Management of urticaria?

Suggest the diagnosis and treatment of the case Patient age 32/M - intense (excess) itching - reddish - < from sun, heat - > from cold water - patient saying after taking bath he feels like constrition of skin when he sits in fan - having pain on touch - having this problem since 1year

35 years old female suffering from recurrent painless nonitchy swelling for last 5 years. No h/o respiratory distress. No family history of such lesions. She is a known Hypertensive and for that she is on Telmisertan 40 mg/day. Patient has been treated with Levocetirizine 10mg twice a day for six months and Monteleukast 10 mg at night for six months, but no relief. Only responding to short courses of systematic Steroid 2 mg /kg with tapering dose. 1). Diagnosis 2). D/D 3). Investigations 4). Management. Please give your answers in chronological order.

A 40yrs male pt having intesne itching in early morning everyday nd whenever weather became cold he gets itching nd apearnce like this showed in images....since 3yrs, itching subside while seating in sunlights or while taking medication plz dx nd Rx

21 male w severe urticaria after shower.... Airway clear spo2 maintained...admitted for further mx...

Friends today I am discussing about hives or urticaria. ALLERGIES URTICARIA & ANGIOEDEMA Symptoms of Urticaria (Hives) While the symptoms of urticaria (hives) may seem relatively self-apparent, they are frequently mistaken for those of other skin conditions such as eczema, rosacea, and pityriasis rosea. But, in the same way that the biological mechanism of urticaria is specific, so, too, are the signs and characteristics of the common skin rash—if you consider them carefully. While hives (also referred to as wheals or weals) can differ in their distribution and appearance, they are characterized by itchy, raised welts on the skin's surface that are either red or skin-colored. urticaria symptoms Urticaria is caused by an inflammatory reaction that prompts capillaries in the dermis (the layer of tissue just beneath the outer skin) to leak fluid. When this happens, the accumulation of fluid results in a defined area of raised skin that persists until the fluid is eventually reabsorbed into the surrounding cells. Hives have specific characteristics that set them apart from other skin conditions: The elevated area of skin has a clearly defined border. When you press the rash, it will "blanches" (turns white). They will be itchy, sometimes intensely so. There may also be paired with pain or a burning sensation. They can appear on anywhere on the body and change shape, move around, disappear, and reappear over short periods of time. When they resolve, the skin will return to normal without scarring. Most will not be accompanied by systemic reactions such as fever, nausea, muscle aches, joint pain, or headaches. Urticaria is classified as being either acute or chronic depending on the duration of the eruption. Acute hives last for less than six weeks, while chronic hives extend well beyond six weeks. Acute urticaria is more common in children and young adults. The majority are classified as idiopathic, meaning that we don't know the cause. Most cases are self-limited; individual lesions tend to resolve on their own within a few hours. An eruption rarely lasts more than several days, although it may recur over weeks. If a cause is found, it is usually related to an infection, insect bite, or a food or drug allergy. Urticaria is known to affect up to 20 percent of the population and strikes people irrespective of age, race, or gender. Hives most often appear in the evening or early morning just after waking. Itching is typically worse at night, often interfering with sleep. The distribution and appearance of hives can vary significantly. Some may be widespread, while others may be diffuse or limited to a single, small weal. The appearance of a hive can sometimes give a clue as to the underlying cause. Cold urticaria, caused by exposure to cold temperatures, usually manifests with welts that are between a quarter of an inch and an inch in size that are either slightly reddish or skin-colored. Fainting can occur if large areas of skin are involved. Cholinergic urticaria, also known as heat rash, is caused by excessive sweating and will appear as very small weals surrounded by bright red flares. Strenuous exercise is a common cause. Dermographism urticaria is caused by the firm stroking of the skin and manifests with hives along the line of contact. The weals tend to appear five to 10 minutes after contact and generally disappear 10 to 15 minutes after they occur. Pressure urticaria is caused by any pressure placed on the skin, including tight clothing or standing on your feet too long. It manifests with a denser, localized eruption that is red, itchy, and maybe even a little painful. Solar urticaria, caused by exposure to ultraviolet (UV) light, appears in areas of exposed skin, often within minutes of exposure. The rash is very itchy and appears "angry" with an often intense redness and warmth. As with cold urticaria, fainting can occur if the hives are widespread. Vibratory urticaria can be caused by any form of vibration, including clapping or a bumpy car ride. It tends to be short-lasting, appearing and disappearing within an hour. While difficult to distinguish by looks alone, vibratory hives are sometimes accompanied by unusual symptoms such as flushing, headaches, blurry vision, or a metallic taste in the mouth. Water urticaria (aquagenic urticaria) is a rare form of hives caused by contact with water. The hives tend to be small and most often develop on your neck, upper trunk, and arms. As with vibratory urticaria, it tends to come and go within an hour. Rare Symptoms Less commonly, urticaria may precede a severe, all-body allergic reaction known as anaphylaxis. Anaphylaxis is often caused by a hyperallergic response that triggers the development of hives, angioedema (a related skin condition affecting deeper layers of tissue), and severe respiratory symptoms. Common allergy triggers are food, medications, vaccines, and insect stings, although some cases have no known causes. Symptoms of anaphylaxis include: Widespread hives and angioedema with hot skin Coughing, sneezing, and wheezing Throat tightness and shortness of breath Swelling of the lips and/or tongue Rapid or irregular heartbeat Dizziness or lightheadedness Stomach cramps Nausea, vomiting, and diarrhea Chest pains Breathing restriction advancing to airway obstruction Confusion A feeling of impending doom Fainting and collapse Seizures If left untreated, anaphylaxis can lead to shock, asphyxiation, coma, cardiac or respiratory failure, and death. Homeopathy treats diseases as a whole, and similarly, when treating urticaria tries to identify associated symptoms and thereby treat the cause also. After a detailed discussion about predisposition and associated symptoms, a customized remedy will be prescribed, which may include one of the following common homeopathic remedies. Apis Mell: The hives consist of isolated patches that are painful, tender, itch at night, feel like bee stings, become purple. There is burning pain, slight fever, and warmth of the surrounding skin. It is worsened by changing weather and exercise, causing severe itching and burning. The patient may already have asthma. Arsenic Album: The urticaria is caused by eating shellfish and causes burning and restlessness. The condition gets worse being at the seaside and by getting into sea water. Arsenic is also useful to treat urticarial symptoms during the recession of the lesions. The person also could be down emotionally with depression, despair, indifference and irritability. If the lesions are more severe, the restlessness is also severe. It is worse after midnight, from 1 to 2 a.m. Rhus toxicodendron: Prepared from the leaves and bark of the plant poison ivy, Rhus works on multiple body systems including skin, joints, eyes, extremities, and overall vitality. In addition to urticaria, it is also used in cellulitis, arthritis, fevers, etc. It is effective if the urticaria has a burning sensation, inflamed reddened rash that is worsened by cold and improved by warmth. Urtica urens: Made from a plant called stinging nettle, which itself has a tendency to produce urticaria, it is used when there is urticaria from bee stings or after eating shellfish. The lesions are red with severe burning and itching, recurring every year, could be associated with weather changes. Natrum Muriaticum: The common salt sodium chloride is potentized, and its inner healing power activated. It is used for chronic urticaria, where the lesions develop after severe irritation. Dulcamara: The lesions develop followed a general prickly sensation setting in and at night when it is cold and damp. The hives are irregular white patches surrounded by a red area that itch badly. The hives are associated with violent cough, swelling of the lymph nodes, fever, restlessness, sleeplessness, decreased appetite, nausea, vomiting, bitter taste, and intense aching in pit of stomach.