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UrticariaA presentation for patients
Provided courtesy of UNEV
Urticaria
Hives or angioedema
Hives and angioedema
Men and women
Young and elderly
Urticaria is common
Gesamtbevölkerung
Total population
Urticaria
Urtikaria
Urticaria is common
Acute Urticaria
Akute
Urtikaria
Chronic
Urticaria
Chronische
Urtikaria
Urticaria
http://www.arianapagerussell.com/work/skin/
People and animals
http://www.facebook.com
What happens in the skin?
What happens in the skin?
What happens in the skin?
What happens in the skin?
What happens in the skin?
What happens in the skin?
Triggers
http://www.kkr.it/de/referenzen.htm?menID=2433,0&grp=1&p=2
© Rolf Neeser http://vitagate.ch/de/schoenheit/hautpflege/juckreiz
Triggers
http://www.pcmodding.biz
http://wallpaperstock.net
…. without triggers
Chronic
Spontaneous
Urticaria
Causes
Auto-reactivity
20%
Intolerance
38%
Infection
26%
Other
2%
No known cause
30%
Infection
Auto-reactivity
Zirkulierende MZ
Sekeretagoga = Circulating MZ
secretagogues
Auto-reactivity
Intolerance
MZ
MZ
Intolerance
Intolerance
Auto-reactivity
20%
Intolerance
38%
Infection
26%
No known cause
30%
?
Other
2%
Treatment
complete symptom
control
aus: http://memo-an-mich.de/
Systemic steroids in exacerbations,
possibly as a brief therapy
Treatment
If after 2 weeks of continued symptoms
Symptoms persist after
two weeks
Increase dose (up to 4-fold)
Symptoms persist after
2 weeks
2nd-generation H1-antihistamine
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