Hives (Urticaria)

Home / Medical Conditions / Hives (Urticaria)

Hives are raised often itchy red bumps called welts or wheals on the surface of the skin. They are often an allergic reaction to food, medicine, insect bites or sunlight.
In Early Childhood and Infancy

Types

Acute urticaria is hives lasting less than 6 weeks
Acute angioedema
Chronic urticaria lasting longer than 6 weeks
Chronic angioedema
Physical urticaria Caused exposure to sunlight, cold air or water, heat, vibration, sweating, exercise, and pressure. These hives typically develop due to direct physical stimulation of the skin
Dermatographism is called “Writing on the Skin”. It results in localized Hives where normal skin is stroked with a dull object. Dermatographism is also called mechanical urticaria.
Hereditary angioedema is associated with a deficiency in an acute-phase protein called C1-inhibitor.

Causes

Since there are many types of Hives there are also different causes of hives. Each type is listed with each possible cause bellow. Please consult with your doctor because all causes are not listed and might not even be known at this time.

Physical urticaria Caused exposure to sunlight, cold air or water, heat, vibration, sweating, exercise, and pressure. These hives typically develop due to direct physical stimulation of the skin.

The cause of Dermatographism is unclear but likely to be caused by ‘mechanico-immunological’ stimulation of mast cells that release histamine in the absence of a typical immune signal.

Hereditary Angioedema

In General

Patients may be considered atopic if they have a first degree family history or person history of asthma, allergic rhinitis, or atopic dermatitis. Atopic means that they have a predisposition to these items.
Causes of Hives in infants may be due to benign viral illnesses, often associated with antibiotic drug therapy. In a one study 58% of early childhood and infants with acute urticaria had the criteria for atopy.1

Symptoms

Hives causes itching.
Patients with Dermatographism experience extreme itching.

Diagnosis

To diagnose any of these types of hives or angioedema, a full medical history evaluation and physical examination must be performed.

Prevention

Acute urticaria is common in toddlers with atopic dermatitis and may be prevented with cetirizine in this high-risk population according to a study of toddlers.

If a history of physical urticaria is known, skin tests may be performed to test for certain allergies.

Treatment

Acute urticaria in infants can be treated with Oral antihistamines such as dexchlorpheniramine maleate, terfenadine, or hydroxyzine hydrochloride.2

Dermatographism’s treatment may include avoidance of the physical stimuli that caused it, reduction of stress and anxiety. H1-antihistamines are medications used to treat it. Combining H1 and H2 antihistamines has sometimes resulted in better control of the wheals. Other treatment options like NB-UVB therapy and psovalent + UVA (PUVA) therapy have been used with limited success.2

Mortureux P, Léauté-Labrèze C, Legrain-Lifermann V, Lamireau T, Sarlangue J, Taïeb A. Acute Urticaria in Infancy and Early Childhood: A Prospective Study. Arch Dermatol. 1998;134(3):319-323. doi:10.1001/archderm.134.3.319.

Prevention of acute urticaria in young children with atopic dermatitis
Simons, F.Estelle R.
Journal of Allergy and Clinical Immunology , Volume 107 , Issue 4 , 703 – 706

Dermatographism
Bhute Dipti, Doshi Bhavana, Pande Sushil, Mahajan Sunanda, Kharkar Vidya

Year : 2008 | Volume: 74 | Issue Number: 2 | Page: 177-179