What is Chronic Urticaria?

Urticaria is a disease characterized by the development of raised hives (hives), edema (swelling), or both. Hives or urticaria are localized itchy and swollen patches of varying size; lesions are fleeting, last less than 24 hours in one place and do not leave traces. When the swelling involves deeper tissue, we call it "angioedema".

Chronic Spontaneous Urticaria (CSU), also called Chronic idiopathic Urticaria (CIU), refers to a certain type of skin condition.

The name is self-explanatory:

We use the term "chronic" to define something that lasts for a long time, or that repeats itself over and over again.
The words "spontaneous or idiopathic" refer to something unprompted, for which the cause is unknown.
Hives (urticaria) are raised patches (papules) that are normally surrounded by a red ring. These patches appear and disappear within 24 hours, and are often associated with itching and/or burning.
Urticaria can also be acute.  Exposure to certain medications and viral infections, for example, can cause acute urticaria. In these cases, it often resolves in less than 6 weeks.

Engiodema

Urticaria & swelling

Urticaria

Acute urticaria (99%)

Allergic

Non allergic

Chronic urticaria (1%)

Chronic spontaneous urticaria

Autoimmune

Chronic inductible urticaria

Physical:

with cold

  • Cold urticaria

  • Delayed pressure urticaria

  • Heat urticaria

  • Solar urticaria

  • Symptomatic dermographism

  • Vibratory angiodema

Others:

  • Aquagenic urticaria

  • Cholinergic urticaria

  • Contact urticaria

Chronic urticaria, a skin disease

Chronic urticaria is not an allergic disease.  It’s a chronic inflammatory disease of the skin that awakens with viral infections, drugs or stress …

The lesions persist due to the presence of fragile skin mast cells or hypersensitivity.

PHYSICAL URTICARIES

Physical urticaria usually develops over several years. They have the distinction of appearing only after external physical stimulation. The diagnosis is often simple, because the urticaria appears most often in the minutes following the stimulation, and then disappears quickly when it stops. They can be confirmed by provocation tests.

Cold

A relatively rare form of physical urticaria can be caused by exposure to cold or by lowering the body temperature. The ice cube test confirms the patient’s reactivity to cold by provoking the desired conditions.

Delayed pressure

Particularly disabling, like dermographism, it occurs on pressure zones, but with a delay of several hours. For example :

  • Shoulders after wearing a backpack;

  • On the palm of a hand when handling a tool for a long time;

  • Soles of the feet, after playing golf …
     

It manifests through painful edema that sometimes takes several days to disappear.

Urticaria from heat

A very rare form of physical urticaria that quickly causes itching, redness and the appearance of papules during passive warming of the skin. Hot baths, saunas, hot drinks, spicy food or sunbathing are situations that can trigger hives. For the provocation test, the arm is immersed in hot water.

Solar

Redness appears a few minutes after the beginning of exposure to areas that are in direct contact with ultraviolet rays from the sun. It disappears rather quickly when the exposure stops.

Dermographism

Dermographism, the most common form of physical urticaria,  is caused by the simple rubbing of the skin, tight clothing, electric hair removal or waxing …

Vibratory

The rarest of physical urticaria, is triggered by vibrations of different kinds:

  • jackhammer or other tools;

  • lawn mower;

  • snow blower;

  • mountain bike, motorcycle …

Urticaria is most often manifested by painful edema.

OTHER FORMS OF URTICARIA

Aquagenic

Choligenic

Induced by an increase of body heat during a physical activity, a hot shower or bath, an emotional outburst, ingesting certain foods or hot drinks. This form manifests itself by numerous pinhead-sized lesions that are predominantly on the thorax. The urticaria may disseminate over the whole body, with the exception of the face.

By Contact