Common Misconceptions About Urticaria

Prof. Dr. İnsu Yılmaz, Member of the Board of the Turkish National Allergy and Clinical Immunology Society addressed common misconceptions about urticaria, also known as hives, on 1 October World Urticaria Day. Yılmaz stated, "Subjecting these patients to unnecessary and incorrect dietary restrictions will not improve the disease; instead, it can stress the patient and further exacerbate the condition." Urticaria, commonly referred to as hives in everyday language, is not a life-threatening disease but is listed among conditions that seriously affect quality of life. Sometimes swelling that appears in specific parts of the body, known as angioedema, can accompany this disease. In urticaria, skin lesions called "urticaria" manifest as redness, swelling, itching, and recurrent appearances and disappearances. If this lasts less than 6 weeks, it is called acute urticaria. If it lasts longer than 6 weeks, it is classified as chronic urticaria. Every person has approximately a 20 percent chance of experiencing acute urticaria at some point in their lifetime. Chronic urticaria appears in approximately 1 to 3 percent of the population. While the causative factor is often unknown in acute urticaria, Prof. Dr. İnsu Yılmaz, Member of the Board of the Turkish National Allergy and Clinical Immunology Society, stated that infections, foods, and medications can trigger acute urticaria. He noted that antihistamine medications are used in acute urticaria treatment, and in some cases, corticosteroid therapy is added as well. Yılmaz pointed out that causative factors are investigated thereafter, emphasizing that during this process, it is necessary to determine whether the patient has an infection, check for medications that could be triggers, and question dietary factors.

Yılmaz, explaining that chronic urticaria is divided into two categories—chronic spontaneous (idiopathic) urticaria and inducible urticaria—continued as follows:

"In chronic spontaneous urticaria, which is more common than inducible urticaria, there is no causative factor. The body itself produces the urticaria and eliminates it after a certain period. It can last an average of 5 years. It is a condition related to the body producing antibodies against its own cells and showing a reaction (auto-allergy) or developing an autoimmune response against its own allergy cells. In other words, it has no relationship with external triggers such as foods. Subjecting these patients to unnecessary dietary restrictions will not improve the disease; instead, it can stress the patient and further exacerbate the condition. In chronic spontaneous urticaria treatment, antihistamines can be used, and in resistant cases, medications such as omalizumab or cyclosporine. Chronic inducible urticaria is a less common form of chronic urticaria. This group is mostly composed of physical urticarias. Some examples include symptomatic dermographism, which is pressure-related urticaria, solar urticaria, heat urticaria, vibratory urticaria, and cold urticaria."

Develops more easily in areas under body pressure

Yılmaz stated that symptomatic dermographism, the most common form among these, is observed in many cases, noting that in such cases there is continuous itching on the body, redness and swelling appear in the areas the patient scratches, and they disappear after a certain time. Yılmaz concluded with the following remarks: "In areas under pressure (regions exposed to pressure from socks, belts, etc.), patients feel this condition more intensely. Another type of inducible urticaria is cholinergic (heat-induced) urticaria. It manifests particularly with pinpoint rashes appearing as a result of hot baths or sweating, and it is very itchy. In the treatment of inducible urticaria, staying away from triggering factors and using antihistamines can help. Our patients should never become anxious about this disease, should know that even the chronic form will certainly resolve, and should never give up. They should also know that there are medications available to control their urticaria."