Symptoms of urticaria

In acute urticaria (often caused by exposure to allergens) a few minutes after contact with the allergen, the patient has erythema on the skin, then urticaria strongly itchy elements of various sizes and bizarre forms with annular hyperemia and clear boundaries appear. Hives are characterized by a lack of pigmentation after the disappearance of elements.

Rashes in acute urticaria is a monomorphic rash with erythema border. Sometimes the rash is similar to scarlet fever and measles. The disease begins acutely and is accompanied by severe itching of the skin. On sites of an itch appear hyperemic sites of an eruption. As the edema of the papillary layer of the dermis increases, the papular elements pale. When exudation in the center of the papules formed in the form of bubbles, as well as the development of edema papillary layer. Pathogenetic link is the increase in the permeability of the microcirculatory bed and the development of acute edema in the surrounding area. With hives, the capillaries of the subcutaneous tissue become permeable, along with this, vasodilation and small eosinophilic infiltration are observed.

Often the swelling of the skin within a few hours can change its intensity and is accompanied by severe itching. In some cases, you can see a garlandlike form of edema and erythema with a pale, sunken center. In addition to skin manifestations with edema of the mucous membrane of the gastrointestinal tract, abdominal syndrome can be observed. Usually it starts with nausea, vomiting first with food, then with bile. There is acute pain, initially local, then diffused throughout the abdomen, accompanied by flatulence with increased intestinal peristalsis. During this period, there may be a positive symptom of Shchetkin-Blumberg. The attack ends with profuse diarrhea. Abdominal swelling is combined with cutaneous manifestations in 20-40% of cases. When the pathological process is localized in the urogenital tract, a picture of acute cystitis with acute urinary retention develops. Swelling of the genitals is accompanied by a corresponding clinical picture. Sometimes, swelling of the joints is noted, fever from subfebrile to intermittent fever, headache, general malaise with symptoms of intoxication.

Urticaria can acquire a hemorrhagic character due to the exit from the vascular bed of red blood cells, which disintegrate into the surrounding tissue. The dimensions of the elements of the rash are different - from a few millimeters to a dozen centimeters. They can be separately located or drained. The preferred location of the elements is on the extensor surfaces of the limbs, trunk and gluteal region. The duration of the acute period is from several hours to several days. Urticaria often recurs.

When a reaction to food before the appearance of typical rashes the patient feels a tingling of the tongue, lips, palate, edema in these places, often sharp pains in the abdomen. Often observed phenomena of conjunctivitis, less often - difficulty breathing due to edema of the larynx. Sometimes patients develop vomiting, collapse, anaphylactic shock. With food allergies, there may be perioral and perianal dermatitis.

Patients have a special type of dermographism - a fast persistent papular reaction, reminiscent of the skin reaction to the administration of histamine. Urticaria is often caused by insect bites, contact with plants, physical factors (delayed urticaria from pressure, solar urticaria, generalized and limited thermal urticaria, cold urticaria), neurogenic causes.

About a chronic urticaria speak, when rashes persist for more than 6 weeks. Such a course is characteristic of non-immune urticaria, urticaria in systemic diseases.

Complications of hives. Anaphylactic shock, laryngeal edema (croup), neurological disorders.