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This sqadia.com medical video lecture provides an in-detail explanation of urticaria. Our medical specialist, Dr Mahwish Dildar has elaborated about the pathophysiology and classification of urticaria. Moreover, the acute and chronic urticarias alongside some physical urticarias like contact urticaria syndrome, vasculitis and cholinergic urticaria have been comprehensively delineated. Furthermore, treatment strategies encompassing first, second- and third-line therapies have been elucidated.
Cause and Clinical Features
The prime focus of section one is on the causes and clinical features of urticaria. In the beginning, Dr Mahwish has defined the term urticaria followed by a discussion on hives and wheals. Their pathophysiology has also been elaborated including triple response of Lewis. Furthermore, clinical presentation has also been highlighted. Towards the end, various types of urticaria, categorized based on duration, has been explained. Conclusively, etiologic classification, differential diagnosis and initial evaluation has been extensively delineated.
This section emphasizes on the acute urticaria. Firstly, etiology, IgE and complement mediated reactions and non-immunologic releases of histamine has been shed light upon. Proceedingly, evaluation along with certain laboratory tests have been elucidated. Allergen testing including skin tests, RAST and food tests have been elaborated. Anaphylaxis, IV contrast media and latex allergy has been discussed under management. In the end, timeline of acute urticaria ranging from initiation and development to flare and resolution has ben expansively elucidated.
The major emphasis of this section is on the chronic urticaria. It has been described in the beginning followed by a discussion on its underlying pathogenesis. Counselling of patients has also been mentioned. Additionally, diagnosis, history and examination has been comprehensively explained. Furthermore, a range of laboratory investigations along with the management strategies has been shed light upon. Moreover, restrictions and differential diagnosis has also been highlighted.
Physical Urticarias have been deliberated in this section. Primary and secondary cold urticaria syndrome has been delineated. Following this, laboratory investigations, diagnosis and treatment via antihistamines and antibiotics have been conversed about. Additionally, heat, water and vibration urticarias, solar urticaria along with aquagenic pruritis has been given account for. Dermographism, skin-writing, darier’s sign and pressure urticarias have been explained in detail. Cholinergic urticarias and exercise induced types have been extensively elucidated. Moreover, immunologic and non-immunologic contact urticaria syndrome and vasculitis has been explicated.
Under treatment strategies, a range of medications including sedative and non-sedative, H1 and H2 antagonists, first and second line therapies have been comprehensively explained. The latter include oral corticosteroids and leukotriene modifiers. Third line therapy encompassing IV immunoglobins, methotrexate and topical measures have been expounded.