Unexplained itching of the skin "rash" - acute urticaria

Unexplained itching of the skin "rash" - acute urticaria

In the emergency department, we often encounter the following scenario: the patient comes to the triage desk and tells the triage nurse that he is itchy and scratches his body. The patient's skin is flushed with rash and burning sensation... The triage nurse immediately triages the patient and measures vital signs. The nurse immediately tells the doctor that there is a patient who needs to be treated first . The patient is finally diagnosed with acute urticaria.

In daily life, wheals inexplicably grow on the skin of the body, accompanied by itching, which sometimes lasts for several hours, sometimes takes several days to subside, and will recur, making people very painful. Acute urticaria is a localized edema reaction caused by the dilation of small blood vessels in the skin and mucous membranes and increased permeability. The main symptoms of patients: wheal-like rashes of varying sizes, itching, and burning sensations on the skin; angioedema, fever, nausea, vomiting, abdominal pain, diarrhea, hypotension, throat edema, difficulty breathing, etc., and even suffocation or shock may occur.

The causes or triggers of urticaria are more complicated:

(I) Exogenous: 1. Physical factors ( friction, pressure, temperature, sun exposure, contact with objects, etc.). 2. Food ( animal proteins such as fish, shrimp and eggs, fruits and vegetables, as well as wine and beverages) and food additives . 3. Inhalants ( plant pollen, dust mites, animal fur, etc. ). 4. Drugs ( penicillin, cephalosporins, sulfonamides, serum preparations, various vaccines, etc. ). 5. Implants ( artificial joints, staplers, heart valves, orthopedic steel plates or nails, and IUDs, etc. ). 6. Contact or bites or stings ( by ants, bees, caterpillars, etc. ).

(ii) Endogenous factors: autoinflammatory reactions caused by infections ( bacterial, fungal, viral, parasitic, etc. ), fatigue or mental stress, autoimmune reactions, etc.

How to deal with symptoms :

If the patient only has a rash accompanied by itching, it is recommended that the patient take anti-allergic drugs and observe the symptoms; if it is suspected to be related to food or drugs, look for possible food or drug-induced or aggravating factors and avoid them, but there is no need to abstain from food blindly; if the urticaria is related to infection or inflammation and is resistant to or ineffective with other treatments, anti-infection or inflammation control treatment may be considered as appropriate; avoid corresponding stimuli or inducing factors, such as emotional and mental stress, and the patient should maintain a happy mood, which will help relieve symptoms.

If the patient develops symptoms such as systemic wheal rash, itching, burning sensation, angioedema, fever, nausea, vomiting, abdominal pain, diarrhea, hypotension, throat edema, difficulty breathing, or even suffocation or shock, go to the hospital immediately or call 120.