Occasional Urticaria

• Occasional Urticaria Symptoms
• Occasional Urticaria Icd 10 Code
• Occasional Urticaria Treatment

Breaking out in hives, medically known as urticaria, is the worst. Your skin itches all over, you're covered in unsightly red welts, and if that weren't bad enough, it's not always clear what might. In some instances, we cannot find the causative agent (idiopathic urticaria). In occasional instances, malignant cells acting as a foreign antigen can also degranulate mast cells, but this is very unusual. Viruses and connective tissue disorders, even sinusitis can cause chronic urticaria & angioedema. Urticaria is a common condition that occurs in up to 20 percent of the population at one time or another. 1  It can affect any person of any race at any age on any part of the body in any season of the year, but it often shows up in the evening or in the morning (just after waking). Pressure urticaria shows up as a deep welt in an area of prolonged pressure. Occasional people react to the cold. Even more rare is a reaction to sunlight. Occasionally, a person will continue to have hives for many years.

Introduction to Urticaria

Urticaria, or hives, is a common problem seen in doctors’ offices. In some patients, in addition to hives, there may also be swelling of the lips or throat. This is called angioedema. The cause of the hives and angioedema is most likely degranulation of mast cells. Everyone has mast cells on the exposed parts of the body. Theses mast cells are loaded with histamine, leukotrienes, and several other chemicals. If these chemicals stay inside the mast cells, they do not cause any problems. Once they are released, the open up the blood vessels and create inflammation.

An inflammatory reaction in the outer layers of the skin is a hive. An inflammatory reaction in the deeper layers of the skin or in the GI Tract is angioedema. The question everybody asks is what makes these mast cells degranulate. The most common cause is an allergic reaction. However, these hives are acute and usually last no more than a few days. We can do skin testing and identify the allergen in these situations.

However, in chronic urticaria, infective agents like viral antigens may be the cause for the degranulation of the mast cells. These hives can last for weeks and sometimes for months.

Some physical factors like exposure to the cold and physical pressure can also degranulate mast cells. More common in this group is dermographism, but most of these hives have a “streaky” appearance.

Some medications such as morphine and codeine, and histamine-containing foods such as chocolate and eggplant, can also degranulate the mast cells. In some instances, we cannot find the causative agent (idiopathic urticaria). In occasional instances, malignant cells acting as a foreign antigen can also degranulate mast cells, but this is very unusual. Viruses and connective tissue disorders, even sinusitis can cause chronic urticaria & angioedema. The majority of cases, however, have no underlying disease and will resolve in time.

In acute reactions, giving epinephrine, a short course of oral steroids, and antihistamines are indicated. In chronic hives, the usual treatment is a long-acting antihistamine along with short-acting antihistamines and also using an H2 blocker like Tagamet on a regular basis for a few weeks and possibly a short course of oral steroids.

In spite of these treatments, some patients have chronic hives for months or years. In these instances, we do blood work and a chest x-ray to rule out any other illnesses that may cause these hives.

What are the different types of urticaria?

They can be classified into two categories: Immunologic and Non-Immunologic. Allergic or Immunologic Urticaria is the least common form. It is caused by the immune system’s overreaction to foods, drugs, infection insects stings, blood transfusions or other substances. Foods such as eggs, nuts and shellfish, and drugs such as penicillin and sulfa are common causes of allergic or immunologic urticaria.

Non-Immunologic Urticaria are those types of urticaria where a clear-cut allergic basis cannot be proven. These take many forms. Dermographism is urticaria that develops when the skin is stroked with a firm object. Cold-Induced Urticaria appears after a person is exposed to low temperatures-for example, after a plunge into a swimming pool or when an ice cube is placed against the skin. Cholinergic Urticaria, which is associated with exercise, hot showers and/or anxiety, is a form of hives that is related to release of certain chemicals from parts of the nervous system that control such body functions as blood pressure and heart rate. Pressure Urticaria develops from the constant pressure of constricting clothing such as sock bands, bra straps, belts or other tight clothing. Solar Urticaria arises on parts of the body exposed to the sun: This may occur within a few minutes after exposure. Some cases of non-immunologic urticaria may be caused by non-allergic reactions to aspirin and possibly, certain food dyes, sulfites, and other food additives. In many cases, particularly in chronic urticaria, the trigger for the problem can’t be found; in this instance it is called Idiopathic Urticaria.

How is urticaria treated?

Your allergist first will alleviate the discomfort with medications; for example, antihistamines. Severe attacks of urticaria can be temporarily relieved by injections of epinephrine; rarely in these cases corticosteroids may be prescribed for a short period. Other drugs may be required for specific types of urticaria.

Occasional Urticaria Symptoms

Of course, if the cause can be identified, the best course of treatment is avoidance of the substance that triggers urticaria. If a problem with a specific food is strongly suspected, then is should be avoided. This may require a careful reading of packaged food labels and inquiry about ingredients in restaurant meals. Persons with Solar Urticaria should wear protective clothing and apply sunscreen lotions when outdoors. Loose-fitting clothing will help relieve Pressure Urticaria. Avoid harsh soaps and frequent bathing to reduce the problem of dry skin, which can cause itching and scratching that can aggravate urticaria. Vigorous toweling after a bath may precipitate hives. Although success of identifying the cause of chronic urticaria varies from clinic to clinic according to patient populations, it usually is no higher than 20% of cases. It may last for months or for years and burn itself out, never to bother the sufferer again.

It's Time to Do Something About Your Allergies!

It's Time to Do Something About Your Allergies!

It should be understood that hives caused by anything can show up on any part of the body at any time, so having hives on knees and elbows is not necessarily any more or less common than having them appear somewhere else. But there is anecdotal evidence that points strongly to hives on knees and elbows being caused by an allergic reaction. Allergic reactions, contrary to popular belief, are not the most common cause of hives. Of those cases that are diagnosed, most of them are found to be caused by a virus or some other infection.

But for some reason hives behind knees, or hives on knees and elbows are most commonly the result of an allergic reaction. So if this applies to you, the obvious job for you is to see if something you ate or something you have come in contact with is causing these hives. Some people find that keeping a journal or diary of your food intake and activities will help you narrow it down if the allergen is not readily apparent. But there are some other conditions that either mimic hives, or resemble hives and cause hives on knees and elbows. Some of these are explored below.

Angioedema Most Closely Resembles Hives

Angioedema is swelling that that affects the deeper layers of the skin but closely resembles hives. And in the most common of the acute cases triggered by allergens, angioedema starts in many times with hives on knees and elbows. The hives of angioedema is usually not as itchy as common hives, but the swelling and pain can be worse with these hives. Knees and other joints can become more painful. Food and drugs are common triggers.

Occasional Urticaria Icd 10 Code

Occasional Urticaria Treatment

Contact Dermatitis Can Mimic Hives As Well

Contact dermatitis happens when certain substances come into contact with the skin and cause a rash. This rash can look very similar to hives. And the reaction can look like hives on knees and elbows in particular. Because the contact causes the rash, it occurs often on the knees and elbows because we naturally kneel or lean and rest with our elbows, which become the first area of contact. Poison ivy is an example of this type reaction. The best treatment is to wash the area thoroughly as soon as possible to avoid spreading further.

A cold soak or cold compress will relieve the itching, as will some lotions and ointments.

Similar to contact dermatitis is eczema, which is also triggered by allergens. The rash is a little more scaly and red but can look similar to hives on knees and elbows. Do not scratch eczema and treat it the same way as contact dermatitis.