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Urticaria: what is it and how to recognize it?

Urticaria is an undesirable companion, both in its acute form (lasting less than 6 weeks) and in its chronic form (lasting more than 6 weeks), which affects a large part of the population at some point in their lives.

bumps on the thighs of a 20-month-old boy
Bumps on the thighs of a 20-month-old child

This is a situation in which very conspicuous lesions appear and produce significant itching or pruritus. The lesions, called wheals, are easily recognized because they are very itchy, red, palpable welts that blanch under pressure (visible when a clear glass or crystal is placed over a lesion). They can appear on any part of the body, including the head, and sometimes there are so many lesions that they are joined together and entire body regions such as the abdomen, back or a limb are seen to be inflamed. An essential characteristic to diagnose a wheal or urticaria is that the lesions last less than 24h. It seems as if they “move”, while some disappear, others appear somewhere else.

Urticaria: coalescing wheals
Urticaria: coalescing wheals

In most cases, urticaria is a benign, though striking, process that lasts for a few days or weeks and then disappears.

In chronic urticaria (more than 6 weeks), an in-depth study is indicated to look for a specific cause that is producing it, such as an allergy to food, pollen or animal. In most cases this cause is not found and in many cases chronic urticaria is associated with stress or unknown causes.

In a case of urticaria, the most important thing is to reassure the patient and family members that, in most cases, urticaria does not produce any type of complication and disappears easily with time and with the help of different types of antihistamines. When these drugs are not sufficient, the next indicated treatment is oral cortisone, always recommended and supervised by a physician.

There is a severe and much less frequent form of urticaria called angioedema that can produce swelling of the face, mouth, lips and airway, which can be life-threatening. In these cases, the patient should be rushed to the hospital as adrenaline administration may be necessary.

Dr. Federico Feltes Guzman