Monday, 17 March 2014

Dermatology Made Simple : Urticaria

Urticaria

Urticaria is defined as transient pruritic swellings on the skin.

It is also termed as wheals or hives.

Pathophysiology:

It occurs due to oedema in the superficial layers of the skin.

Causes:

It can occur in association with:

Allergic reactions

Infection or

Physical stimuli

In association with vasculitis,pemphigoid or dermatitis herpetiformis.

Angio-oedema is painful rather than itchy.

It appears as diffuse swelling that affects the deeper layers of the skin.

It can occur rapidly and may involve the mucous membranes.

Urticaria is a fairly common skin disorder that may occur as a single episode or recurrent.

The prognosis is varied and depends upon the underlying cause.

Pathophysiology:

Urticaria results from release of histamine,bradykinin and pro-inflammatory mediators being released from 
basophils and mast cells in response to various trigger factors.

These chemicals released by degranulation cause capillaries and venules to leak causing tissue oedema.

Urticaria maybe IgE mediated with cross linking of two adjacent IgE receptors or complement mediated causing direct degranulation of mast cells or mast cells may directly be stimulated by an exogenous or 
unknown substance.

In patient with chronic urticarial, histamine canbe released spontaneously or in response to non-specific 
stimuli and their vasculature is more sensitive to histamines.

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