The world ofurticaria“to always be addressed with great care and attention, as hives could be there external and visible manifestation of a pathological condition, organ or systemic, which silently broods without giving macroscopically appreciable signs. Several cases of urticaria are caused by allergic reactions, although the triggering agents can be multiple: drugs, foods, pollen, mites, animal hair and dander, fungal spores, chemical substances such as drugs or contrast agents or insect venom or contact with stinging herbs. But an acute or chronic picture of urticaria will always be appropriate to approach with an approach that is as open as possible to expanded clinical options, trying where possible to overcome the often limiting concept of forms defined as ‘idiopathic’ and, in any case, always distrusting and excluding the inconclusive appeal to ifake initiatives of inconclusive and fake intolerance testsuntil to fake news“. The immunologist takes stock of urticaria Mauro Minelliprofessor of dietetics and human nutrition at the Lum University of Bari.
How is allergic reaction urticaria treated? “Some patients – the immunologist takes stock – respond well to antihistamine therapy, others may require cortisone treatment. In more complex cases there are reports on the use of biological drugs. In other published studies, patients with urticaria were examined chronic and high D-dimer levels, in which the use of anticoagulants seems to have given good results. And there are also cases of urticaria secondary to focal pathologies (dental granulomas), cases of urticaria in patients with infections such as Helicobacter pylori. , with a fair percentage of remission of urticaria after eradicating therapy. And then there are urticaria caused by parasites (helminths, pinworms, anisakis) and those that can result from physical trauma, the action of additives, dyes, or intense conditions. of emotional stress or even to a non-immunological activation of the complement”.
“On the clinical side, urticaria, which when they regress within 6 weeks of onset they are defined as ‘acute’ – specifies Minelli – they are characterized by the sudden appearance of ‘wheals’ which vary in number and location. These are red and itchy, fleeting rashes of different shapes and sizes ranging from a few millimeters to a few centimeters in diameter. Generally i wheals they appear in a rounded shape, or in the form of rings and large patches. They usually disappear more or less quickly and then reappear, in successive bursts, accompanied by itching, in different body sites. In some cases, on the eyelids, auricles, genital organs, hands, feet, together with the wheals, a swelling of the tissues (angioedema) which is little or no itchy but often painful”.
“Sometimes extensive urticaria can be associated with systemic cardiovascular manifestations (hypotension up to shock), respiratory (dyspnea, cough) or gastrointestinal (abdominal pain, diarrhea, vomiting) – warns the immunologist – In some cases of chronic urticaria it may also be useful to explore the thyroid, considering that the thyroid hormones tetra-iodothyronine or thyroxine (T4) and tri-iodothyronine (T3) also play an important role in maintaining normal skin functions, in particular oxygen consumption, synthesis protein, mitoses, skin thickness, hair growth and normal sebum secretion. It follows – concludes Minelli – that any alterations of the skin and its appendages could be associated with malfunctions of the thyroid and in particular with hyperthyroidism or hypothyroidism, perhaps due to autoimmune diseases affecting the gland”.
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