pathophysiology

Pathophysiology

Urticaria is also known as hives. The condition is characterized by an outbreak of swollen, pale red bumps on the skin. It usually occurs suddenly; it results from either body reaction to specific allergens. An allergen refers to something which produces an allergic reaction to the body.
In most cases, the allergic reaction in human bodies, when an allergic reaction occurs, it releases histamine which accumulates in the blood vessels known as leak fluid. This then causes a rash on the human body.

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Cellular mechanism of urticaria

The skin lesions which are caused by the hives are usually raised red and itchy bumps. In most cases, the reaction begins itchy cutaneous mast cells and the basophils releasing the histamine and many other inflammatory mediators on the skin surface. When the response occurs, the mast cells are stimulated to release the chemicals known as Immunoglobulin E, which binds to any of the allergens to fight against any foreign component in the body. In addition, the histamine triggers the dilation of the blood vessels causing the skin to become reddish. This type of dilation later becomes leaky and releases the fluids which cause swelling of the skin or edema of the skin. Therefore, making the skin to remain to release excess fluids by the surrounding cells thus swelling (Maurer, et al., 2017).


Causes of Urticaria

In most cases occurs when the body reacts to the allergic component releasing histamine in the skin. Histamine chemicals cause inflammation and accumulate beneath the skin, causing wheals. It is triggered by the medication such as antibiotics and the anti-inflammatory drugs (Maurer, et al., 2017). It can also be caused by taking foods such as nuts, shellfish and wheat products. The long term urticaria occurs when the autoimmune disease such as the rheumatoid persist.

Pharmacological and non-pharmacologic treatment of urticaria

H1 antagonist is the cornerstone pharmacological management of hives. However, the treatment of hives can include the prescriptions which includes the following:
Anti-itch drugs
The common treatment is antihistamines medications, which in most cases are used to reduce itching, swelling and any other related symptoms of allergy (Axelrod & Davis-Lorton, 2011).
Anti-inflammatory drugs
In cases of severe hives, doctors prescribe oral medications which include prednisone, which helps in reducing swelling, redness and the general itching.
Drugs which suppress the immune system
When drugs such as antihistamine and the corticosteroids become ineffective, Doctors prescribe medicines which are capable of calming any over activeness of the immune system. In addition, drugs which reduce pain and swelling are also considered when it comes to treating this problem. For instance, chronic hives can be treated by nonsteroidal and inflammatory medication such as leukotriene antagonists (Axelrod & Davis-Lorton, 2011).

Signs and symptoms

The signs and symptoms of hives is the appearance of welts in several body parts. These welts may be skin coloured, pink or red. Itching causes swelling and disappears after sometimes. In addition, urticaria can be divided into two. One is acute, while the other is chronic. Chronic occurs daily or frequently as compared to an acute one. Chronic has affected many people as compared to acute. In percentage, almost 25% of the people who have been affected by hive suffer more from chronic one (Moy, Murali, & Nazarian, 2016). The pathogenesis of chronic hive has not been found yet. The treatment and management of this type can be non-pharmacological, but sometimes it becomes difficult to control the disease.

Conclusion

The complications of hive include anaphylaxis. This is the condition when the whole-body allergic reaction which causes one to have difficulties in breathing. In addition, the hive which results from allergic body reaction can be easily controlled as compared to the chronic one.

References

1. Axelrod, S., and Davis-Lorton, M. (2011). Urticaria and Angioedema. Mount Sinai Journal of Medicine, 78(5), 784–802. https://doi.org/10.1002/msj.20288
2. Maurer, M., Staubach, P., Raap, U., Richter, H. G., Bauer, A., Ruëff, F., … Chapman, R. N. (2017). H1-antihistamine-refractory chronic spontaneous urticaria: it’s worse than we thought - first results of the multicenter real-life AWARE study. Clinical and Experimental Allergy, 47(5), 684–692. https://doi.org/10.1111/cea.12900
3. Moy, A. P., Murali, M., and Nazarian, R. M. (2016). Identification of a Th2- and Th17-skewed immune phenotype in chronic urticaria with Th22 reduction dependent on autoimmunity and thyroid disease markers. Journal of Cutaneous Pathology, 43(4), 372–378.


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