About Acute Urticaria (Acute Hives)
Acute urticaria is a form of urticaria (hives) that lasts for less than six weeks. It is characterized by the development of wheals (hives) and an itching sensation. Wheals are superficial skin swellings of variable size, usually surrounded by redness, and they may cause an itching or burning sensation. These wheals typically resolve within 30 minutes to 24 hours.
Acute urticaria can occur as a result of a hypersensitivity reaction or may be associated with other systemic symptoms including but not limited to, swelling of the face, lips and tongue, trouble breathing or swallowing, vomiting and diarrhea, indicating an anaphylactic (life-threatening) reaction. If you are experiencing symptoms of acute urticaria, it is recommended to seek medical evaluation for proper diagnosis and treatment.
In approximately 50% of patients with acute urticaria, the exact cause is unknown. Causes of acute urticaria include:
- Medications: Antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), and opiates/narcotics can commonly cause urticaria.
- Foods: Milk, eggs, peanuts, tree nuts, fish, and shellfish are the predominant food triggers for urticaria.
- Viral Infections: Certain viral infections such as Epstein-Barr virus and herpes simplex virus can be associated with acute urticaria.
- Stress: Stress has been identified as a contributing factor for acute urticaria.
- Parasitic Infections: In some cases, parasitic infections can trigger acute urticaria.
- Contact Allergens: Contact with allergens like latex can cause urticaria.
Risk factors for acute urticaria include:
- Medication Usage: Avoiding medications known to commonly cause urticaria (e.g., certain antibiotics and NSAIDs) may help reduce the risk.
- Food Choices: Being cautious with food triggers like milk, eggs, peanuts, tree nuts, fish, and shellfish may help prevent episodes of urticaria.
- Stress: Avoiding or finding ways to deal with stress can help reduce the number of episodes of urticaria.
Remember to consult your healthcare professional for personalized advice regarding your individual risk factors.
The most common early symptoms of acute urticaria include:
- Raised or swollen welts on the skin (hives or wheals)
- Itching, which can sometimes be severe
As acute urticaria progresses or becomes more severe, other symptoms may include:
- Swelling of the lips, eyelids, or throat (angioedema)
- Changes in the size, fading, and reappearance of hives
- Aggravation of symptoms by heat, exercise, or stress
It's important to note that some cases of acute urticaria may also be caused by bacterial infections. In these cases, additional symptoms such as fever, sore throat, and elevated white blood cell levels may be present. However, it's always best to consult with a healthcare professional for an accurate diagnosis and appropriate management.
To diagnose acute urticaria, the following examinations, tests, and procedures are commonly performed:
- Thorough clinical history: This includes information about the frequency, timing, duration, and pattern of recurrence of lesions, as well as potential triggers and response to previous therapies.
- Physical examination: A detailed examination of the skin to assess the shape, size, site, and distribution of lesions.
- Diagnostic tests: Depending on the history and physical exam findings, additional tests may be considered to help confirm the diagnosis. These tests may include blood tests or skin prick tests to check for allergies.
Additional examinations, tests, and procedures may be recommended. These can include:
- Autologous skin serum test (ASST): This test is used to assess autoimmunity in chronic urticaria but is not validated for diagnosing acute urticaria.
- Urticaria activity score in 7 days (UAS7): A validated instrument used to quantify the severity and control of chronic spontaneous urticaria.
- Urticaria quality of life (QoL) test: Another validated instrument used to assess the impact of chronic urticaria on a person's quality of life.
It's important to consult with a healthcare professional for proper evaluation and guidance. They can recommend specific examinations, tests, and procedures based on individual circumstances.
The goals of treatment for acute urticaria are to achieve complete symptom control and provide reassurance to the patient. Here are the recommended treatments and how they work to achieve these goals:
Medications:
- Antihistamines: These medications help control itching and swelling associated with urticaria. They work by blocking the effects of histamine, a substance released during an allergic reaction.
- Steroids: Glucocorticoids such as prednisone may help suppress the inflammation associated with urticaria.
Self-care and health behavior changes:
- Avoid known personal triggers for urticaria.
- Avoid stressful situations when possible.
It's important to note that these recommendations are general and may vary depending on individual circumstances. Always consult with a healthcare professional for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.