Urticaria is a disease of considerable concern amongst the patients only because of its chronicity. It may last for years undiagnosed but with a definite response to treatment.It is important to understand that all urticaria can be under control provided the patient is willing to take the medication on a regular basis in the same manner one would take sugar and BP medicine.
In urticaria the patient develop hives or raised red patches on the body surface causing much itching and consequently distress.
This may be acute when it last for less than three weeks or chronic. The acute type is more common in children and usually may be due infection or infestation. Allergies to food items can be present in 40% of patients with acute urticaria, the hallmark being its disappearance within 24 hours. The sudden appearance of hives may be first sign of an underlying disorder leading to a life threatening condition called anaphylaxis. It should on its first Appearance be thoroughly examined and investigated.
Chronic urticaria is usually present in adult. It is more difficult to treat. Food as a cause may be present in not more than 10% of the cases of chronic urticaria. On the contrary, doing skin prick test may be misleading with many false positive results leading to unnecessary avoidance of food. After a detailed history the patient needs to be investigated for thyroid, autoimmune renal and, liver disorders and to rule out chronic infestation. There are many drugs which may initially not cause any rashes but continue to be the cause after years of therapy. In at least 50% of the cases there may be no abnormal finding. The latter patients may need to be on long term antihistamine coverage. There is no risk or side effects to being on long term medication.
A few of the urticaria are exaggerated on exposure to cold, sunlight, physical stimulation and rarely to even water.
All urticaria can be treated but the patient need to have patience and an understanding that it is a chronic non threatening disorder which requires treatment for years and various levels of drug therapy which may include immunosuppressive such as methotrexate and cyclosporine. Unfortunately, it is the commonest cause of doctor shopping and a recourse to alternative medicine including baba’ therapy.