Sunday, 23 March 2014

Dermatology Made Simple : Management Of Urticaria:




Management Of Urticaria

1.Avoidance of allergens/trigger factors.

2.Treatment of Underlying  Medical condition.

3.Pharmacological Treatment:

Antihistamine:

H1 receptor blockers : Cetrizine,loratidine and chlorpheniramine

Combination of H1 receptor blockers and H2 receptor blockers in severe cases.

Leukotriene receptor antagonists:

Montelukast and Zafirlukast

Oral Corticosteroids maybe used in very severe eruptions.

Intramuscular adrenaline in life threatening scenarios and anaphylactic shock.

Clinical History in Urticaria:

This is of primary significance.

It is important to ask about onset,duration and course of lesions and associated rash and swelling.

Urticaria is very itchy and  angioedema is painful.

Patients with urticarial complain of itcy spots and rashes lasting minutes or hours. Usually less than 24 hours 
and that resolve leaving no scars or marks.

In angio-edema,there may be swelling of face and lips and tongue that may last for hours and days.

Incase the lesions last for more than 24 hours and is painful and resolves with bruising,urticarial vasculitis is more likely than ordinary urticaria.

Pateints may occasionally feel unwell before the onset of rash or swelling and in severe reactions,anaphylaxis may result.

It is important to find out about any possible trigger before onset of rash,eg any food eaten,medications taken,insect stings,infections etc.



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