Chronic Urticaria

"The treatment with Omalizumab, in patients who did not respond to more aggressive treatments, makes the beans and all the symptoms disappear, without it being necessary to follow another treatment".

DR. MARTA FERRER PUGA
DIRECTOR. ALLERGY AND IMMUNOLOGY DEPARTMENT

Urticaria is a disease of unknown origin and autoimmune in a percentage of cases, which is characterized by the presence of hives and wheals, produces intense itching throughout the day and can be associated with angioedema (swelling of lips and eyelids).

The cells of the immune system have histamine granules inside, if this is released, it stimulates the nerve fibers of the skin and causes itching. The contact of histamine with blood vessels causes them to release fluid that accumulates on the skin and causes wheal. If it affects deeper layers, angioedema occurs.

While acute urticaria lasts between 48-72 hours, chronic urticaria can last for several years.

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What are the symptoms of chronic urticaria?

The symptoms of chronic urticaria consist of the almost daily appearance of wheals or hives all over the body, sometimes accompanied by angioedema, which consists of a swelling of lax skin areas such as lips or eyelids.

If this swelling is very intense, it can produce a complete deformation of the face. Its duration is at least two and a half months. It produces a significant alteration in the quality of life. Skin lesions appear without interruption.

Also, although much less frequently, the tongue or glottis may become inflamed, which will cause difficulty in breathing and require immediate attention in an emergency department.

In 50% of patients we have been able to demonstrate that it is an autoimmune mechanism, that is, the body itself activates the skin cells that cause them to release histamine and produce hives.

<p>Infogr&aacute;fico sobre la urticaria cr&oacute;nica, qu&eacute; es, c&oacute;mo se diagnostica y su tratamiento</p>

Learn more about chronic urticaria (available in spanish)

The most common symptoms are:

  • Skin rashes or welts
  • Intense itching
  • Inflammation of lips or eyelids
  • Inflammation of the tongue or glottis
  • Breathing difficulty

Do you have any of these symptoms?

You may suffer from chronic urticaria

What causes urticaria?

In most cases, it is not possible to determine the causes that cause chronic urticaria.

There is a type of urticaria called physical urticaria that occurs in the area where the skin comes into contact with some physical stimulus such as cold, vibration, pressure, water, sun exposure, etc. The most frequent of this group is called dermography, which is produced after rubbing or scratching.

In the case of chronic urticaria, as the lesions on the skin appear without interruption, triggers are sought: certain foods are dispensed with in the diet, it is attributed to situations that produce stress, etc.

The lack of responses can cause distress and emotional destabilization. As the process does not stop, the possibility that it is a reflection of a more serious and profound illness will be analyzed.

As there is no causal treatment, the rash may reappear. There are factors that can make it worse, such as taking nonsteroidal anti-inflammatory drugs (Aspirin® and derivatives).

What is your prognosis?

In general, an isolated episode of acute urticaria without angioedema, which has had no impact, does not require further evaluation by the physician.

If urticaria does not improve, repeats itself, is accompanied by significant swelling (with respiratory complication) or if food or medication is suspected to be the cause, a study by the allergy specialist is required. Since skin lesions caused by chronic urticaria appear without interruption, triggers are sought.

The lack of responses can cause distress and emotional destabilization. As the process does not stop, the possibility that it is a reflection of a more serious and deeper disease will be analyzed. 

As there is no causal treatment, the rash may reappear. A positive aspect of this disease is that, in the vast majority of cases, after several years the chronic urticaria disappears by itself without leaving any kind of sequel.

How is chronic urticaria diagnosed?

<p>&nbsp;Pruebas cutaneas</p>

Almost every day, wheals or welts appear all over the body, sometimes accompanied by angioedema, and lasting at least two and a half months.

Since skin lesions appear without interruption, triggers are tirelessly sought: certain foods are dispensed with, situations that produce stress are blamed, etc. Lack of response can lead to distress and emotional destabilization.

As the process does not stop, it is analyzed if it could be a reflection of a more serious and deeper illness. It involves multiple analyses and endless visits to specialists.

Chronic urticaria is not usually a reflection of any underlying pathology. It is characterized because all the tests to which the patient is submitted are always normal.

How is chronic urticaria treated?

Treating urticaria is about the symptoms, not the cause

The acute process is treated in an emergency consultation with antihistamines and, depending on the severity of the condition, with steroids. Generally, an isolated episode of acute urticaria without angioedema, without repercussions, does not require further evaluation by the physician.

If the urticaria does not improve, is repeated, if it has been accompanied by significant swelling (with respiratory complication) or if it is suspected that the cause has been a food or a medicine, it requires a study by the allergy specialist.

The treatment is effective when it is followed in a constant way in spite of not having beans. In the vast majority of cases, after several years, chronic urticaria disappears on its own without leaving any kind of sequelae. Chronic urticaria is treated with antihistamines.

If the response is not adequate, it is possible to increase the dose or combine them.

Currently, and in specific cases, the Clínica Universidad de Navarra is using an antibody with which promising results are being obtained. When a chronic urticaria is studied and confronted with patience, in most cases it occurs with effective treatment, which allows one to develop a completely normal life and leave behind a great problem.

Where do we treat it?

IN NAVARRE AND MADRID

OUR MEDICAL TEAM

Specialists from the Department of Allergy

The Department of Allergy and Immunology of the Clinic is part of the Global Allergy and Asthma European Network, composed of the 25 best departments of Allergy in Europe, chosen for their scientific excellence, multidisciplinary work, teaching and international activities.

We have the most advanced diagnostic techniques, we are at the forefront of research and we collaborate with the best experts. We have more than 50 years of experience in the field.

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