Urticaria and Angioedema

14


Urticaria and Angioedema




Urticaria and angioedema can occur at any age and are estimated to have an overall lifetime prevalence of 10–25%.


Urticaria (hives) is characterized by wheals: evanescent, pale to pink-red, edematous papules or plaques (Fig. 14.1); lesions often have central clearing, a peripheral erythematous flare, and associated pruritus.



Individual wheals last <24 hours, which can be documented by outlining them with ink.


Angioedema represents deeper dermal and subcutaneous or submucosal swelling (Fig. 14.2); affected areas are ill-defined, have minimal or no overlying erythema, and may be painful as well as pruritic.



In addition to the skin/subcutis, angioedema can affect the mouth and respiratory or gastrointestinal tract; an area of swelling may persist for several days.


A classification scheme and DDx for urticaria and angioedema are presented in Table 14.1; patients with angioedema may have associated urticaria, including physical urticaria.



Urticaria and urticaria-associated angioedema result from the release of histamine and other proinflammatory and vasoactive substances from mast cells; this leads to extravasation of plasma, vasodilatation, and pruritus.


Stimuli for mast cell degranulation are shown in Fig. 14.3.



Apr 22, 2016 | Posted by in Dermatology | Comments Off on Urticaria and Angioedema

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