URTICARIA / PAPULAR URTICARIA

Urticaria is a reactive phenomenon which is characterised by itching
wheals (hives). These may be any shape or size, appear anywhere on the
body and as angioedema in the face, at any interval. Sometimes there is
a single attack of urticaria, sometimes there are attacks every few hours.
Urticaria may come and go during a few days or persist for many years.
There are many types of urticaria and possible causes of urticaria: contact
urticaria (e.g. stinging nettles, caterpillars, formaldehyde); physical
urticaria (cold, heat, pressure); cholinergic urticaria (sweat, exerciseinduced);
Drug-induced non-allergic urticaria (aspirin, pethidine, morphine,
hydralazine); allergic urticaria by drugs (see drug eruptions), food
(fish, milk, nuts, tomatoes, citrus fruits, cocoa, strawberries), insect allergens
(bee, wasp), vaccines, worm infestations, and internal diseases.
This list is not complete.
Papular urticaria is a specific form of urticaria which occurs again and
again in susceptible children. It presents as very itchy persistent hives
and papules, sometimes with vesicles on top. It is an exaggerated
response to contact with insects, their vomits and bites. When extensive
the rash may resemble HIV related papular pruritic eruption (though this
usually occurs in adults) or scabies (in papular urticaria other family
members are not affected).
Management of urticaria /
papular urticaria
- Avoid or treat the cause if possible.
A thorough history is essential.
- Calamine lotion or phenol-zinc lotion.
- Antihistamines, a low or high dose may be
required, this varies per patient.
- Topical steroids if necessary.
- Avoid the use of aspirin.
- Papular urticaria: Insect repellents and
impregnated bednets.