necessarily be used as part of the diagnostic process. Based on the symptoms observed and the information gleaned from the patient’s medical history, the doctor will decide what tests are required in the respective case.
- Physical challenge tests: Physical challenge testing can help to identify or exclude a trigger of urticaria caused by physical irritation. It can be used to diagnose pressure urticaria or dermatographia, as the doctor strokes or applies gentle pressure to the skin using a tongue depressor or another suitable medical instrument. In the case of suspected solar urticaria, light testing is carried out in which the skin is radiated with light of varying wavelengths. Cold urticaria can be diagnosed with the help of ice cubes or special temperature-controlled baths.
- Allergy tests: Allergy testing – such as skin prick testing – is ordered to identify allergies.
- Stool sample: Microbiological analysis of a stool sample can provide indications of potential parasites.
- Other laboratory tests: Other laboratory testing includes determining signs of inflammation in the blood, determining the presence of antibodies against specific viruses and analysing the patient’s urine for indications of inflammation and other parameters.
- Elimination diet: In an elimination diet, the patients follows a special nutritional plan in which they must avoid foodstuffs associated with hives (foods with high histamine content, high levels of additives (flavourings, colouring agents and preservatives) and allergens).
- Ultrasound scans of the abdominal organs and lymph nodes
- Further testing as required (examinations of the ear, nose and threat (ENT), the gastrointestinal tract, psychosocial triggers, etc.). Treatment for hives The treatment prescribed for hives is determined by the form of the condition and the patient’s symptoms.
- Acute urticaria usually recedes on its own within a few days or weeks, which is why symptomatic treatment is prescribed. Patients are given antihistamines to combat the red, raised patches and itchiness; if necessary, they may be prescribed other medications to treat specific symptoms (difficulty swallowing, angioedema, etc.). If triggers have been identified, it is important that the patient avoids them as far as possible. If the symptoms are caused by taking certain medications, these should be replaced by alternatives following consultation with a doctor.
- A three-stage course of therapy is available to treat chronic spontaneous urticaria. First of all, patients are treated with a selected antihistamine. If the symptoms improve in the fortnight that follows, the dosage is then increased (up to four times the original dosage). If altering the dosage and trying another antihistamine both fail to remove the patient’s symptoms within two months, treatment with an immunologically active protein is then prescribed.
Patients with a severe form of chronic spontaneous urticaria are advised to carry an emergency kit around with them so they can manage a serious onset if necessary. The emergency kit contains at least one antihistamine and a fast-acting cortisone preparation.
- Treatment of chronic inducible urticaria should target the cause of an outbreak – that is to say, patients should avoid the diagnosed triggers as far as possible. While it may not always be possible to avoid the triggers in every case, the patient should at least avoid direct, intentional contact with them (e.g. by jumping into cold water or eating very cold foods if they have cold urticaria; by exposing their skin to direct sunlight without a high-factor sun lotion if they have solar urticaria, etc.). Otherwise, this can result in dangerous cardiovascular responses and symptoms of shock.
Ointments and creams containing witch hazel or calendula may help to relieve the itchiness. These plants have anti-inflammatory and vasoconstrictive properties. A vinegar compress may also reduce the urge to itch.
Hives (urticaria) is a very common skin condition.
Primary symptom: Skin alterations in the form of red, raised patches
The red, raised patches may range from a few millimetres to a several centimetres in diameter, and may be isolated, extensive or across the entire body.
Other possible symptoms: Itchiness, burning sensation, soreness sensitivity of the skin, angioedema and difficulty swallowing, difficulty breathing, tiredness and lethargy Forms: Acute urticaria (duration: less than six weeks) and chronic urticaria (duration: longer than six weeks).
Sub-forms of chronic urticaria: Chronic inducible urticaria and chronic spontaneous urticaria Potential triggers of chronic inducible urticaria: Cold (cold urticaria), warmth (heat-induced urticaria), light (solar urticaria), pressure (pressure urticaria), shearing forces such as rubbing, chafing or scratching (dermatographia) and others.
Diagnosis: Discussion of medical history, skin examination and further testing as required (e.g. physical challenge tests, allergy testing, laboratory tests, elimination diet, etc.) Treatment: Medication containing antihistamines The chronic form of urticaria is treated in a three-stage treatment plan
Other treatments: Avoiding known triggers, antipruritic creams and ointments
Autor: Katharina Miedzinska, MSc
Uti wa kibofu (Urticaria) ni hali ya ngozi ambayo huonekana kama nywele nyekundu, ambazo mara nyingi huambatana na kukwaruza. Urticaria ni moja ya maambukizi ya ngozi ya kawaida na huathiri mtu mmoja kati ya watu wanne hadi watano wakati fulani katika maisha yao. Siku ya kwanza ya Dunia ya Urticaria iliadhimishwa mnamo Oktoba 1, 2014 na lengo la kuongeza ufahamu wa dalili za ugonjwa huo ulimwenguni kote. Soma ili upate maelezo zaidi kuhusu aina mbalimbali za kibofu, visababishi vinavyoweza kusababisha kibofu, na matibabu yanayopatikana kwa kibofu. Hives ni hali ya ngozi ya kawaida ambayo inaweza kuchukua aina mbalimbali za aina. Karibu mtu mmoja kati ya watu wazima wanne hadi watano atapata ugonjwa wa kibofu angalau mara moja maishani mwao. Dalili kuu ya urticaria ni mlipuko wa madoa mekundu yaliyoinuka. Maambukizi ya ngozi ni tofauti kwa kila aina ya hali na inaweza kuwa peke yake, kuenea au kuonekana katika mwili wote. Ukubwa wa mlipuko pia hutofautiana kutoka kwa mgonjwa mmoja hadi mwingine: katika baadhi ya kesi, mlipuko una sehemu za milimita chache tu, wakati watu wengine huendeleza patches za sentimita kadhaa kwa kipenyo. Mlipuko huo huambatana na kukwaruza sana. Hisia ya kuchoma na unyeti mkubwa pia waweza kutokea katika sehemu zilizoathiriwa. Wagonjwa fulani pia hupata uvimbe wa ngozi, unaojulikana kama angioedema, usoni na kwenye viungo vya mwili. Aina mbili za kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu. "Utaji wa ""urticaria kali"" ni dalili au malalamiko ambayo huonekana mara moja kwa siku chache au wiki chache kabla ya kupungua hatua kwa hatua kwa hiari yao wenyewe." Kwa sehemu kubwa, dalili za aina hii ya ugonjwa huo zaweza kudhibitiwa kwa matokeo. Kwa upande mwingine, ugonjwa wa kukohoa ni ugonjwa tata zaidi wa ngozi na ni vigumu kutibu. Ugonjwa wa urticaria sugu hugunduliwa wakati dalili hizo zinadumu kwa muda mrefu kuliko majuma sita. Matofali hayo yanaweza kuonekana kwa muda wa saa 24 au zaidi, lakini yanaweza kuonekana tena katika sehemu nyingine za mwili. Uti wa mkojo wa muda mrefu hugawanywa zaidi katika urticaria ya muda mrefu inayoweza kusababishwa (ambapo kichocheo kinaweza kutambuliwa) na urticaria ya muda mrefu ya moja kwa moja (ambapo kichocheo kinabaki kuwa haijulikani). Ugonjwa wa kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu. Ugonjwa wa urticaria unaweza kusababishwa na allergies, allergies, na intolerance ya dawa, kama vile penicillin, sulfonamide, na dawa nyingine. Dawa za kupunguza maumivu ya antipyretic (kwa mfano, Ibuprofen, diclofenac, na mengineyo. Dawa za kuzuia shinikizo la damu au matatizo ya moyo (kwa mfano, Beta blockers, diuretics, na mengineyo. - Ugonjwa wa kukohoa sugu: Tofauti na kukohoa sugu, kukohoa sugu (kwa namna inayoweza kusababishwa na ya ghafula) karibu kamwe hakusababishwa na mzio. - Chronic inductable urticaria (fiziological urticaria): Chronic inductable urticaria ni kawaida triggered na vichocheo kimwili na <unk> kulingana na kichocheo kimwili <unk> inaweza kugawanywa katika: - Baridi urticaria: Baridi urticaria ni moja ya aina ya kawaida ya kimwili urticaria. Katika fomu hii, dalili za kawaida za hali hiyo husababishwa na kuwasiliana na baridi (kwa mfano hewa baridi, maji baridi, vitu baridi, jasho, nk). Mabadiliko ya ngozi huonekana kwenye sehemu za mwili zinazohusiana na baridi, na kwa hiyo maeneo yasiyofunikwa ya ngozi kama vile mikono na uso huathiriwa. - Urticaria inayosababishwa na joto: Urticaria inayosababishwa na joto si ya kawaida kuliko aina nyingine za hali hiyo. Kifo cha urticaria kinachosababishwa na joto ni joto la mahali fulani (kwa mfano, joto la joto). Kuoga au kuoga kwa maji moto, kutumia kifaa cha kukausha nywele, kula chakula moto, nk. - Ugonjwa wa kuvuja jua: Ugonjwa wa kuvuja jua huchochewa na mwangaza unaoonekana au mnururisho wa ultraviolet. Aina hii ni ya kawaida miongoni mwa watu wazima vijana, na wanawake kwa wastani ni uwezekano mkubwa zaidi wa kuteseka kutokana na hilo kuliko wanaume. Nuru ya jua husababisha madoa mekundu ya kawaida ya ngozi, pamoja na kukwaruza kusikitisha. Hata hivyo, utaratibu unaounganisha mnururisho wa nuru na kuibuka kwa kibofu cha nyuki haujatambuliwa kikamili. - Uti wa mkojo unaosababishwa na joto si wa kawaida kama aina nyingine za ugonjwa huo. Ugonjwa wa urticaria unaosababishwa na shinikizo la ngozi huitwa urticaria ya shinikizo. Kushinikiza ngozi au kugonga kitu kinaweza kusababisha uvimbe ambao, katika visa vingi, unaweza pia kuwa na maumivu. "Dermagrafia: ""Dermagrafia"" (au urticaria) ni ugonjwa wa ngozi unaosababishwa na nguvu za kukata ambazo zinaweza kusababishwa, kwa mfano, kwa kutikisa, kukwaruza au kukwaruza." Mmenyuko huo hutokea kwenye ngozi muda mfupi baada ya ngozi kuchochewa. Hata hivyo, ni sehemu za ngozi ambazo zimenyunyizwa, kuchomwa au kukwaruzwa tu ndizo zinazoathiriwa. Kwa baadhi ya wagonjwa, hata kutikisa ngozi kidogo ni kutosha kusababisha mlipuko wa patches zilizoinuliwa; wagonjwa wengine wanaweza tu kuendeleza dalili baada ya scratching zaidi ya nguvu au mkali au rubbing. Aina zote za urticaria ya muda mrefu ya mtu binafsi zinaweza kuonekana ama peke yake au pamoja na aina nyingine. - Ugonjwa wa kifafa wa kudumu: Sababu hususa za kifafa cha kudumu ya kifafa bado hazijulikani. Kwa ujumla inadhaniwa kwamba sababu zinazowezekana ni maambukizo, autoimmunity na athari kwa intolerance (kwa mfano. Kwa sababu hii, dawa za kulevya, virutubisho vya chakula na vihifadhi vya chakula vinapaswa kuhifadhiwa. Kama jina lake linavyodokeza, ugonjwa wa urticaria wa kawaida huanza ghafula. Vipande vyenye rangi nyekundu vinaonekana mara kwa mara kwa muda wa majuma zaidi ya sita. Ingawa sababu za aina mbalimbali za urticaria zinaweza kutofautiana, mchakato ambao hatimaye husababisha mabadiliko ya ngozi na malalamiko ni sawa kwa kila aina na aina ndogo. Baada ya kuchochewa kwa njia fulani, chembe za mast (mastocytes) za mwili hutoa viashiria mbalimbali vya kibiokemia, kutia ndani histamini. Mast cells ni chembe za mfumo wetu wa kinga ambazo ni muhimu, miongoni mwa mambo mengine, katika kulinda mwili dhidi ya vimelea na kuponya majeraha. Kwa kuongezea, chembe za mast pia hutimiza fungu muhimu linapokuja suala la mzio, hasa kupitia athari za mzio za papo hapo. Mara tu kitu kinachowasumbua kinapoamsha chembe za mast, chembe hizo huanza kutolewa kwa wajumbe maalum katika interstitium (mahali kati ya chembe, tishu au viungo). Histamini ni kile kinachoitwa homoni ya tishu. Inaonekana karibu kila mahali mwilini, kutia ndani ngozi. Histamine ina jukumu muhimu katika michakato mingi ya kisaikolojia. Histamini inapotolewa, mishipa ya damu hupanuka na hivyo kuruhusu umajimaji uingie katika tishu. Hii ndiyo husababisha mwekundu na madoa yaliyoinuka kwenye ngozi. Wakati huohuo, histamini husababisha hisia ya kukwaruza kwenye mwisho wa neva. Ugonjwa wa kibofu Daktari kwa kawaida hutambua madoa mekundu yaliyoinuka kwa mtazamo wa kwanza. Mgonjwa anapotembelea daktari wakati ambapo hakuna mchochota wa ngozi, mgonjwa kutoa maelezo ya kina ya malalamiko yao na dalili inaweza kuwa na uamuzi katika kugundua hali. Kwa vyovyote vile, ni muhimu kujadili kwa undani historia ya ugonjwa wa mgonjwa. Pamoja na kutoa habari muhimu, ni chombo muhimu cha utambuzi katika kutambua au kuondoa vichocheo vya uwezekano (baridi, joto, mwanga, shinikizo, nguvu za shear, dawa, chakula, maambukizo, nk). Kwa hivyo, kwa sababu ya hali ya kawaida ya ugonjwa huo, ni muhimu kujua ikiwa mgonjwa ana aina ya mkali au ya muda mrefu ya urticaria. Ugonjwa wa urticaria unaosababishwa na urticaria vasculitis na syndromes ya autoinflammatory (cryopyrin-associated periodic syndrome, Schnitzler syndrome) ni dalili za kawaida za urticaria ya kawaida na lazima ziwe mbali kabla ya matibabu kuanza. Baada ya kujadili historia ya ugonjwa wa mgonjwa, daktari anaweza kufanya uchunguzi na vipimo mbalimbali ili kutambua kisababishi cha kibofu. Uchunguzi ulioelezwa hapa chini hauwezi kutumiwa kama sehemu ya mchakato wa utambuzi. Kulingana na dalili zilizochunguzwa na habari zilizopatikana kutoka kwa historia ya matibabu ya mgonjwa, daktari ataamua ni vipimo gani vinavyohitajika katika kesi husika. - Majaribio ya kuchochea mwili: Majaribio ya kuchochea mwili yanaweza kusaidia kutambua au kuondoa kisababishi cha urticaria kinachosababishwa na kuchochea mwili. Ugonjwa wa urticaria au dermatogenesis huitwa urticaria ya shinikizo, kwa sababu daktari huchoma au kushinikiza ngozi kwa kutumia kifaa cha kuondoa ulimi au kifaa kingine cha matibabu. Katika kesi ya udhaifu wa jua, uchunguzi wa mwanga hufanywa ambapo ngozi huangazwa na mwanga wa urefu wa mawimbi tofauti. Ugonjwa wa kuhara wa baridi unaweza kugunduliwa kwa kutumia vipande vya barafu au bafu za pekee zenye joto linalodhibitiwa. - Majaribio ya mzio: Majaribio ya mzio <unk> kama vile majaribio ya ngozi <unk> huamriwa kutambua mzio. - Sampuli ya mkojo: Uchunguzi wa microbiolojia wa sampuli ya mkojo unaweza kutoa dalili za vimelea vinavyoweza kutokea. - Uchunguzi mwingine wa maabara: Uchunguzi mwingine wa maabara ni pamoja na kuamua ishara za uvimbe katika damu, kuamua uwepo wa antibodies dhidi ya virusi maalum na kuchambua mkojo wa mgonjwa kwa dalili za uvimbe na vigezo vingine. Katika chakula cha kuondoa, wagonjwa hufuata mpango maalum wa lishe ambao lazima waepuke vyakula vinavyohusiana na kibofu (vyakula vyenye kiwango cha juu cha histamine, viwango vya juu vya viambatisho (vitu vya ladha, rangi na vihifadhi) na allergens). - Uchunguzi wa ultrasound wa viungo vya tumbo na lymph nodes - Uchunguzi zaidi kama inahitajika (uchunguzi wa sikio, pua na tishio (ENT), njia ya tumbo, triggers psychosocial, nk). Matibabu ya vimelea Matibabu yanayopendekezwa kwa vimelea huamuliwa na aina ya hali na dalili za mgonjwa. - Ugonjwa wa kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu cha kibofu. Kwa sababu ya dalili za ugonjwa huo, dawa za antihistamines zinatumiwa kwa ajili ya kupambana na nywele nyekundu, nywele zilizoinuka, na kukwaruza; ikiwa ni lazima, dawa nyingine zinaweza kuagizwa kutibu dalili maalum (ugumu wa kumeza, angioedema, nk). Ikiwa visababishi vimegunduliwa, ni muhimu kwamba mgonjwa aziepuke kadiri iwezekanavyo. Ikiwa dalili hizo husababishwa na kutumia dawa fulani, hizo zapasa kubadilishwa na dawa nyingine baada ya kushauriana na daktari. - Kuna utaratibu wa matibabu wenye hatua tatu unaopatikana ili kutibu ugonjwa wa urticaria usio na utaratibu. Kwanza kabisa, wagonjwa hutibiwa kwa dawa ya kupambana na histamini iliyochaguliwa. Ikiwa dalili zinapungua katika wiki mbili zinazofuata, kipimo huongezeka (hadi mara nne ya kipimo cha awali). Ikiwa kubadilisha kipimo na kujaribu antihistamine nyingine zote mbili zinashindwa kuondoa dalili za mgonjwa ndani ya miezi miwili, matibabu na protini inayofanya kazi ya kinga huamriwa. Wagonjwa wenye aina kali ya urticaria ya kawaida hupendekezwa kubeba kitanda cha dharura ili waweze kusimamia mwanzo mbaya ikiwa ni lazima. Kifaa cha dharura kina angalau dawa moja ya kuzuia antihistamini na dawa ya cortisone inayofanya kazi haraka. - Matibabu ya urticaria ya kudumu inayoweza kusababishwa inapaswa kulenga sababu ya mlipuko <unk> yaani, wagonjwa wanapaswa kuepuka vichocheo vilivyogunduliwa kadiri iwezekanavyo. Ingawa sio mara zote inawezekana kuepuka vichocheo katika kila kesi, mgonjwa anapaswa angalau kuepuka mawasiliano ya moja kwa moja, ya makusudi na wao (kwa mfano, Kuingiza ngozi yako kwenye maji baridi au kula chakula baridi sana ikiwa una urticaria ya baridi, au kufunua ngozi yako kwa mwangaza wa jua bila lotion ya jua yenye nguvu ikiwa una urticaria ya jua, na kadhalika. Vinginevyo, hilo laweza kusababisha majibu hatari ya moyo na mishipa ya damu na dalili za mshtuko. Mafuta na krimu zenye hazel ya mchawi au calendula zaweza kusaidia kupunguza kukwaruza. Mimea hiyo ina uwezo wa kuzuia uvimbe na kuzuia mishipa ya damu. Pia, dawa ya siki inaweza kupunguza hamu ya kukwaruza. Uvimbe (urticaria) ni ugonjwa wa ngozi unaopatikana mara nyingi. Dalili za msingi: mabadiliko ya ngozi katika fomu ya nyekundu, patches zilizopandwa nyekundu, patches zilizopandwa zinaweza kuanzia milimita chache hadi sentimita kadhaa kwa kipenyo, na zinaweza kuwa peke yake, kubwa au katika mwili wote. Ugonjwa wa ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa kibofu: Ugonjwa wa urticaria ni ugonjwa wa kawaida ambao huathiri watu wengi, na unaweza kusababishwa na joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto, joto. Ugonjwa: Majadiliano ya historia ya matibabu, uchunguzi wa ngozi na upimaji zaidi kama inahitajika (kwa mfano Utafiti wa kiasili, uchunguzi wa mzio, uchunguzi wa maabara, chakula cha kuondoa, nk.) Matibabu: Dawa zenye antihistamines Aina ya muda mrefu ya urticaria hutibiwa katika mpango wa matibabu wa hatua tatu Matibabu mengine: Kuepuka vichocheo vinavyojulikana, krimu na mafuta ya antipruritic Mwandishi: Katharina Miedzinska, MSc