HOMOEOPATHIC APPROACH TO URTICARIA……

    URTICARIA

DEFINATION:- Urticaria is characterised by very itchy weals (hives),with or without surrounding erythematous flares. The name urticaria is derived from the common European stinging nettle Urtica dioica. Urticaria can be acute or chronic, spontaneous or inducible.

A weal (or wheal) is a superficial skin-coloured or pale skin swelling, usually surrounded by erythema that lasts anything from a few minutes to 24 hours.

Urticaria can co-exist with angioedema which is a deeper swelling within the skin or mucous membranes.

CLASSIFICATION:- Urticaria is classified according to its duration.

·         Acute urticaria (< 6 weeks duration, and often gone within hours to days)

·         Chronic urticaria (> 6 weeks duration, with daily or episodic weals)

Chronic urticaria may be spontaneous or inducible. Both types may co-exis

CHRONIC URTICARIA:- Chronic inducible urticaria includes:

·          Dermographism

·          Cold urticaria

·          Cholinergic urticaria

·          Contact urticaria

·          Delayed pressure urticaria

·          Solar urticaria

·          Heat urticaria

·          Vibratory urticaria

·          Vibratory angioedema

·          Aquagenic urticaria

 Acute urticaria :-acute urticarial can be induced by the following factors, but the cause is not always identified.

·         Acute viral infection—upper respiratory infection, viral hepatitis, infection mononucleosis, mycoplasma

·          Acute bacterial infection—dental abscess, sinusitis

·         Food allergy (IgE mediated)—usually milk, egg, peanut, shellfish

·         Drug    allergy (IgE      mediated drug-induced        urticaria)—often an antibiotic

·         Drug-induced urticaria due to pseudoallergy—aspirin, nonselective nonsteroidal anti-inflammatory drugs, opiates, radiocontrast media; these cause urticaria without immune activation

·          Vaccination

·          Bee or wasp stings

·         Widespread reaction following localised contact urticaria — for example, latex .

CHRONIC URTICARIA :- Chronic spontaneous urticarial is mainly idiopathic (cause unknown). An autoimmune cause is likely. About half of investigated patients carry functional IgG autoantibodies to immunoglobulin IgE or high- affinity receptor FcεRIα.

·          Chronic spontaneous urticaria has also been associated with:

·         Chronic underlying infection, such as Helicobacter pylori, bowel parasites

·         Chronic autoimmune diseases, such as systemic lupus erythematosus, thyroid disease, coeliac disease vitiligo, and others

·         Weals in chronic spontaneous urticaria may be aggravated by:

·          Heat

·          Viral infection

·          Tight clothing

·         Drug pseudoallergy—aspirin, nonsteroidal anti- inflammatory drugs, opiates

·         Food pseudoallergy—salicylates, azo dye food colouring agents such as tartrazine , benzoate preservatives and other food additives .

Inducible urticaria is a response to a physical stimulus.

 

Types	Example of Stimulus.
Dermographism	Stroking or scratching the skin Tight clothing Towel drying after a hot shower
Cold urticaria	Cold air on exposed skin Cold water Ice block Cryotherapy
Cholinergic urticaria	Sweat induced by exercise Sweat induced by emotional upset Hot shower
Contact urticaria	Eliciting substance absorbed through the skin or mucous membrane Allergens (IgE-mediated): white flour, cosmetics, textiles, latex saliva, meat, fish, vegetables Pseudoallergens or irritants: stinging nettle, hairy caterpillar, medicines
Delayed pressure urticaria	Pressure on affected skin several hours earlier Carrying heavy bag Pressure from a seat belt Standing on a ladder rung

	Sitting on a horse
Solar urticaria	Sun exposure to non-habituated body sites Often spare face, neck, hands May involve long wavelength UV or visible light
Heat urticaria	Hot water bottle Hot drink
Vibratory urticaria	Jackhammer
Aquagenic urticaria	Hot or cold water Fresh, salt, or chlorinated water

•  Recurrent angioedema without urticaria can be due to inherited or acquired complement C1 esterase deficiency.

DIAGNOSIS:-

Urticaria is diagnosed in people with a history of weals that last less than 24 hours with or without angioedema. A medication and family history should be elicited. A thorough physical examination should be undertaken.

Treatment :- homoeopathic indication : APIS MELLIFICA:

•  Hives burning, stinging and itching.
•   Rosy red, sensitive sore skin, Stinging pains.
• Urticaria like bee stings, or stings from other insects, with intolerable itching at night, large urticaria.

URTICA URENS:

•   Urticaria burning heat with formication, violent itching.
•  Angioneurotic oedema
• Hives with rheumatism, after shellfish, with pinworms.
• Itching raised , red blotches

PULSATILLA NIGRICANS:

•   Skin itches on being heated
•   Urticaria with rich food, with diarrhoea.
• Urticaria from delayed menses, worse undressing
•  Urticaria in summer.

ANTIMONIUM CRUDUM:

•  Thick hard honey coloured scabs
•  Urticaria, white with red areola, itching fearfully.
•  Itching of the skin, feels sore when scratched.

RHUS TOX:

• Urticaria from getting wet with rheumatism
•  Urticaria during chills and fever
•  Red swollen intense itching.

NATRUM MURATICUM:

•  Obstinate cases with constipation and earthy complexion

RADIUM BROMATUM:

•  Itching of skin all over the body, burning of skin as if on fire.
• Burning swelling and redness.

DULCAMARA:

•  Urticaria red spots, brought on by exposure or sore stomach.
•   Nettle rash over whole body with violent itching.

ARSENICUM ALBUM:

• Skin symptoms alternate with asthma or internal disorders.
•  Itching, burning, swellings oedema.

ANTIPYRINUM:

• Rash, erythema or urticaria, with troublesome itching, chiefly between fingers. Irregular rounded pimples lying close together, in some places confluent, forming patches, between which skin was normal, giving a marbled appearance, lasted five days, turned brownish and desquamated slightly.
• Eruption thickest on body and extremities, extensor more covered than flexor surfaces. Eruptions begins on face and arms, last on legs. Scarlet macular eruption.

CHLORALUM HYDRATUM :

• Urticaria-erythema, intense itching <spirituous liquors, hot drinks, chill >warmth.

COPAIVA OFFICINALIS:

•   Chronic urticaria in children,hives with fever and constipation

ASTACUS FLUVIATILIS:

• Chronic urticaria with nettle rash on whole body with itching

FRAGARIA:

• Swelling of whole body due to urticaria

BELLADONNA:

• Urticarial rash is attended by severe headache with redness of face <touch,noise,lying down

Chronic idiopathic Urticaria pictures

Drug-induced urticarial

Heat urticarial

                                                   Cholinergic urticarial     

 

Urticaria and Angioedema

                                            Chronic spontaneous urticarial

 

Nettle rash urticarial

Dermatographic urticarial

Cold-Induced Urticaria