Hives (Urticaria) : Symptom, Cause, Diagnosis, Treatment, And Drug

Hives are a skin reaction that causes red or white itchy welts.Hives may cause a burning or stinging sensation.Hives vary in size from as small as a pen tip to as large as a dinner plate.Hives may last for a few days or less.Acute hives are hives that last less than six weeks.Chronic hives are hives that last more than six weeks.Hives fixed means "not moving."Fixed drug eruption is fixed hives happen when a person takes a certain medicine.Fixed solar urticaria is fixed hives happen when a person gets too much sunlight.Hives can cause trouble breathing or severe chest tightness, tongue or throat swelling, and dizziness.If people have these symptoms , they should visit to doctor to check the bout.Hives can occur within minutes of exposure to the trigger.

Symptoms of Hives

• Slightly raised, pink, or red swelling.
• Welts that occur alone,  in a group, or connect over a large area.
• Skin swelling goes away within 24 hours at one spot but may appear at another spot.
• Itch, sting, and hurt.
• Batches of red or white welts are usually on rge face, trunk, arms, and legs.
• Swelling causes pain or burning, especially inside the throat and around the eyes, cheeks, lips, hands, feet, and genitals.

Causes of Hives

1. The allergic reactions, including 

• Foods : fruits (citrus fruit), shellfish, peanut, egg, milk.
• Medicines
• Pollen
• Animals
• Insect bites or stings
• Allergy shots

2. Stress

3. Bacterial infections or fungi infections

4. Some illnesses, such as lupus, vasculitis, thyroid disease

5. Exposure to sun, heat, cold, or water
6. Pressure on the skin

7. Exercise

8. Scratching the skin

9. Contact with chemicals

Diagnosis

Some tests and procedures are done by dermatologist to diagnose the skin.

• Medical history is about patient's health habit and past illnesses.
• Physical exam is an exam of the body to check general signs of health.
• Allergy Test is a test on the skin.
• Blood Test is a laboratory analysis performed on a blood sample.
• Blood work is to rule out an illness or infection
• A Skin Biopsy is the removal of a small piece of affected skin by viewing under a microscope to check the signs of hives.

Treatment of Hives

The most common treatment of a mild or moderate hives is a non-sedating (does not cause drowsiness) antihistamine.By taking this drug everyday can prevent hives from forming.

Some medicines that are prescribed to treat hives

• Dapsone is a sulfone antimicrobial agent.
• Cortisones are for short-term use only because of side effects with long-term use.

Antihistamine that block the histamine H1 receptor are the first line of therapy.

• First Generation Antihistamines, such as Diphenhydramine (Benadryl), Hydroxyzine (Atarax) block central and peripheral H1 receptors and can be very sedating.
• Second Generation Antihistamines, such as Loratadine (Claritin), Cetirizine (Zyrtec), Desloratadine (Clarinex), Levocetirizine (Xyzal), and Fexofenadine (Allegra).

Several medications are used if Antihistamines alone do not relieve the symptoms of hives :

• Histamine (H-2) Blockers or H-2 Receptor Antagonists may be injected or taken orally.These medications include Ranitidine (Zantac), Nizatidine (Axid), Cimetidine (Tagamet), Famotidine (Pepcid). Their side effects are headache and digestive problems.
• Anti-Inflammatory Medications include Oral Corticosteroids (Prednisone) that can help in lessening swelling, redness, and itching.
• The Tricyclic Antidepressant Doxepin (Zonalon) is to relieve itching.It is used in cream form.The side effect of this drug causes dizziness and drowsiness.
• Leukotriene-Receptor Antagonist include montelukast and Zafirlukast.These drugs are used to treat The patient with CU.

Several medications for treating Chronic Hives :

• The drug Omalizumab (Xolair) is very effective against chronic hives.It is without side effects.
• Oral glucocorticoids are effective to control the symptoms of chronic hives.
• Cyclosporine includes Neoral, Gengraf that relieve the chronic hives.The drugs cause nausea, headache.
• Tacrolimus reduces the immune system response that causes hives.
• Mycophenolate is to improve the signs and symptoms of hives.It is not recommended for pregnant women because it can lead miscarriage.
• Sirolimus is to treat chronic hives.

Drugs for Hives

• Omalizumab
• Dapsone
• Sulfasalazine
• Hydroxychloroquine

Drug combination used in Hives

• Hydroxyzine and Cimetidine