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Hives (Urticaria)

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Hives (Urticaria)

Acute Urticaria

  • Defined as hives lasting less than 6 weeks. It is estimated to affect 15-25% of the population at least once in their life.
  • Possible causes include:
    • Medication reaction (Penicillin, Sulfa, or other antibiotics) (Motrin, Ibuprofen, Aspirin, etc.)
    • Fixed food allergies (nuts, chocolate, fish, eggs, berries, tomatoes, milk)
    • Latex exposure
    • Insect sting
    • Allergies to pollens or chemicals
    • Infections
  • Treatment involves identifying and avoiding the obvious triggers and possible adding nonĀ­sedating antihistamines such as over the counter Zyrtec, Xyzal, Allegra, or Claritin.

Chronic Urticaria

  • Defined as hives lasting more than 6 weeks and 70% of the time no cause can be found.
  • Identifiable causes include:
    • Autoimmune diseases such as thyroiditis, Rheumatic diseases such as Lupus or Sjogren's.
    • Alpha-galactose
    • Infectious causes such as Hepatitis B&C, Mononucleosis, or bacterial infections of the sinuses, teeth, etc.
    • Physical causes such as cold exposure, stress, exercise, water exposure, sunlight exposure, and pressure applied to the skin.
    • Inflammation of the vessels in the skin caused by medications (ACE inhibitors, Penicillin's, Sulfamides, Thiazides, Fluoxetine, etc.)
  • Work up includes blood tests and allergy screening.
  • Treatment includes:
    • Possible food avoidance
    • Non- sedating antihistamine in the morning (may increase the dose if necessary)
    • May add Benadryl at night if needed
    • May add histamine blocker such as over the counter Zantac
    • May add Singulair
    • May add oral steroids