Saturday, April 3, 2010

Its not German Measle, but it s ACUTE URTICARIA


Sila bace..

Acute urticaria is a condition where an itchy rash suddenly develops. The rash may be triggered by an allergy, or by another factor such as heat or exercise. In most cases the rash lasts 24-48 hours and is not serious (BBUT MY BABY BOY HAD BAAAD RASHES ALL OVER HIS BODY!). You may not require any treatment, but antihistamines can ease the symptoms until the rash clears.

This type of urticaria can occur with anaphylaxis – a severe allergic response leading to difficulty in breathing and possible death.

What is acute urticaria?

Urticaria (sometimes called hives) is an itchy rash caused by tiny amounts of fluid that leak from blood vessels just under the skin surface. Urticaria is classed as:
  • Acute urticaria - if it develops suddenly and lasts less than six weeks. Most cases last 24-48 hours.(NABIL HAD IT FOR 5 DAYS ALREADY!) About 1 in 6 people will have at least one bout of urticaria in their life. It can affect anyone at any age. Some people have recurring bouts of acute urticaria.(DOC SAID IT MITE HAPPENS AGAIN!)
  • Chronic urticaria - if it persists longer than six weeks. (Chronic means persistent or ongoing.) This is uncommon.NAUZUBILLAH!

This rest of this leaflet deals only with acute urticaria. There is a separate leaflet for information about chronic urticaria.

An identifiable cause for the problem is rarely found.

What does the rash of acute urticaria look like?

The rash usually appears suddenly and can affect any area of skin. Small raised areas called weals develop on the skin. The weals look like mild blisters and they are itchy. Each weal is white or red and is usually surrounded by a small red area of skin which is called a flare. The 'weal and flare' rash of urticaria looks similar to the rash caused by a nettle sting.(NABIL TAKLEH TIDO MALAM..MENGGARU NON STOP!SEDIH SGT TENGOK DIA GARU SAMPAI LUKA, SO AKU PAKAIKAN DIA BAND TANGAN KASI TUTUP KUKU TAKUT LEBIH LUKA)

The weals are commonly 1-2 cm across but can vary in size. There may be just a few but sometimes many develop over various parts of the body. Sometimes weals next to each other join together to form larger ones. The weals can be any shape but are often circular. As a weal fades, the surrounding flare remains for a while. This makes the affected area of skin look blotchy and red. The blotches then fade gradually and the skin returns to normal.(RUPA DIA MCM KENA ULAT BULU, TAPI LAAAGI TERUK.BENGKAK MATA SAMPAI TUTUP BIJI MATA!)

Each weal usually lasts less than 24 hours. However, as some fade away, others may appear. It can then seem as if the rash is moving around the body. The rash may appear quite dramatic if many areas of skin are suddenly affected.(DOC PESAN INCASE NAIK RASH OR ADA FEVER LAGI LESS THAN A MONTH NI, TERUS DIRECT KE WARD SEKARANG DAN URGE FOR A DOCTOR IMMEDIATELY)

Are there any other symptoms?

  • Most people with acute urticaria do not feel 'ill', but the appearance of the rash and the itch can be troublesome.(TAPI BAGI BABY MCM NABIL, MEMANG MENDA NI TROUBLESOME..SETENGAH BUDAK TU DOC KATA ADA YG JADIK BERAIR DAN BERBAU,TU YG AKU BALUT FINGERS DIA TIME DIA MENGGARU,)
  • In some cases a condition called angio-oedema develops at the same time as urticaria. In this condition some fluid also leaks into deeper tissues under the skin which causes the tissues to swell.

    • The swelling of angio-oedema can occur anywhere in the body but most commonly affects the eyelids, lips and genitals.
    • Sometimes the tongue and throat are affected and become swollen. The swelling sometimes becomes bad enough to cause difficulty breathing.
    • Symptoms of angio-oedema tend to last longer than urticarial weals. It may take up to three days for the swollen areas to subside and go.

  • A variation called 'vasculitic urticaria' occurs in a small number of cases. In this condition the weals last more than 24 hours, they are often painful, may become dark red, and may leave a red pigmented mark on the skin when the weal goes.

What causes acute urticaria?

A 'trigger' causes cells in the skin to release chemicals such as histamine. The chemicals cause fluid to leak from tiny blood vessels under the skin surface. The fluid pools to form weals. The chemicals also cause the blood vessels to open wide (dilate) which causes the flare around the weals. The trigger is not identified in about half of cases. Some known triggers include:
  • Allergies - for example:

    • Food allergies such as allergies to nuts, strawberries, citrus fruit, egg, food additives, spices, chocolate, or shellfish. Sometimes you can develop an allergy to a food even if you have eaten it without any problem many times before.
    • Allergies to insect bites and stings.
    • Allergies to medicines such as penicillin, aspirin, anti-inflammatory painkillers, etc.

  • A viral infection such as a cold or 'flu can trigger an urticarial rash in some people. (You 'react' to the virus.) A mild viral infection which causes few other symptoms is probably a common trigger of an urticarial rash that develops without an apparent cause.
  • Skin contact with 'sensitizers' causes a local area of urticaria in some people. For example, chemicals, latex, cosmetics, plants, ointments, nettle stings, etc.
  • Physical urticaria. This is when a localised rash appears when the the skin is physically stimulated. The most common is called dermographism when a rash develops over areas of skin which are firmly stroked. Sometimes an urticarial rash is caused by heat, cold, emotion, exercise, or strong sunlight. See separate leaflet called 'Physical Urticarias'.

It is is fairly common and occurs with exercise, sweating, or any activity that leads to a warming of the core body temperature such as warm or hot baths or showers. (aku wonder juga adakah mandi water heater yg buat Nabil dapat menda ni..tapi doc kata it could be resulted from VARIOUS UNKNOWN factors)

Is acute urticaria serious?

Usually not. The rash is itchy but normally fades within a day or so and causes no harm. Most people with acute urticaria do not feel too unwell unless they have a cold or 'flu that is triggering the rash. The cause of the rash is not known in more than half of cases and it is commonly a 'one-off' event.

However, urticaria may be more serious in the following situations.
  • Food allergy. If a food allergy is the cause then the rash is likely to return each time you eat the particular food. This is more often a 'nuisance' than serious.
  • Severe allergies. People who have a severe allergic reaction to peanuts, insect stings, etc, often have an urticarial rash as one of the symptoms. This is in addition to other symptoms such as severe angio-oedema, breathing difficulties, collapse, etc. A severe allergic reaction is called anaphylaxis. But note: most people with acute urticaria feel well and do not have anaphylaxis.
  • Chronic urticaria. This means the rash keeps coming and going on most days for six weeks or longer. This is uncommon. See separate leaflet called 'Chronic Urticaria'.

What is the treatment for acute urticaria?

  • Often no treatment is necessary as the rash commonly goes within 24-48 hours.
  • A cool bath or shower may ease the itch.
  • Antihistamine tablets can ease symptoms. Antihistamines block the action of histamine which is involved in causing urticaria. You can get antihistamines on prescription. You can also buy them from pharmacies. There are several brands. The pharmacist will advise.

    • Modern brands usually work well and are unlikely to cause side-effects. They sometimes cause drowsiness - particularly if you drink alcohol.
    • Older brands will often make you drowsy - but this effect may be welcome at bedtime if itch is troublesome.

  • If you can identify a 'trigger' such as a food, then it would be sensible to avoid it in the future.
  • A short course of steroid tablets is sometimes prescribed in severe cases to help reduce swelling in the skin.

If you have a severe episode of urticaria then you may be referred to specialist (immunologist or dermatologist). In particular, if angio-oedema or anaphylaxis occurred at the same time. This is to confirm the diagnosis, and where possible, to identify a cause. For example, if a nut allergy is suspected to have caused a severe episode then this can confirmed by tests. You may then be given advice on how to avoid the cause, and on what to do if it should occur again.


hungover said...

Good points!

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