URTICARIA
Definition
Symptoms (EJ)
1.urticaria: local wheals (hives) & erythema in the dermis (hives are raised, erythematous and edematous
plaques, with sharply defined borders often with pale centers & red borders known as an erythematous halo (2
zones) & individual hives last less than 24 hours)
2. angioedema: a similar eruption but with larger edematous areas that involve the dermis & subcutaneous area
as well
3. if accompanied by fever & arthralgia, may be prodrome to viral hepatitis, or a serum sickness reaction
4. pruritis is common complaint
DDx
1. erythema multiforme
2. juvenile rheumatoid arthritis
3. erythema marginatum
4. necrotizing vasculitis (persistent urticaria > 96 hours)
5. cholinergic urticaria (exercise to sweating)
6. angioedema-urticaria-eosinophilia syndrome (fever, high leukocytes, increase in body weight, cyclic pattern
over period of years)
Etiology/Epidiemology
Acute: usually disappears within 48 hours - due to drug allergy (ask about prescription & over-the-counter), insect
stings & bites, desensitization injection, foods(particularly shellfish, eggs, nuts, and fruits) , viral infections
(hepatitis, mononucleosis, rubella), unknown cause (EJ)
Chronic: lasting more than 3 weeks & difficult to find cause - idiopathic, unsuspected chronic drug or chemical
ingestion, chronic underlying disease (SLE, polycythemia vera, lymphoma, infection) (EJ)
Other causes could include cold, pressure, sunlight, emotions (EJ)
The hives may follow severe viral or streptococcal infections, or be a result of a chronic infection (check
dental abscesses for instance).
Pathophysiology (EJ)
1. mechanisms:
immunologic: IgE mediated; complement mediated
nonimmunologic: agents directly causing mast cell degranulation (opiates); agents that cause alteration in
arachidonic acid metabolism (aspirin, NSAID)
2. result of insult is vasodilation, increased vascular permeability & extravasation of proteins & fluids mediated
principally by histamine
Key PE
Key Lab
Strategy (EJ)
1. discontinue any suspected medication
2. avoidance therapy for physical urticarias
3. may try topical palliative treatment for urticaria
4. anti-histamine therapy
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URTICARIA
TX PROTOCOLS
Nutrient Considerations (EJ)
1. Vit. C & bioflavinoids
2. Pantothenic acid
3. omega-3 oils
4. vit E
5. Hesperedin-Catechin Complex (Thorne)
6. Allerplex or Antronex (Standard Process)
7. vit K
8. selenium
9. 10. check HCL levels & possibly supplement
10. beta-carotene
11. vit B-12
Dietary Considerations (EJ)
1. Salicylate free diet (stone fruits, orange, nut, strawberry, tomato, pea & bean, shellfish)
2. Preservative & additive free diet
3. Brewer's yeast free diet
4. Tyramine free diet (banana, pineapple, old cheese)
5. Alcohol free diet
Botanicals
1. Comfrey gel & ointment (JH)
2. Euphorbia (EM)
3. Yerba sante (EM)
4. Feverfew (EM)
5. euphorbia, yerba santa, feverfew (equal parts) (EJ)
6. quercitin (EJ)
7. ephedra (EJ)
8. urtica (EJ)
9. coleus forshoklii (EJ)
10. crataegus (EJ)
11. curcumin (EJ)
12. gingko (EJ)
13. momardica charanta (EJ)
14. tanacetum (EJ)
15. zingiber (EJ)
16. garlic (EJ)
17. bromelain (EJ)
Homeopathy
1. Apis (B&T) (EJ)
2. Ant C (B&T)
3. Antipyr (B&T)
4. Bombyx (B&T)
5. Copaiv (B&T)
6. Fragaria (wood strawberry) (B&T)
7. Nat mur (B&T)
8. urtica (EJ)
9. homeopathic histamine (EJ)
Physical Medicine
1. Cold application
2. Hives may be somewhat relieved by drinking large amounts of water, and irrigating the bady with an
enema to help get rid of waste materials.
3. A dry hot pack, which can be used even for the very young, will create heavy perspiration, drain off the
irritating substances, and also stimulate the liver and the kidneys.
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URTICARIA
Oriental Medicine
Acupuncture
1. Liver & Spleen channels: med to strong stimulation, once a day, retain needle 15-20 minutes.
Liv. 13, 14,2
SP 6, 10
ST 36
(Outline of Chinese Acupuncture)
Psychology
Other
Avoid allergens
TOPICAL:
1. impatience capensis ice cubes
2. baking soda bath
3. Avena bath
4. flowers of sulphur bath
5. symphytum gel or ointment
6. plantain
7. chickweed cream
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