What are the symptoms of urticaria

Urticaria is a relatively common skin allergy disease, which is quite harmful to patients, especially severe urticaria, which often leads to repeated attacks and endangers patients' health for many years. The most common skin manifestation of urticaria is wheal, which causes itching, pain and other symptoms in patients. Severe cases may even cause sore throat and difficulty breathing.

1. Adrenal urticaria

It manifests as small, itchy wheals surrounded by white halos. It can be caused by emotional excitement or coffee ingestion. Intradermal injection of norepinephrine can cause wheals. The disease is caused by sensitivity to norepinephrine secreted by sympathetic nerve endings and should be differentiated from cholestatic urticaria. Clinical treatment often uses beta-blockers and antihistamines, and avoids the use of epinephrine.

2. Compression urticaria

4 to 8 hours after the skin is compressed, red edematous patches occur locally on the skin. The edema is often deep and involves the dermis and subcutaneous tissue, similar to angioedema, with a burning or painful sensation that lasts for about 8 to 12 hours before disappearing. About half of the patients may experience systemic symptoms such as fever, sweating, dizziness, headache, nausea, fatigue, weakness, shortness of breath, irritability, etc. A few may also show signs of mental depression, which is common in compressed areas such as the soles of the feet and buttocks after walking. The white blood cell count may be slightly increased.

3. Autoimmune urticaria

Circulating autoantibodies were found in the serum of some patients with chronic idiopathic urticaria, hence the name. According to statistics, autoantibodies were found in at least 30% of patients with chronic idiopathic urticaria. Intradermal injection of autologous serum can cause wheals and erythema reactions. There are IgG autoantibodies against IgE or high-affinity IgE receptor (FcεRla). Both of the above autoantibodies release histamine and can stimulate eosinophils in the blood. The condition of urticaria is directly related to the amount of autoantibody FcεRIa in the serum.

4. Solar urticaria

A few seconds to minutes after the skin is exposed to sunlight or artificial light, local itching, erythema, wheals, and occasionally angioedema may occur. In severe cases, the rash may be accompanied by chills, fatigue, syncope, spasmodic abdominal pain, bronchospasm, etc. It is often idiopathic and sometimes associated with systemic lupus erythematosus, erythropoietic protoporphyria, etc.