Diagnosis and treatment of urticaria

Urticaria is diagnosed through a number of skin tests and blood tests to determine IgE antibodies.

Dr. Vo Thi Tuong Duy, a specialist in Dermatology - Dermatology, Tam Anh General Hospital, Ho Chi Minh City, said that most urticaria are diagnosed through clinical examination. The doctor will ask the patient about their health status, family factors, lifestyle, home environment, and work environment. The doctor will also perform basic activities such as looking, touching... to detect abnormalities.

The eyelids, genitals, lips... are sensitive areas so hives can easily appear. The red rash can cause swelling of the entire skin area (angioedema). If angioedema occurs in the larynx or digestive tract, the patient will have difficulty breathing, abdominal pain, diarrhea...

In many cases, the doctor will order some skin tests and blood tests to determine what the patient is allergic to. In addition, during the medical history review, the doctor will determine whether the patient has acute or chronic urticaria to prescribe appropriate tests.

There are many factors that cause hives. Photo: Freepik — There are many factors that cause hives. Photo: *Freepik*

Acute urticaria presents as a rash lasting less than 6 weeks. The disease appears suddenly, the bumps can be concentrated in some areas of the skin or spread throughout the body. 10% of cases of acute urticaria cause angioedema (a deep swelling of the skin in the mucous membranes that makes the skin turn red and swell), causing itching and pain. If treated properly, angioedema will improve after 72 hours.

Skin lesions lasting more than 6 weeks are called chronic urticaria. This type is characterized by rashes, itchy bumps that are pink, red or pale white on the skin. The patient feels itchy, burning, and uncomfortable. In addition to causing skin lesions, chronic urticaria also seriously affects health, spirit and quality of life. Chronic urticaria is persistent and recurs continuously, changing skin color (pigmented urticaria), affecting daily activities, sleep, and appearance, making the patient self-conscious in communication.

Most chronic urticaria patients are due to common causes such as autonomic reactions, infections, and intolerance. The 60-allergen test is a method that uses 60 allergen samples, that is, 60 available allergen samples, to determine the cause of urticaria. This method helps doctors find the correct treatment direction, and at the same time helps patients know which allergens their body is allergic to.

Red rash on the skin. Photo: Freepik — Red rash on the skin. Photo: *Freepik*

To treat acute urticaria, the doctor only needs to find and instruct the patient to eliminate the causative agent. For chronic urticaria, the patient is treated with antihistamines or a combination of drugs. If antihistamines do not help the patient reduce pain and itching, the doctor will prescribe oral or injectable steroids. In cases where the above drugs are not effective, biological drugs may be used to control urticaria. The use of drugs must be monitored by a specialist and strictly follow the regimen of the Ministry of Health .

In case of severe rash, the patient needs to inject epinephrine, cortisone or immunomodulators. If the patient has hives and symptoms such as dizziness, wheezing, difficulty breathing, chest tightness, swelling of the tongue, face, lips... they should go to a hospital with a dermatology department for timely treatment, because these could be early symptoms of anaphylactic shock.

Chronic urticaria often responds poorly to treatment. Although the disease is not immediately dangerous, if not properly cared for and treated, it can easily cause complications: eczema, hyperpigmentation (darkening of the skin) and increase the risk of other allergic diseases.

While waiting for the hives and swelling to subside, the patient should apply cool compresses or wet towels to the affected skin area, live and work in a cool, clean place, wear loose clothing... to reduce discomfort and restlessness.

Dawn

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