Urticaria- A presentation for patients Provided courtesy of UNEV

Urticaria

Hives or angioedema

Hives and angioedema

Men and women

Young and elderly

Urticaria is common Total population Urticaria

Urticaria is common Acute UrticariaChronic Urticaria

Urticaria

People and animals

What happens in the skin?

Triggers © Rolf Neeser

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…. without triggers Chronic Spontaneous Urticaria

Causes Infection 26% Intolerance 38% Auto-reactivity 20% No known cause 30% Other 2%

Infection

Auto-reactivity Zirkulierende MZ Sekeretagoga = Circulating MZ secretagogues

Auto-reactivity

Intolerance MZ

Intolerance

? Infection 26% Intolerance 38% Auto-reactivity 20% No known cause 30% Other 2%

Treatment aus: complete symptom control

Treatment 2nd-generation H1-antihistamine Increase dose (up to 4-fold) If after 2 weeks of continued symptoms Systemic steroids in exacerbations, possibly as a brief therapy Symptoms persist after two weeks Symptoms persist after 2 weeks

What doesn‘t help.... Cortisone ointments are rarely effective in urticaria and have long-term side effects. Anti-allergic creams and gels penetrate too slowly into the skin to be effective

Summary Urticaria is often incredibly annoying and often disfiguring The most common form is chronic spontaneous urticaria Possible causes are infections, food intolerances or autoimmune processes The treatment of choice is: 1.Antihistamines 2.More antihistamines 3.Mast cell inhibition