Urticaria, commonly known as hives, is a common skin condition characterized by itchy, raised welts. It is categorized into two types: chronic and acute. The primary differences between the two lie in the duration of the condition and the underlying causes. Understanding these distinctions is crucial for effective treatment and management.
Course of Disease
Acute Urticaria: Acute urticaria has a sudden onset, with symptoms typically subsiding within 24 hours, though they may recur. The total duration of the condition does not exceed six weeks.
Chronic Urticaria:Chronic urticaria is characterized by persistent or intermittent symptoms lasting more than six weeks. Some patients may experience it for months or even years, with daily or weekly recurrences of welts.
Causative Factors
Acute Urticaria:Often triggered by specific causes, such as food allergies (e.g., seafood, nuts), drug reactions (e.g., penicillin, aspirin), insect bites, or viral infections.
Chronic Urticaria: Approximately 50% of chronic urticaria cases have no identifiable cause. It may be associated with thyroid diseases, chronic infections, or immune system disorders.
Symptom Characteristics
Both chronic and acute urticaria present with itchy skin welts. Acute urticaria may also be accompanied by angioedema (swelling of the deeper layers of the skin), particularly around the eyelids and lips, or systemic symptoms such as fever and abdominal pain. Chronic urticaria typically manifests only on the skin, with welts of varying sizes and shapes, and may be accompanied by a positive scratch test.
Treatment Principles
Acute Urticaria: Treatment primarily involves antihistamines such as loratadine and cetirizine. In severe cases, glucocorticoids may be required.
Chronic Urticaria: Long-term and regular use of second-generation antihistamines, such as ebastine and fexofenadine, is necessary. For refractory cases, biological agents like omalizumab may be needed.
Prognostic Differences
Acute Urticaria: Most cases of acute urticaria can be completely cured, and recurrence can be prevented by avoiding allergens.
Chronic Urticaria: Chronic urticaria may persist for several years, but about 50% of patients experience spontaneous remission within one year. Regular monitoring is required to check for concurrent autoimmune diseases.
Management Tips for Patients
Patients with urticaria should wear loose, cotton clothing and avoid scratching to prevent skin irritation. Keeping a food diary can help identify allergens. During acute episodes, cold compresses can provide relief from itching. Chronic patients need to maintain a regular schedule and manage stress levels. In some cases, limiting the intake of high-histamine foods, such as pickled and fermented products, may be necessary. Immediate medical attention is required if symptoms worsen or if systemic reactions, such as breathing difficulties, occur.
Conclusion
Understanding the differences between chronic and acute urticaria is essential for effective management. While acute urticaria is often short-lived and manageable with antihistamines, chronic urticaria requires long-term treatment and monitoring. By following medical advice and adopting lifestyle changes, patients can better manage their symptoms and improve their quality of life.
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