Urticaria or hives, are red, itchy, swollen areas of the skin that can range in size and appear anywhere on the body. The blotches can migrate on body, appearing in different areas throughout the course of the reaction.
The causes of acute urticaria (< 6weeks duration) is readily identifiable—often a viral infection, or allergic reaction to drugs, food or latex. These hives usually go away spontaneously or by avoiding the allergic trigger. However, in some cases, medical intervention is needed to increase comfort or prevent recurrence. Treatment with oral antihistamines is frequently successful, but in severe cases, steroids may be needed.
Chronic urticaria (>6 weeks duration) can occur almost daily for months or, in some cases, years. For these individuals, scratching, pressure or stress may aggravate the condition. The majority of these case are autoimmune in origin. Autoantibodies form that bind to a mast cell and trick the mast cell into believing it has encountered an allergen releasing it’s inflammatory contents in the skin causing hives or tissue swelling.
Hives can be flared by stress, hormone changes, medications (NSAIDS). The treatment goal is avoidance of possible triggers and selecting the best combination of medications to control the frequency of outbreaks. Annual thyroid testing is recommended. This diagnosis is benign and will wax and wane over time.