Causes and features of acute urticaria or hives

This article describes about the various causes and features of Acute Urticaria and hives. Read to know the causes of hives, the clinical features of Acute Urticaria and the sites where Acute urticaria can develop.

Acute utricaria also known as hives is a pruritic lesion with a central wheal and sorrounded by erythematous halo for less than 2 months. Utricaria is caused due to dilatation of blood vessels of the skin.

Angioedema is the edema within the dermis or within subcutaneous region. Angioedema mostly occurs with utricaria but its existence alone cannot be denied.

Causes of acute utricaria with or without angioedema

There a wide variety of causes of utricaria but it is considered as a medical emergency so causes are not of much importance in treatment of it. There are maximum case where causes are not certain.
However the important causes of acute utricaria are as follows :-

Causes of utricaria can be immune mediated or non immune mediated.

Immune mediated causes of utricaria

Atopy of allergy is the most important immune medaited cause of utricaria. Among allergens the antigen sensitivity like pollens, foods which include shellfish, choclates, milk products, eggs, nuts, prawns are the main culprits. Certain helminhs and drugs are also the cause. Other causes include hereditary angioedema, Serum sickness, blood transfusion reactions, Nectrotising vasculitis and Hepatitis B infection are the other causes of acute utricaria.

There are some physical utricaria seen as dermatographism, solar,cold and cholinergic utricaria seen in sweating.

Non immune causes of utricaria

Among the non immune causes the main culprits are mast cell releasing agents like in mastocytosis, food additives like tartrazine etc. There are some prostaglandin inhibitors which may cause acute utricaria like Aspirin, NSAIDs, Benzoates and Azo dyes.

Clinical features of acute utricaria

Acute utricaria usually presents with circumscribed, raised erythematous lesion with pruritis. The raised lesion is due to the dermal edema which extend to deep in tissues and cause subcutaneous swelling ie angioedema.

The lesion in utricaria appears all of a sudden and usually not last for more than 48 hours, but some may continue for longer. In anaphylactic syndrome attacks of utricaria may be associated with diarrhea, vomitting, vertigo, syncope, hypotension, shock and laryngeal edema which may be fatal if not treated urgently. Bronchospasm is another dangerous associated feature.

Helminthic infestation specially in children causes utricaria which may be associated with fever and pain abdomen.

Sites involved in acute utricaria

Though utricaria can occur at any part of skin and subcutaneous tissues but the main part usually involved are forearm, back, face including eyelids, cheeks, neck, legs, thighs etc. The lips, tongue and gastrointestinal tract are also important site where acute utricaria can occur.

The investigations required for diagnosing acute utricaria and its treatment is given here at Diagnosis and treatment of acute utricaria.


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