28 سنوات
Recenly i have been suffering from hives after exercise or when i get hot or even when under stress. Any advise????should i take claritine?
14 نوفمبر 2014
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Cholinergic urticaria is one of the physical urticaria (commonly referred to as hives) that gets provoked during sweating. It usually presents with a number of small, short-lasting hives but may also have accompanying cutaneous inflammation (wheals) and pain which develops usually in response to exercise, bathing, staying in a heated environment, or emotional reactions such as excitement, shock, laughter, stress, and anxiety.
Cholinergic urticaria appears rather rapidly, usually within a few minutes after the onset of sweating, and lasts from a half hour to an hour or more, with a mean duration of about 80 minutes.
Although symptoms of Cholinergic urticaria tend to subside rapidly, commonly within 1 hour, they are sufficiently uncomfortable to cause many patients to change their patterns of activity to prevent attacks.
Exercise is the most common precipitating event for cholinergic urticaria, but any stimulus that causes sweating, including elevated environmental temperature, hot food, sauna baths, immersion in hot water, gustatory stimuli, emotional stress can precipitate an urticarial attack in some persons. Exercise and hot baths exacerbate pruritus (itchiness) and provoke lesions in previously unaffected areas.
Often in cholinergic urticaria, itching, burning, tingling, warmth, or irritation precedes the onset of numerous small (1-4mm in diameter), pruritic wheals with large, surrounding flares.
Sweat hypersensitivity
This subtype of cholinergic urticaria refers to those who are hypersensitive to their own sweat. The hives are observed to coincide with perspiration points of sweating.
Treatment
• It is important to always keep in mind when deciding on the treatment approach that cholinergic urticaria is in most cases a self limited condition. Traditional treatment options for cholinergic urticaria are antihistamines, leukotriene inhibitors, and immunosuppressives. However, cholinergic urticaria in some patients may be refractory.
• Non-pharmacological treatment: Forced perspiration by excessive body warming (hot bath or exercise) used daily may reduce the symptoms through exhaustion of inflammatory mediators. This method is contraindicated with people who have poor sweating (hypohydrosis)
• Antihistamines are a commonly prescribed first-line treatment for conventional urticaria, but they are not as effective in the treatment of cholinergic urticaria. If it is to be used, we opt for first-generation antihistamines with anticholinergic properties such as diphenhydramine; these have sedating properties (they numb the itchiness) and are most successful at treating cholinergic urticaria.
Cholinergic urticaria appears rather rapidly, usually within a few minutes after the onset of sweating, and lasts from a half hour to an hour or more, with a mean duration of about 80 minutes.
Although symptoms of Cholinergic urticaria tend to subside rapidly, commonly within 1 hour, they are sufficiently uncomfortable to cause many patients to change their patterns of activity to prevent attacks.
Exercise is the most common precipitating event for cholinergic urticaria, but any stimulus that causes sweating, including elevated environmental temperature, hot food, sauna baths, immersion in hot water, gustatory stimuli, emotional stress can precipitate an urticarial attack in some persons. Exercise and hot baths exacerbate pruritus (itchiness) and provoke lesions in previously unaffected areas.
Often in cholinergic urticaria, itching, burning, tingling, warmth, or irritation precedes the onset of numerous small (1-4mm in diameter), pruritic wheals with large, surrounding flares.
Sweat hypersensitivity
This subtype of cholinergic urticaria refers to those who are hypersensitive to their own sweat. The hives are observed to coincide with perspiration points of sweating.
Treatment
• It is important to always keep in mind when deciding on the treatment approach that cholinergic urticaria is in most cases a self limited condition. Traditional treatment options for cholinergic urticaria are antihistamines, leukotriene inhibitors, and immunosuppressives. However, cholinergic urticaria in some patients may be refractory.
• Non-pharmacological treatment: Forced perspiration by excessive body warming (hot bath or exercise) used daily may reduce the symptoms through exhaustion of inflammatory mediators. This method is contraindicated with people who have poor sweating (hypohydrosis)
• Antihistamines are a commonly prescribed first-line treatment for conventional urticaria, but they are not as effective in the treatment of cholinergic urticaria. If it is to be used, we opt for first-generation antihistamines with anticholinergic properties such as diphenhydramine; these have sedating properties (they numb the itchiness) and are most successful at treating cholinergic urticaria.
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