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Urticaria (Hives) |
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Definition
Hives are raised, often itchy, red welts on the
surface of the skin. They are usually an allergic
reaction to food or medicine.
Causes
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Food, e.g., shellfish, nut,
strawberries
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Environmental, e.g., feathers,
animal hairs, and cosmetics
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Medications, e.g., penicillin,
aspirin
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Medications -- nonallergic form,
e.g., Atropine, Pilocarpine, Morphine
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Insect/bug bites and stings
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Heat
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Cold
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Skin pressure
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Infections such as
Hepatitis B
Symptoms
Hives/wheals -- red,
raised welts. Sometimes the welts will "melt into
each other," giving the appearance of areas with
large raised red swelling
Itching is usually severe, but
occasionally absent.
Swelling of tongue, lips,
eyelids, palms, soles, and genitals in more severe
attacks. Breathing problems may also occur.
Screening and
Diagnostics
Your doctor can tell if you have hives by the
appearance of your skin. If you have a history of an
allergy, then the diagnosis is even more obvious.
Occasionally, skin or blood tests are performed to
confirm that this was an allergic reaction and to test
for the substance that caused your allergic response.
Treatment
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Epinephrine 1:1000 injection for
severe reactions (especially if associated breathing
problems or more severe reactions such as swollen
lips and tongue occur)
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Antihistamines, e.g., Hydroxyzine,
Zyrtec
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Oral Prednisone is sometimes
helpful.
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Doxepin (an older antidepressant)
helps in chronic cases
Complications
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Anaphylaxis (airway is swollen, making breathing
difficult)
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Life-threatening airway obstruction, if swelling
occurs in the throat
Prevention
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Avoid
exposure to substances that give you allergic
reactions.
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Don't
wear tight-fitting clothing and avoid hot baths or
showers just after an episode of hives. These can
both cause the hives to return.
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