URTICARIA
URTICARIA(medically known as HIVES) are red, itchy, raised
areas of skin. They range in size from a few millimeters to several inches in
diameter.
- Urticaria can be small
round or large patches. Wheals (welts), red lesions with a red “flare” at the
borders, are another manifestation of urticaria. It can occur anywhere on the
body such as the trunk, arms, legs, etc.
- Urticaria is commonly
caused by allergic reactions. But there are many non-allergic causes also i.e.
most cases of urticaria lasting less than six weeks (known as acute urticaria)
are the result of an allergic trigger. Chronic urticaria (lasting longer than
six weeks) are rarely due to an allergy.
- The majority of patients
with chronic urticaria have an unknown cause. Perhaps as many patients with chronic
idiopathic urticaria will have an autoimmune cause.
- Acute viral infection is
another common cause of acute urticaria (viral exanthema).
- Less common causes of
urticaria include friction, pressure, temperature extremes, exercise, and sunlight.
- One hallmark of urticaria
is their tendency to change size rapidly and to move around, disappearing in
one place and reappearing in other places, often in a matter of hours.
Individual usually last for 2 to 24 hours.
Types of Urticaria
Acute Urticaria:
- It usually shown up a few
minutes after contact with the allergen and can last a few hours to several
weeks (not more than 6 weeks). Food allergic reactions often fit in this
category.
- The most common food
allergies in adults are shellfish and nuts. The most common food allergies in
children are shellfish, nuts, peanuts, eggs, wheat, and soy. A less common
cause is exposure to certain bacteria, such as streptococcus or possibly
Helicobacter pylori.
Chronic Urticaria:
-It refers to urticaria that
persists for 6 weeks or more. There are no visual differences between acute and
chronic urticaria. Some of the more severe chronic cases have lasted more than
20 years.
- A survey indicated that chronic urticaria lasted a year or more in
more than 50% of sufferers and 20 years or more in 20% of them.
Drug-induced Urticaria:
-It has been known to result
in severe cardio-respiratory failure. The anti-diabetic sulphonylurea
glimepiride, others dextroamphetamine, aspirin, penicillin, clotrimazole,
sulfonamides and anticonvulsants.
Physical Urticaria:
They are often categorized
into the following:
• Aquagenic: Reaction to
water.
• Cholinergic: Reaction to
body heat, such as when exercising or after a hot shower.
• Cold: Reaction to cold,
such as ice, cold air or water – worse with sudden change in temperature
• Delayed Pressure: Reaction
to standing for long periods, bra-straps, elastic bands on undergarments, belts
• Dermatographic: Reaction
when skin is scratched
• Heat: Reaction to hot food
or objects
• Solar: Reaction to direct
sunlight
Causes of Urticaria
EXOGENOUS CAUSES
- INSECT BITES: Nettles,
wasps, bugs, caterpillars.
- Exposure to extremes of heat
or cold, sun.
ENDOGENOUS CAUSES
- FOODS: Fish, prawns, eggs,
strawberry, masroom, Food preservatives, Artificial colors.
DRUGS
- Salicylates.
- Bromides.
- Iodides.
PARASITES
- Round worm.
- Tape worm.
- Hook worm.
- Hydatid disease.
- Filariasis.
PSYCHOGENIC
- Emotional stress.
- Over-exertion.
SYSTEMIC DISEASES
- Rheumatiod Arthritis
- Systemic Lupus Erythmatous
SYMPTOMS:
- Intense itching.
- Burning.
- Sense of heat.
LESION
- Starts as red erythematous
macules. Soon paleoedematous wheals
develop.
- Irregular, asymmetrical.
- Velvetty to touch.
- Erythema well defined,
fades on pressure.
- Subside within few hours
without leaving any trace.
- Dermographism positive.
- Wheals develop along line
of scratching or pressure.
Common sites involved:
eyelids, tongue, lips, glottis, genitalia, trunk, hands, feet.
GENERAL MANAGEMENT of
URTICARIA
- Identify and eliminate
offending agent.
- Correct underlying cause.
- Avoid precipitating
causes.
Homeopathic Remedies for
Urticaria
APIS MELL.
- The characteristic of
urticaria is the stinging & itching as if from bee stings. Itching always
< at night.
- The urticarial elevation
which is quite painful & tender to touch; this later become purple or
livid. There is slight fever & heat of skin, accompanying urticaria. There
is burning pain.
- Generalized anasarca as a
strong concomitant to the urticaria. Change of weather, warmth, & exercise
cause troublesome itching & burning urticaria. The urticaria is worse
during both chill as well as fever. The urticaria sometimes accompanies
asthmatic troubles (broncho-spasm).
- Adapted to the strumous
constitution; glands enlarged, indurated; scirrhous or open cancer. Women,
especially widows; children and girls who, though generally careful, become
awkward, and let things fall while handling them.
URTICA URENS
- Itching and burning of the
skin as if scorched; raised red blotches; fine stinging points; pale rash
requiring constant rubbing; consequences of suppressed urticaria; eruption and
itching disappears as soon as she lies down and reappear immediately after rising.
- There is edema of the
face, chest and limbs without inflammation.
- Urticaria affects patient
every year in the same season.
- Site of urticaria is face,
arms, shoulders, scalp.
- Vomitting and diarrhea
from suppression of urticaria.
ANTHRAKOKALI:
- The urticaria of
Anthrakokali increases with general sweat. There is intense itching which is
worse at night.
- The site or urticaria is
hands, tibia, shoulders and dorsum of feet.
- Eruptions always decrease
with the full moon.
- Concomitant symptoms with
urticaria are dropsy and intense thirst
RHUS-TOX
- Vesicular urticaria from
getting wet, during rheumatism, with chills and fever, worse in cold air.
- Patient has itching all
over; worse on hairy parts with burning after scratching.
- Adapted to persons of
rheumatic diathesis; bad effects of getting wet, especially after being
over-heated.
ARSENIC ALBUM
- Arsenic causes urticaria
with burning and restlessness. It is also useful for persistence of complaints
during recession of the urticaria.
-The urticaria may occur
after eating shellfish. Urticaria gets worse at the sea-shore and due to sea
bathing.
- Great Prostration, with
rapid sinking of the vital forces; fainting. The disposition is:
a. Depression, melancholy,
despairing, indifferent.
b. Anxious, fearful,
restless, full of anguish.
c. Irritable, sensitive,
peevish, easily vexed.
- The greater is the
suffering the greater the anguish, restlessness and fear of death. Mentally patient
is restless, but physically too weak to move.
- Indicated by its
periodicity and time aggravation: after mid-night, and from 1-2 a.m. And by its
intense restlessness, mental and physical: its anxiety and prostration.
DULCAMARA
- Urticaria come on at
night, especially when the nights are cool, with heavy dew, after a hot day or
when weather changes from warm to cold and damp; urticaria with violent cough
and oedema of glands; feverish urticaria, obliging one to scratch and burning
after scratching, every eruption being preceded by sensation of pricking over
whole body.
- Eruption of white,
irregular blotches raised upon the skin, surrounded with red areola, appearing
in warmth, and disappearing in cold and extremities, face, chest and back,
violently itching and burning after scratching,
- Headache, want of
appetite; nausea, bitter taste, vomiting, intense aching in pit of stomach and
praecordial region, restlessness and sleeplessness, night-sweats turbid, dark
urine, diarrhea, pains in limbs.
- Urticaria from gastric
disorders.
- Aggravation of sufferings
chiefly in the evening or at night, and during repose, better by movement.
- Pain with coldness of the
body.
BOVISTA
-The urticaria of bovista
covers nearly the whole body. There is burning, itching of a type which is not
relieved by scratching and comes on more at night.
- Urticaria which is caused
by tar, the itching is worse on getting warm. Urticaria with a disposition to
diarrhea. Each stool is followed by tenesmus. - The other concomitant symptoms
of urticaria are scorbutic gums. Inflammation of the eyes, metrorrhagia and
various mental symptoms.
- Persons who suffer from
tettery eruptions, dry or moist. Adapted to old maids with palpitation.
- Stammering children.
- Discharge from nose and
all mucous membranes very tough, stringy, tenacious. Usually deep impression on
finger, from using blunt instruments, scissors, knife, etc.
- Intolerance of tight
clothing around the waist. Sweat in axilla, smells like onions.
CHLORAL HYDRATE
- The urticaria of chloral
hydrate is characterised by its periodicity. It disappears by day and comes on
by night with such intense itching as to prevent sleep.
NAT. MUR.
- The skin of nat-mur is
characteristically dirty, unhealthy and greasy, with a yellowish colour.
- There is great rawness and
soreness of the skin, beginning at the feet and gradually ascending.
- Urticaria around joints
with great itching, especially above the ankles.
- Eruptions itch, smart and
burn after exposure to cold damp air, near the seashore and in intermitent
fever. Itching is particularly worse from physical exercise. Urticaria may even
be over the whole body with large red intensely itching blotches.
- Irritability: child cross
when spoken to; crying from slightest cause; gets into a passion about trifles,
especially when consoled with Awkward, hasty, drops things from nervous
weakness.
- Marked disposition to
weep; sad weeping mood, without cause, but consolation from others < her
troubles
- For the anaemic and cachetic,
whether from loss of vital fluids- profuse menses, seminal loses- or mental
affections.
- Great emaciation; losing
flesh while living well. Throat and neck of children emaciate rapidly during
summer complaint.
- Great liability to take
cold.
PULSATILLA
- Urticaria of gastric or
uterine origin.
- Urticaria from pastries or
pork or delayed menses.
- Urticaria with diarrhea,
itching is worse night.
- Patient is chilly all the
time, even in a warm room. Adapted to persons of indecisive, slow, phlegmatic
temperament; sandy hair, blue eyes, pale face, easily moved to laughter or
tears; affectionate, mild, gentle, timid, yielding disposition- the woman’s
remedy.
- Weeps easily: almost
impossible to detail her ailments without weeping.
SEPIA
- Chronic urticaria with
burning, stitching and itching which gets worse on exposure to open air.
- Urticaria first appears on
face, neck and forearms and then gradually spreads over the whole body. The
attacks are preceded by nausea and pressing headache with face swollen as in
erysipelas.
- Urticaria on upper body
breaks out in cold air and disappears in a warm room.
- Eruption in the form of
wheals as if due to blows with a whip or rod.
- Adapted to persons of dark
hair, rigid fibre, but mild and easy decomposition.
SULPHUR
- The urticaria of sulphur
is found on the face, arms, on back of hands, neck and lower extremities.
- Urticaria with fever.
- Itching of urticaria over
the whole body, hands and feet.
- Eruptions alternate with
other complaints.
- There is voluptuous itching
which is worse at night, worse when in bed and worse after scratching and
washing.
- Scratching is followed by
burning.
- Adapted to persons of a
scrofulous diathesis, subject to venous congestion; especially of portal
system. Persons of nervous temperament, quick motioned, quick tempered,
plethoric, skin excessively sensitive to atmospheric changes.
- For lean, stoop-shouldered
persons who walk and sit stooping like old men. Standing is the worst position
for sulphur patients; they cannot stand; every standing position is
uncomfortable.
- Dirty, filthy people,
prone to skin affections. Aversion to being washed; always < after a bath.
Other homoeopathic remedies
are:
Lycopodium, calcarea carb,
kali carb, vespa, antim crud, etc.
- Homeopathy treats the
person as a whole. It means that homeopathic treatment focuses on the patient
as a person as well as his pathological condition.
- The homeopathic remedies
for urticaria are selected after a full individualizing examination and
case-analysis, which includes the medical history of the patient, physical and
mental constitution etc.
