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Uritcaria and
angioedema (Aetiology (Idiopathic
Food e.g. nuts,…
Uritcaria and
angioedema
Definitions
Urticaria
Superficial swelling involving superficial dermis,
raising the epidermis
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Pathophysiology
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Mast cells release histamine (vascular permeability),
also PGs, LTs, chemotactic factors
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Aetiology
Idiopathic
Food e.g. nuts, shellfish, dairy, fruit)
Insect bites
Contact e.g. latex
Drugs
NSAIDs, ACEi, penicillin, contrast media, morphine
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Clinical
presentation
UrtIcarial rash
Erythematous, raised wheals, itchy
Angioedema
Swollen tongue/lips
Diagnosis
Examination
Derm exam
Profuse erythematous wheals,
swollen lip/tongue
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History
DH
Current/recent meds, allergies
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SH
Living arrangements, occupation/school,
diet, exercise, pets, smoking
PC/HPC
Rash, swelling (SOCRATES)
Previous episodes, known trigger
Management
Conservative
Information, advice, support
Refer for skin prick testing (immunologist)
Lifestyle (avoid trigger)
Medical
Steroids
Indication: severe acute urticaria, angioedema
MOA: reduce inflammation
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Antihistamines
Indication: urticarial rash
E.g. cetirazine, loratadine
MOA: H1 receptor antagonist,
prevent histamine release