urtikariassa

Urtikariassa, commonly known as urticaria or hives, is a dermatological condition characterized by transient, pruritic wheals that arise from increased vascular permeability in the superficial dermis. The wheals are typically well circumscribed, may change shape and location, and often last less than 24 hours in a given spot. Itching is a prominent symptom, and sometimes there is accompanying angioedema of deeper tissues.

Urtikariassa is broadly classified as acute or chronic. Acute urtikariassa lasts less than six weeks and is commonly triggered by infections, medications, foods, or contact with allergens. Chronic urtikariassa persists for more than six weeks and can be idiopathic or associated with autoimmunity, thyroid disease, or other underlying conditions. Physical urtikariassa, a subcategory, is elicited by specific stimuli such as pressure, cold or heat, exercise-induced body temperature rise (cholinergic), or sun exposure.

The underlying mechanism generally involves mast cell degranulation and the release of histamine and other mediators, leading to transient dermal edema. In many chronic cases, an autoimmune component or autoantibodies targeting IgE or its receptor may play a role. In a small subset, urtikariassa and angioedema can be part of a more serious hypersensitivity reaction.

Diagnosis is clinical, based on history and examination, with consideration of differential diagnoses such as urticarial vasculitis or drug reactions. Laboratory tests are guided by suspicion of underlying causes and may include complete blood count, thyroid function, and inflammatory markers.

Treatment focuses on symptom control and trigger avoidance. Second-generation H1 antihistamines are first line, often at standard doses and sometimes up to higher doses if needed. ADDITIONAL options include H2 blockers, leukotriene receptor antagonists, short courses of systemic corticosteroids for severe flares, and in refractory chronic cases, omalizumab or other immunomodulatory therapies. Prognosis varies; many cases resolve within weeks, while chronic urtikariassa affects a minority of individuals for months to years.