Urticaria Flashcards Preview

Dermatology - Clinical Medicine IV > Urticaria > Flashcards

Flashcards in Urticaria Deck (34):
1

What is the duration of acute?

2

What is the duration of acute?

3

What is duration of chronic?

>6 wks, 50% resolve in 6 mo, 20% in 12-36 mo, small amount >36 mo

4

What is the recurrance rate of chronic urticaria?

25-40%

5

What is the etiology of urticaria?

Idiopathic
Food/Food additives
Drugs
Physical contact
Insect bites
Hypersensitivity
Infectious diseases
Systemic disease

6

What are the physical causes of urticaria?

Dermatographism
Cold
Pressure
Vibration
Heat
Sunlight (solar)
Emotional stress
Exercise

7

What are acute causes of urticaria?

Infection (40%)
Drug (10%)
Food (≤ 1%)
Idiopathic (50%)

8

What is the chronic cause of urticaria?

Autoimmune (40-50%)
Chronic Infection (≤5%)
Idiopathic (50%)

9

Who gets acute urticaria?

common in children

10

Who gets chronic urticaria?

4th to 5th decades, women

11

What labs do you want for urticaria?

CBC; Sed rate; Thyroid panel; ANA; RF; serology- Hep B
Parasitology

12

What skin testing do you do?

allergic extracts, screening for dermatographism

13

When do you get skin biopsy?

urticaria vasculitis

14

What is the tx for life threatening urticaria?

ED for resuscitation

15

What are the meds for urticaria?

Oral Histamines
H1 blocker 1st generation
Hydroxyzine 25 mg Po q 6 hrs
Diphenhydramine 25-50 mg PO q 6-8 hrs
H1 blocker 2nd generation
Loratadine 10 mg qd
Cetirizine 10 mg qd
Fexofenadine 180 mg
H2 blockers
Cimetidine (Tagamet) 300 mg 4 x a day (or 800 mg qd)
Famotidine (Pepcid) 40 mg qd
Ranitidine (Zantac) 150 mg BID (or 300 mg qd)
Tricyclic antidepressant/ antihistamine
Doxepin (Sinequan)10-25 mg q 3-4 times a day (or 25-50 mg qd)
Glucocorticoids
Prednisone 40-60 mg daily x 5 days
Not indicated for long term use

16

What is the treatment for chronic urticaria?

Omalizumab (Xolair)
Monoclonal antibody that binds to IgE and inhibits binding to cell receptors
Doxepin Cream (Zonalon) 5%
Capsaicin

17

When do you give dermatology referral?

chronic urticaria and urticarial vasculitis

18

What is the prognosis?

acute - excellent - resolves 1-4 days
chronic - variable

19

What is duration of chronic?

>6 wks, 50% resolve in 6 mo, 20% in 12-36 mo, small amount >36 mo

20

What is the recurrance rate of chronic urticaria?

25-40%

21

What is the etiology of urticaria?

Idiopathic
Food/Food additives
Drugs
Physical contact
Insect bites
Hypersensitivity
Infectious diseases
Systemic disease

22

What are the physical causes of urticaria?

Dermatographism
Cold
Pressure
Vibration
Heat
Sunlight (solar)
Emotional stress
Exercise

23

What are acute causes of urticaria?

Infection (40%)
Drug (10%)
Food (≤ 1%)
Idiopathic (50%)

24

What is the chronic cause of urticaria?

Autoimmune (40-50%)
Chronic Infection (≤5%)
Idiopathic (50%)

25

Who gets acute urticaria?

common in children

26

Who gets chronic urticaria?

4th to 5th decades, women

27

What labs do you want for urticaria?

CBC; Sed rate; Thyroid panel; ANA; RF; serology- Hep B
Parasitology

28

What skin testing do you do?

allergic extracts, screening for dermatographism

29

When do you get skin biopsy?

urticaria vasculitis

30

What is the tx for life threatening urticaria?

ED for resuscitation

31

What are the meds for urticaria?

Oral Histamines
H1 blocker 1st generation
Hydroxyzine 25 mg Po q 6 hrs
Diphenhydramine 25-50 mg PO q 6-8 hrs
H1 blocker 2nd generation
Loratadine 10 mg qd
Cetirizine 10 mg qd
Fexofenadine 180 mg
H2 blockers
Cimetidine (Tagamet) 300 mg 4 x a day (or 800 mg qd)
Famotidine (Pepcid) 40 mg qd
Ranitidine (Zantac) 150 mg BID (or 300 mg qd)
Tricyclic antidepressant/ antihistamine
Doxepin (Sinequan)10-25 mg q 3-4 times a day (or 25-50 mg qd)
Glucocorticoids
Prednisone 40-60 mg daily x 5 days
Not indicated for long term use

32

What is the treatment for chronic urticaria?

Omalizumab (Xolair)
Monoclonal antibody that binds to IgE and inhibits binding to cell receptors
Doxepin Cream (Zonalon) 5%
Capsaicin

33

When do you give dermatology referral?

chronic urticaria and urticarial vasculitis

34

What is the prognosis?

acute - excellent - resolves 1-4 days
chronic - variable