Urticaria and Angioedema, anaphylaxis

What is urticaria and angioedema

Same process, different levels of skin

Where does urticaria occur

Dilation of vascular structure in SUPERFICIAL dermis, last for <24h and intesnely pruritic

Where does angioedema occur

Deeper dermis and subcutaneous tissue

Acute urticaria

Exposure to food, environment, drug or viral infection

Chronic urticaria

Idiopathic

Dermatographism

Linear wheal with erythema

Physical urticaria

Pressure: response to stimulus, cholinergic, solar, cold, aquagenic, contact, vibratory

Pressure urticaria

Cholinergic urticaria

Cold urticaria

Dermatogarphism

What is isolated angioedema

Autosomal dominant mutation; idiopathic or from bradykinin generation

Angioedema

What is anaphylaxis

Medication and stinging insects leading trigger in adults; systemic allergic reaction

Anaphylaxis cause

IgE binding and cross linking on surface of mast cell and basophil

Biphasic anaphylaxis

Recurrent anaphylaxis occurs 1-72 hours after first episode; <1%-20% of patients

Anaphylaxis criteria

Sudden onset of illness with skin, mucosal involvement or both (respiratory and BP symptoms)

Augmentation anaphylaxis reaction

Physical exertion, infection, mental stress, drug, alcohol

Concomitant disease in anaphylaxis

Bronchial asthma, cardiovascular disease, mastocytosis, thyroid disease