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- $Unique_ID{BRK04303}
- $Pretitle{}
- $Title{Urticaria, Papular}
- $Subject{Urticaria, Papular Urticaria Giant Urticaria Hives Lichen Urticatus
- Angioneurotic Edema Angioedema Quincke Syndrome }
- $Volume{}
- $Log{}
-
- Copyright (C) 1986, 1987, 1989 National Organization for Rare Disorders, Inc.
-
- 248:
- Urticaria, Papular
-
- ** IMPORTANT **
- It is possible the main title of the article (Papular Urticaria) is not
- the name you expected. Please check the SYNONYMS listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- Urticaria
- Giant Urticaria
- Hives
- Lichen Urticatus
- Angioneurotic Edema
- Angioedema
- Quincke Syndrome
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
-
- Papular Urticaria, more commonly known as "hives", is characterized by
- local elevated ridges (wheals) and redness (erythema) of the skin. This
- condition is usually triggered by allergic reactions to insect bites,
- sensitivity to drugs, or other environmental causes.
-
- Symptoms
-
- The first symptom of Papular Urticaria is usually itching (pruritus). This
- is followed shortly by the appearance of elevated ridges (wheals) that may
- remain small or become large. The larger wheals tend to be clear in the
- center, and may be noticed first as large rings of erythema and edema.
- Ordinarily, crops of hives come and go. A lesion may remain for several
- hours, then disappear only to reappear elsewhere.
-
- Angioedema is a more diffuse swelling of loose tissue under the skin
- usually affecting the back of hands or feet, lips, genitalia and mucous
- membranes. Swelling (edema) of the upper airway may produce respiratory
- distress, and the high-pitched tone of difficult breathing may be mistaken
- for asthma.
-
- Causes
-
- Acute Papular Urticaria and Angioedema are essentially exaggerated allergic
- reactions limited to the skin and tissues right under the skin (subcutaneous
- tissues). They may be caused by a drug allergy, insect stings or bites,
- desensitization injections (allergy shots) or ingestion of certain foods
- (particularly eggs, shellfish, nuts or fruits) by people who are allergic to
- these substances. In some cases (such as reactions to strawberries) the
- reaction may occur only after overindulgence, and possibly result from direct
- toxic histamine release into the blood. Papular Urticaria may accompany, or
- even be the first symptom of various virus infections including hepatitis,
- infectious mononucleosis, or German measles (rubella). Some acute reactions
- are unexplained, even when recurrent. If acute Angioedema is recurrent,
- progressive, and never associated with Urticaria, a hereditary enzyme
- deficiency should be suspected.
-
- Affected Population
-
- Children from 2 to 7 years are most commonly affected by Papular Urticaria,
- especially in the summertime when the insect population increases. It is
- more rare in adults, perhaps in part because adults learn to avoid substances
- and conditions to which they are allergic.
-
- Related Disorders
-
- Physical Urticaria is a condition in which red allergic skin lesions and
- itching are produced by exposure to cold temperatures, water or mild trauma.
-
- Cholinergic Urticaria is a condition characterized by red spots on the
- skin, itching and possibly abdominal cramps, diarrhea, faintness, weakness
- and sweating. It is caused by sensitivity to heat, sunlight, exercise, etc.
- For more information on these disorders and other types of urticaria,
- choose "Urticaria" as your search term in the Rare Disease Database.)
-
- Therapies: Standard
-
- Acute Papular Urticaria is a self-limited condition that generally subsides
- in 1 to 7 days. Therefore, treatment is chiefly symptomatic. If the cause
- is not obvious, all nonessential medication should be stopped until the
- reaction has subsided. Symptoms such as itching and swelling can usually be
- relieved with an oral antihistamine. Corticosteroids (e.g. prednisone) may
- be necessary for the more severe reactions, particularly when associated with
- angioedema. Topical corticosteroids are of no value. Epinephrine should be
- the first treatment for acute pharyngeal or laryngeal angioedema. This may
- be supplemented with local (topical) treatment (e.g. nebulized epinephrine)
- and an intravenous antihistamine. This usually prevents airway obstruction,
- but making an opening in the trachea (tracheotomy) and oxygen may be
- necessary.
-
- Although the specific cause of chronic Papular Urticaria can seldom be
- identified and removed, spontaneous remissions usually occur within 2 years
- in 50% of cases. Control of stressful life situations often helps. Certain
- drugs (e.g. aspirin) may aggravate symptoms, as can alcoholic beverages,
- coffee and tobacco. If so, they should be avoided. When Urticaria is
- produced by aspirin, sensitivity to related compounds, as well as certain
- food coloring additives, should be investigated.
-
- Oral antihistamines are beneficial in most cases. All reasonable
- measures should be used before resorting to corticosteroids, which are
- frequently effective, but have significant side effects after chronic use. A
- few patients with intractable Urticaria are also found to have a hyperthyroid
- condition.
-
- Therapies: Investigational
-
- This disease entry is based upon medical information available through March
- 1987. Since NORD's resources are limited, it is not possible to keep every
- entry in the Rare Disease Database completely current and accurate. Please
- check with the agencies listed in the Resources section for the most current
- information about this disorder.
-
- Resources
-
- For more information on Papular Urticaria, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- Allergy and Asthma Foundation of America
- 1835 K Street N.W., Suite P-900
- Washington, D.C. 20006
- (202) 293-2950
-
- Allergy Information Association
- 25 Poynter Dr., Suite 7
- Weston, Ontario, MR9 1K8
- Canada
-
- NIH/National Institute of Allergy and Infectious Diseases
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5717
-
- References
-
- CECIL TEXTBOOK OF MEDICINE, 18th ed.: James B. Wyngaarden, and Lloyd H.
- Smith, Jr., Eds.: W.B. Saunders Co., 1988. Pp. 1948-51.
-
- THE MERCK MANUAL 15th ed: R. Berkow, et al: eds; Merck, Sharp & Dohme
- Research Laboratories, 1987. P. 308.
-
-