HIVES(Urticaria; Giant Urticaria; Angioneurotic Edema) |
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HIVES
(Urticaria; Giant Urticaria; Angioneurotic Edema)
DESCRIPTIONHives are an allergic disorder characterized by skin changes with raised areas, redness, and itching. The skin anywhere on the body is involved, including the scalp, lips, palms, and soles.
Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications; emergency-room care for life-threatening reactions that include wheezing, shortness of breath, and fainting.
SIGNS & SYMPTOMS
Itchy skin papules (small, raised bumps) with the following characteristics:
They swell and produce pink or red lesions called wheals. Wheals have clearly defined edges and flat tops. They measure 1cm to 5cm in diameter.
Wheals join together quickly and form large, flat plaques (larger areas of raised, skin-colored lesions).
Wheals and plaques change shape, resolve, and reappear in minutes or hours. This rapid change is unique to hives.
CAUSES
Release of histamines, sometimes for unknown reason. Following are the most common causes:
Medications. Nearly every drug causes hives in some children.
Insect bites.
Viral infections.
Auto-immune disease.
Dysproteinemias.
Exposure to cold, heat, water, or sunlight.
Cancer, especially leukemia.
Exposure to animals, especially cats.
Eating eggs, fruits, nuts, and shellfish. Other foods sometimes cause hives in infants but not in adults.
Food dyes and preservatives (possibly).
RISK FACTORS
Stress; other allergies or a family history of allergies.
PREVENTING COMPLICATIONS OR RECURRENCEIf your child has had hives and you have identified the cause, avoid the source.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; allergy skin tests and desensitization injections (sometimes).
POSSIBLE COMPLICATIONS
Swelling of the child's larynx and inability to breathe.
Hives may be the first sign of life-threatening anaphylaxis. If so, it will be followed by itching, a runny nose, wheezing, paleness, cold sweats, and low blood pressure. Without prompt treatment, coma and cardiac arrest can occur.
PROBABLE OUTCOME
Unpredictable, depending on the cause. If a medication or acute viral infection is responsible, hives usually disappear within hours or days. Some cases become chronic and last for months or years. Most eventually go into spontaneous remission -- even if the cause is not identified.
TREATMENT
HOME CAREInstructions for your child:
Don't take drugs (including aspirin, laxatives, sedatives, vitamins, antacids, pain killers, or cough syrups) not prescribed for you.
Don't wear tight underwear or foundation garments. Any skin irritation may trigger new outbreaks.
Don't take hot baths or showers.
Apply cold-water compresses or soaks to relieve itching.
MEDICATION
Your doctor may prescribe:
Antihistamines, ephedrine, terbutaline, or cortisone drugs to relieve itching and rash.
Sedatives or tranquilizers for anxiety.
Epinephrine by injection for severe symptoms.
ACTIVITY
Your child should decrease activities until several days after hives disappear and should avoid getting hot, sweaty, or excited.
DIET & FLUIDS
If foods are suspected as a cause, keep a food diary for your child to help identify the offending food.
Urge your child to avoid alcohol and coffee or other caffeine-containing beverages. These may trigger outbreaks.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
The following emergency symptoms occur during an episode of hives: swollen lips; shortness of breath or wheezing; a tight or constricted feeling in the throat.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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