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XiaoyangFeng urticaria history between1000 200yearsBC urticariaiscalled FengYinZheng in TheYellowEmperor sInnerClassic Hippokrates 460 377BC describeditchinglesionscausedbynettlesandmosquitoeswhichhecalledknidosisaftertheGreekwordfornettle knido Thewordurticariawasfirstintroducedin1769byWilliamCullen Whatisurticaria hives RedorpaleitchywhealsOnskinDisappearWithnothingleftinfewhours Classification AU acuteurticaria 6wk Physicalurticaria epidemiology 15 to25 ofindividualswillexperienceatleast1episodeofurticariaacutecases 70 aremorecommonthanchronic 30 Acuteurticariaismorecommoninchildrenandadolescentsthaninadults whilechronicurticariamoretypicallyaffectsadults Inchronicurticaria womenareaffectedmoreoftenthanmen 60 versus40 ofcases respectively diagnosis Whealsappear andthendisappearwithnothingleftinafewhours sometimesaccompaniedbyangioedema orswellingdeeperintheskin Therealfactorishardtofigureout Provokingfactors fooditem spicyfood egg fish strawberryevenmilkanditproduct foodadditives asbenzoatecompound Azodyes Drug aspirin certainantibiotics NSAID codeine morphineinhalants pollen spore housedustmite infectionandinfestation psychologicalfactorplayimportantrolecertainsystemicdiseases CTDesp SLE malignancy lymphoma endocrinediseasesas thyrotoxicosis polycythemia liverdisease pregnancy Clinicalsigns AU acuteurticaria CU chronicurticaria Physicalurticaria 1 cholinergicurticaria2 dermographism 3 coldurticaria4 heaturticaria Pathogenesis histaminereleasefrommastcellsIncreasedcapillarypermeability whichallowsproteinsandfluidstoextravasate Theprocesscanbeimmunemediatedornonimmunemediated Immune mediatedmastcellactivationincludes TypeIhypersensitivityreactions inwhichallergen boundIgEantibodiesbindtohigh affinitycellsurfacereceptorsonmastcellsandbasophilsAutoimmunedisorders inwhichantibodies IgG toanIgEreceptorfunctionallycross linkIgEreceptorsandcausemastcelldegranulation Nonimmune mediatedmastcellactivationincludes DirectnonallergicactivationofmastcellsbycertaindrugsDrug inducedcyclooxygenaseinhibitionthatactivatesmastcellsbypoorlyunderstoodmechanismsActivationbyphysicaloremotionalstimuli mechanismispoorlyunderstoodbutpossiblyinvolvesthereleaseofneuropeptidesthatinteractwithmastcells treatment Drugs Antihistaminesremainthemainstayoftreatment CetirizineSomeTradeNames ZYRTEC10mgonce dayFexofenadineSomeTradeNames ALLEGRA180mgonce dayDesloratadineSomeTradeNames CLARINEX5mgonce dayLevocetirizine5mgonce dayAvoidprovokingfactors conclusions ManytypesofurticariaUsuallynonfetalbutreallyannoyingUrticariacanbecausedbyallergicornonallergicmechanisms Shouldavoidallergenandcoulduseallergymedicinesforurticaria Futurestudy ResearchaboutthepoorlyunderstandpartoftheurticarialikehowthephysicalfactorsstimulatethisdiseaseFineaeffectivewaytotesttheallergens Learned Allaboutthisdisease references 1 JuhlinLennart TheHistoryofUrticariaandAngioedemaESHDVSpecialAnnualLecture Geneva October11th 20002 ZuberbierT Bindslev JensenC CanonicaW GrattanCE GreavesMW HenzBM KappA KozelMM MaurerM MerkHF SchaferT SimonD VenaGA WediB EAACI GALEN EDFguideline definition classificationanddiagnosisofurticaria Allergy 2006 61 316 20 doi 10 1111 j 1398 9995 2005 00964 x 3 KindtThomas GoldsbyA Richard OsborneA Barbara Kubyimmunologysixthedition4 Bingha
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