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Hives
Other names: Urticaria
Hives on the arm
Specialty Dermatology, Clinical immunology, Allergology
Symptoms Red, raised, itchy bumps[1]
Duration A few days[1]
Causes Following an infection, result, of an allergic reaction[2]
Risk factors Hay fever, asthma[3]
Diagnostic method Based on symptoms, patch testing[2]
Treatment Antihistamines, corticosteroids, leukotriene inhibitors[2]
Frequency ~20%[2]

Hives, wanda kuma aka fi sani da urticaria, wani nau'i ne ciwon ne na fatar jiki tare da ja, tashe, ƙaiƙayi. [1] Hives na iya ƙonawa ko ci. [2] Fito da kurji na iya bayyana akan sassa daban-daban na jiki, [2] tare da tsawon lokaci mai canzawa daga mintuna zuwa kwanaki, kuma baya barin kowane canjin fata mai dorewa. [2] Kasa da 5% na lokuta suna wuce sama da makonni shida (lalacewar da aka sani da urticaria na yau da kullun). [2] Yanayin yakan sake faruwa. [2] [4]

Hives suna yawan faruwa bayan kamuwa da cuta ko sakamakon rashin lafiyar jiki kamar magani, cizon kwari, ko abinci. [2] Damuwar tunani, zazzabi mai sanyi, ko rawar jiki kuma na iya zama mai jan hankali. [1] [2] A cikin rabin lokuta har yanzu ba a san dalilin ba . [2] Abubuwan haɗari sun haɗa da samun yanayi kamar zazzabin hay ko asma . Ana gano cutar yawanci bisa ga bayyanar. [2] Gwajin faci na iya zama da amfani don tantance alerji. [2]

Rigakafin shi ne ta hanyar guje wa duk abin da ke haifar da yanayin. [2] Jiyya yawanci tare da antihistamines, tare da ƙarni na biyu antihistamines irin su fexofenadine, loratadine da cetirizine an fi son su saboda ƙananan haɗari na lalata da rashin fahimta. [4] A lokuta masu banƙyama, ana iya amfani da corticosteroids ko masu hana leukotriene . [2] Tsayawa yanayin yanayin sanyi shima yana da amfani. [2] Ga lokuta da suka wuce fiye da makonni shida ana nuna maganin antihistamine na dogon lokaci. Hakanan ana iya amfani da magungunan rigakafi kamar omalizumab ko cyclosporin . [4]

Kusan kashi 20% na mutane suna fama da cutar a wani lokaci a rayuwarsu. [2] Matsalolin gajeren lokaci suna faruwa daidai a cikin maza da mata yayin da lokuta masu tsayi sun fi yawa a cikin mata. [5] Abubuwan da ke da ɗan gajeren lokaci sun fi yawa a tsakanin yara yayin da lokuta masu tsawo sun fi yawa a tsakanin waɗanda ke da matsakaicin shekaru. [5] An bayyana hives a kalla tun lokacin Hippocrates . Kalmar urticaria daga Latin urtica ce ma'ana " nettle ".  

Alamomi da alamomi

[gyara sashe | gyara masomin]
Hives akan bangon kirji na hagu. Lura cewa an ɗaga su kaɗan.
Hives
Zane na amya

Hives, ko urticaria, wani nau'i ne na kurjin fata tare da ja, tashe, kumburin ƙaiƙayi. [1] Suna iya konewa ko harbawa. [2] Amya na iya fitowa a ko'ina a saman fata. Ko mai jawo yana da rashin lafiyar ko a'a, hadadden sakin masu shiga tsakani, gami da histamine daga ƙwayoyin mast na fata, yana haifar da ɗigon ruwa daga tasoshin jini na sama. Amya na iya zama alama a girman ko inci da yawa a diamita, za su iya zama daidaikun mutane ko kuma sun haɗu, suna haɗawa zuwa manyan siffofi. [4]

Kimanin kashi 20% na mutane abin ya shafa. [2] Abubuwan da ke faruwa na ɗan gajeren lokaci suna faruwa daidai a cikin maza da mata, suna ɗaukar kwanaki kaɗan kuma ba tare da barin duk wani canjin fata mai dorewa ba. [2] Yawancin lokuta na tsawon lokaci sun fi yawa a cikin mata. Abubuwan da ke da ɗan gajeren lokaci sun fi yawa a tsakanin yara yayin da lokuta masu tsawo sun fi yawa a tsakanin waɗanda ke da matsakaicin shekaru. [5] Kasa da 5% na lokuta suna wuce sama da makonni shida. [2] Yanayin yakan sake faruwa. [2] A cikin rabin lokuta na amya, har yanzu ba a san dalilin ba . [2]

Angioedema wani yanayi ne mai alaƙa (kuma daga rashin lafiyan da ke haifar da rashin lafiya), kodayake ɗigon ruwa ya fito ne daga tasoshin jini masu zurfi a cikin yadudduka na subcutaneous ko submucosal. Kwayoyin cuta guda ɗaya waɗanda ke da zafi, suna wucewa fiye da sa'o'i 24, ko barin rauni yayin da suke warkarwa sun fi dacewa su zama yanayin da ya fi tsanani da ake kira urticarial vasculitis . Hives da ke faruwa ta hanyar shafa fata (sau da yawa a bayyanar a layi) suna faruwa ne saboda yanayin rashin lafiya da ake kira dermatographic urticaria .

Dalili

[gyara sashe | gyara masomin]

Hakanan ana iya rarraba amya ta wurin da ake zargin wakili mai haddasawa. Yawancin abubuwa daban-daban a cikin mahalli na iya haifar da amya, gami da magunguna, abinci da abubuwan motsa jiki. A cikin watakila fiye da kashi 50 cikin dari na mutanen da ke da ciwon daji na yau da kullum wanda ba a san dalilin da ya sa ba, yana faruwa ne saboda amsawar autoimmune . [6] Abubuwan haɗari sun haɗa da samun yanayi kamar zazzabin hay ko asma .

Magunguna

[gyara sashe | gyara masomin]

Magungunan da suka haifar da rashin lafiyar da aka nuna a matsayin amya sun hada da codeine, sulphate of morphia, dextroamphetamine, [7] aspirin, ibuprofen, penicillin, clotrimazole, trichazole, sulfonamides, anticonvulsants, cefaclor, piracetam, maganin rigakafi, da magungunan rigakafi . Magungunan antidiabetic sulfonylurea glimepiride, musamman, an rubuta shi don haifar da halayen rashin lafiyar da ke bayyana a matsayin amya.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (June 2020)">abubuwan da ake bukata</span> ]

Abinci

[gyara sashe | gyara masomin]

Mafi yawan rashin lafiyar abinci a cikin manya shine kifi da goro . Mafi yawan rashin lafiyar abinci a cikin yara shine kifi, goro, qwai, alkama, da waken soya . Ɗaya daga cikin binciken ya nuna Balsam na Peru, wanda ke cikin yawancin abincin da aka sarrafa, ya zama mafi yawan abin da ke haifar da urticaria nan da nan. Wani rashin lafiyar abinci wanda zai iya haifar da amya shine rashin lafiyar alpha-gal, wanda zai iya haifar da hankali ga madara da jan nama. Wani abin da ba a sani ba shi ne kamuwa da wasu kwayoyin cuta, kamar nau'in Streptococcus ko yiwuwar Helicobacter pylori . [8]

Kamuwa da cuta ko wakili na muhalli

[gyara sashe | gyara masomin]

Hives ciki har da amya na yau da kullun na lokaci-lokaci na iya zama mai rikitarwa da alamar kamuwa da cuta, kamar blastocystosis da strongyloidiasis da sauransu. [9]

Kurjin da ke tasowa daga ivy guba, itacen oak mai guba, da hulɗar sumac mai guba yawanci ana kuskure don urticaria. Wannan kurji yana haifar da lamba tare da urushiol kuma yana haifar da wani nau'i na lamba dermatitis da ake kira urushiol-induced contact dermatitis . Ana yada Urushiol ta hanyar hulɗa amma ana iya wanke shi tare da maiko-ko mai narkar da mai da ruwa mai sanyi da kuma shafa man shafawa.

Dermatographic urticaria

[gyara sashe | gyara masomin]

  Urticaria dermatographic (wanda kuma aka sani da dermatography ko "rubutun fata") yana da alamar bayyanar weals ko welts a kan fata sakamakon zazzagewa ko ƙwanƙwasa fata. Ana gani a cikin 4-5% na yawan jama'a, yana daya daga cikin nau'in urticaria da aka fi sani, [10] wanda fata ke tasowa kuma ta yi zafi lokacin da aka shafe shi, da zazzagewa, gogewa, wani lokacin har ma da mari. [11]

Halin fatar jiki yakan bayyana ba da jimawa ba bayan tasar kuma ya ɓace cikin mintuna 30. Dermatographism shine nau'i na yau da kullun na juzu'in amya na yau da kullun, wanda aka yarda da shi azaman "amya ta jiki".[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Ya bambanta da jajayen layi wanda baya ƙaiƙayi da aka gani a cikin mutane masu lafiya waɗanda aka taso. A mafi yawan lokuta, ba a san dalilin ba, ko da yake yana iya kasancewa kafin kamuwa da cuta, maganin rigakafi, ko bacin rai. Ana gano cutar dermatography ta hanyar amfani da matsi ta hanyar shafa ko tarkar da fata. [12] Ya kamata amya ta haɓaka cikin 'yan mintuna kaɗan. Sai dai idan fatar jiki ta kasance mai matukar damuwa kuma tana amsawa akai-akai, ba a buƙatar magani. Shan maganin antihistamines na iya rage amsawa a cikin lamuran da ke damun mutum.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Matsi ko jinkirta matsa lamba

[gyara sashe | gyara masomin]

Irin wannan amya na iya faruwa nan da nan, daidai bayan abin motsa jiki ko a matsayin martanin da aka jinkirta don ci gaba da matsa lamba akan fata. A cikin sigar da aka jinkirta, amya kawai suna bayyana bayan kimanin sa'o'i shida daga farkon aikace-aikacen matsa lamba ga fata. A cikin yanayi na al'ada, waɗannan amya ba iri ɗaya bane da waɗanda aka shaida tare da mafi yawan urticariae. Madadin haka, fitowar a cikin wuraren da abin ya shafa yawanci ya fi bazuwa. Amya na iya wucewa daga sa'o'i takwas zuwa kwana uku. Tufafin da ke haifar da matsa lamba akan fata na iya faruwa daga matsatstsun tufafi, bel, tufafi masu tsauri, tafiya, jingina da wani abu, tsaye, zama a saman ƙasa mai tauri, da dai sauransu. wuraren da aka fi shafan jiki sune hannaye., ƙafafu, gangar jikin, ciki, gindi, ƙafafu da fuska. Ko da yake wannan ya bayyana yana kama da dermatography, babban bambanci shi ne cewa wuraren da suka kumbura ba sa fitowa da sauri kuma suna daɗe da tsawo. Wannan nau'i na cutar fata, duk da haka, ba kasafai ba ne.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Cholinergic ko damuwa

[gyara sashe | gyara masomin]

Cholinergic urticaria (CU) na ɗaya daga cikin urticaria na zahiri wanda ake tsokane shi yayin abubuwan zufa kamar motsa jiki, wanka, zama a cikin yanayi mai zafi, ko damuwa. Amyoyin da aka samar sun fi ƙanƙanta fiye da na gargajiya kuma suna da ɗan gajeren lokaci. [13] [14]

An bayyana nau'o'in nau'i-nau'i da yawa, kowannensu yana buƙatar kulawa ta musamman. [15] [16]

Ciwon sanyi

[gyara sashe | gyara masomin]

Nau'in sanyi na urticaria yana haifar da bayyanar fata zuwa matsanancin sanyi, damshi da yanayin iska; yana faruwa ta hanyoyi biyu. Siffar da ba kasafai ake samun gado ba kuma tana bayyana a matsayin amya a ko'ina cikin jiki sa'o'i 9 zuwa 18 bayan bayyanar sanyi. Nau'in ciwon sanyi na yau da kullun yana nuna kansa tare da saurin farawa na amya a fuska, wuya, ko hannaye bayan kamuwa da sanyi. Cold urticaria ya zama ruwan dare kuma yana ɗaukar matsakaicin shekaru biyar zuwa shida. Yawan mutanen da abin ya shafa su ne matasa masu shekaru tsakanin 18 zuwa 25. Yawancin mutanen da ke fama da cutar kuma suna da dermographism da amya na cholinergic.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Ana iya ganin halayen mai tsanani tare da fallasa ruwan sanyi; yin iyo a cikin ruwan sanyi shine mafi yawan abin da ke haifar da mummunan dauki. Wannan na iya haifar da fitar da histamine mai yawa, wanda ke haifar da raguwar hawan jini, suma, firgita har ma da asarar rai. Ana gano cutar urticaria mai sanyi ta hanyar dasa kumburin ƙanƙara a kan fatar gaban hannu na tsawon mintuna 1 zuwa 5. Ya kamata a samu hive daban-daban idan mutum yana da sanyi urticaria. Wannan ya bambanta da ja na al'ada da ake iya gani a cikin mutanen da ba su da sanyin urticaria. Mutanen da ke fama da urticaria masu sanyi suna buƙatar koyan kare kansu daga raguwar zafin jiki cikin gaggawa. Magungunan antihistamines na yau da kullum ba su da tasiri sosai. Wani maganin antihistamine na musamman, cyproheptadine (Periactin), an gano yana da amfani. Doxepin na tricyclic antidepressant an gano yana da tasiri mai toshe abubuwan histamine. A ƙarshe, an yi amfani da wani magani mai suna ketotifen, wanda ke hana mast cells daga fitar da histamine, tare da nasara.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Rana urticaria

[gyara sashe | gyara masomin]

Wannan nau'i na cutar yana faruwa ne a wuraren fata da aka fallasa zuwa rana; yanayin ya bayyana a cikin mintuna kaɗan na fallasa.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (September 2016)">abubuwan da ake bukata</span> ]

Ruwa ya jawo

[gyara sashe | gyara masomin]

Irin wannan urticaria kuma ana kiransa da wuya kuma yana faruwa ne a lokacin saduwa da ruwa. Amsar ba ta dogara da zafin jiki ba kuma fata ta bayyana kama da nau'in cutar cholinergic. Bayyanar amya yana tsakanin minti ɗaya zuwa 15 na haɗuwa da ruwa kuma yana iya wucewa daga minti 10 zuwa sa'o'i biyu. Irin wannan amya da alama ba sa samun kuzari da fitar histamine kamar sauran amya ta jiki. Yawancin masu bincike sunyi imanin cewa wannan yanayin shine ainihin halayen fata ga abubuwan da ke cikin ruwa, irin su chlorine. Ana gano cutar urticaria ta ruwa ta hanyar dasa ruwan famfo da ruwan famfo a fata da kuma lura da martanin a hankali. Ana kula da urticaria na aquagenic tare da capsaicin (Zostrix) wanda aka gudanar ga fata mai yatsa. Wannan shine magani ɗaya da ake amfani dashi don shingles . Magungunan antihistamines suna da fa'ida mai tambaya a cikin wannan misalin tunda histamine ba shine dalilin ba.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Motsa jiki

[gyara sashe | gyara masomin]

An fara bambanta yanayin a cikin 1980. Mutanen da ke fama da urticaria na motsa jiki (EU) suna samun amya, ƙaiƙayi, ƙarancin numfashi da ƙarancin hawan jini minti biyar zuwa 30 bayan fara motsa jiki. Waɗannan alamomin na iya ci gaba zuwa firgita har ma da mutuwa kwatsam. Gudun gudu shine mafi yawan motsa jiki don haifar da EU, amma ba ya motsa shi ta hanyar zafi mai zafi, zazzabi, ko da bacin rai. Wannan ya bambanta EU daga cholinergic urticaria.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

EU wani lokaci yana faruwa ne kawai lokacin da wani yayi motsa jiki a cikin mintuna 30 na cin abinci na musamman, kamar alkama ko kifi. Ga waɗannan mutane, motsa jiki su kaɗai ko cin abincin da ke raunata ba tare da motsa jiki ba ya haifar da alamun. Ana iya gano EU ta hanyar sanya mutum motsa jiki sannan kuma lura da alamun. Dole ne a yi amfani da wannan hanya tare da taka tsantsan kuma kawai tare da matakan farfadowa masu dacewa a hannu. Ana iya bambanta EU daga urticaria cholinergic ta gwajin nutsewar ruwan zafi. A cikin wannan gwaji, an nutsar da mutum a cikin ruwa a 43 °C (109.4 °F). Wani tare da EU ba zai ci gaba da amya ba, yayin da mutumin da ke da urticaria cholinergic zai ci gaba da halayyar ƙananan amya, musamman a wuyansa da kirji.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Ana kula da alamun wannan nau'in nan da nan tare da maganin antihistamines, epinephrine da tallafin iska. Shan maganin antihistamines kafin motsa jiki na iya zama tasiri. An yarda da Ketotifen don daidaita ƙwayoyin mast da hana sakin histamine, kuma yana da tasiri wajen magance wannan cuta ta amya. Gujewa motsa jiki ko abincin da ke haifar da alamun da aka ambata yana da mahimmanci. A cikin yanayi na musamman, ana iya kawo haƙuri ta hanyar motsa jiki na yau da kullun, amma wannan dole ne ya kasance ƙarƙashin kulawar likita.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Pathophysiology

[gyara sashe | gyara masomin]

Rawanin fata na cututtukan urticarial yana haifar da kumburi mai kumburi a cikin fata, yana haifar da zubar da capillaries a cikin dermis, kuma yana haifar da edema wanda ke ci gaba har sai ruwan tsaka-tsakin ya shiga cikin sel kewaye.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Ana haifar da amya ta hanyar sakin histamine da sauran masu shiga tsakani na kumburi ( cytokines ) daga sel a cikin fata. Wannan tsari zai iya zama sakamakon rashin lafiyan ko rashin lafiyan halayen, daban-daban a cikin hanyar fitar da histamine.

Allergic amya

[gyara sashe | gyara masomin]

Ana fitar da Histamine da sauran abubuwan proinflammatory daga ƙwayoyin mast a cikin fata da kyallen takarda don mayar da martani ga ɗaure ƙwayoyin rigakafi na IgE masu haɗari ga masu karɓar saman sel masu alaƙa. Hakanan ana ganin Basophils da sauran ƙwayoyin kumburi don sakin histamine da sauran masu shiga tsakani, kuma ana tsammanin suna taka muhimmiyar rawa, musamman a cikin cututtukan urticarial na yau da kullun.

Autoimmune amya

[gyara sashe | gyara masomin]

Fiye da rabin duk lokuta na ciwon huhu na idiopathic na yau da kullun shine sakamakon abin motsa jiki na autoimmune. Kusan kashi 50 cikin 100 na mutanen da ke fama da urticaria na yau da kullun suna haɓaka autoantibodies waɗanda aka ba da umarni ga mai karɓar FcεRI wanda ke kan ƙwayoyin mast na fata. Ƙarfafawa na yau da kullun na wannan mai karɓar yana haifar da amya na yau da kullun. Mutanen da ke da amya sau da yawa suna da wasu yanayi na autoimmune, irin su autoimmune thyroiditis, cutar celiac, nau'in ciwon sukari na 1, rheumatoid arthritis, Sjögren's syndrome ko tsarin lupus erythematosus . [6]

Cututtuka

[gyara sashe | gyara masomin]

Rashes-kamar amya yawanci suna rakiyar cututtukan hoto, kamar mura. Yawancin lokaci suna bayyana kwanaki uku zuwa biyar bayan sanyin ya fara, kuma yana iya bayyana bayan 'yan kwanaki bayan sanyin ya ƙare.

Marasa lafiya

[gyara sashe | gyara masomin]

Hanyoyin da ban da hulɗar allergen-antibody an san su suna haifar da sakin histamine daga ƙwayoyin mast. Yawancin kwayoyi, misali morphine, na iya haifar da sakin histamine kai tsaye wanda ba ya haɗa da kowane kwayoyin immunoglobulin . Har ila yau, an gano nau'in nau'in nau'i na sigina da ake kira neuropeptides, an gano cewa suna shiga cikin amya masu motsin rai. Mafi rinjaye gada cutaneous da neurocutaneous porphyrias ( porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria da erythropoietic protoporphyria ) an hade da hasken rana urticaria . Abin da ya faru na urticaria na rana wanda ke haifar da miyagun ƙwayoyi yana iya haɗuwa da porphyrias. Ana iya haifar da wannan ta hanyar ɗaurin IgG, ba IgE ba.

Abincin abinci mai guba histamine

[gyara sashe | gyara masomin]

Ana kiran wannan gubar abinci scombroid . Ciwon histamine kyauta wanda ƙwayoyin cuta ke fitarwa a cikin naman kifin na iya haifar da saurin farawa, nau'in alamun rashin lafiyan wanda ya haɗa da amya. Duk da haka, an ba da rahoton amya da scombroid ke samarwa ba ya haɗa da whal. [17]

Damuwa da kuma na kullum idiopathic amya

[gyara sashe | gyara masomin]

An danganta amya idiopathic na yau da kullun zuwa damuwa tun cikin 1940s. [18] Babban shaidun shaida yana nuna haɗin kai tsakanin wannan yanayin da kuma rashin jin daɗin jin daɗin rai [19] da rage yawan yanayin rayuwa . [20] An kuma nuna alaƙa tsakanin damuwa da wannan yanayin. [21] An yi tunanin wasu lokuta saboda damuwa, ciki har da haɗin gwiwa tsakanin damuwa bayan tashin hankali da kuma amya na idiopathic na yau da kullum. [22] [23] A mafi yawan lokuta na na kullum idiopathic urticaria, ba a gano dalilin ba. [4]

Bincike

[gyara sashe | gyara masomin]
Micrograph na urticaria. dermal edema [tsararrun kibiyoyi a cikin (A, B)] da kuma ɗimbin ɓangarorin na sama waɗanda galibi na perivascular da tsaka-tsakin infiltrate na lymphocytes da eosinophils ba tare da alamun vasculitis ba (kibiya dashe). [24]

Ana gano cutar yawanci akan bayyanar. [2] Da kyar za a iya tantance dalilin ciwon na kullum. [25] Gwajin faci na iya zama da amfani don tantance alerji. [2] A wasu lokuta ana buƙatar gwajin alerji na yau da kullun na dogon lokaci da fatan samun sabon fahimta. [26] [27] Babu wata shaida da ta nuna sakamakon gwajin rashin lafiyar na yau da kullun a cikin gano matsala ko jin daɗi ga mutanen da ke da amya. [26] [27] Ba a ba da shawarar gwajin alerji na yau da kullun ga mutanen da ke da amya ba. [25]

M tare da na yau da kullun

[gyara sashe | gyara masomin]
  • Acute urticaria is defined as the presence of evanescent wheals which completely resolve within six weeks. Acute urticaria becomes evident a few minutes after the person has been exposed to an allergen. The outbreak may last several weeks, but usually the hives are gone in six weeks. Typically, the hives are a reaction to food, but in about half the cases, the trigger is unknown. Common foods may be the cause, as well as bee or wasp stings, or skin contact with certain fragrances. Acute viral infection is another common cause of acute urticaria (viral exanthem). Less common causes of hives include friction, pressure, temperature extremes, exercise, and sunlight.
  • Chronic urticaria is defined as the presence of hives which persist for greater than six weeks.[28] Some of the more severe chronic cases have lasted more than 20 years. A survey indicated chronic urticaria lasted a year or more in more than 50% of those affected and 20 years or more in 20% of them.[29] Provocative skin challenge testing may be done in those with chronic urticaria, in which the skin is exposed to pressure (dermatographisim), cold temperatures, warm temperatures, or light in an attempt to provoke symptoms and aid in the diagnosis.[4] The history of physical examination guide the diagnosis of chronic urticaria, with extensive lab testing not recommended.[4][30]

Cutar cututtuka masu tsanani da na yau da kullum ba a iya bambance su a gani a duban gani kadai.

Sharuɗɗa masu alaƙa

[gyara sashe | gyara masomin]

Angioedema

[gyara sashe | gyara masomin]

Angioedema yana kama da amya, amma a cikin angioedema, kumburi yana faruwa a cikin ƙananan Layer na dermis fiye da a cikin amya, [31] da kuma a cikin subcutis. Wannan kumburi zai iya faruwa a kusa da baki, idanu, a makogwaro, cikin ciki, ko a wasu wurare. Hives da angioedema wani lokaci suna faruwa tare don mayar da martani ga alerji, kuma yana da damuwa a lokuta masu tsanani, saboda angioedema na makogwaro na iya zama m.

Vibratory angioedema

[gyara sashe | gyara masomin]

Wannan nau'i mai wuyar gaske na angioedema yana tasowa don amsawa ga lamba tare da rawar jiki. A cikin angioedema mai girgiza, alamun suna tasowa cikin mintuna biyu zuwa biyar bayan haɗuwa da wani abu mai rawar jiki kuma suna raguwa bayan kusan awa ɗaya. Mutanen da ke da wannan cuta ba sa fuskantar dermographism ko matsa lamba urticaria. Ana gano cutar angioedema mai girgiza ta hanyar riƙe na'urar girgiza kamar injin vortex na dakin gwaje-gwaje a gaban hannun gaba na mintuna huɗu. An lura da saurin kumburin gaba dayan hannun da ya miko cikin hannun na sama kuma daga baya. Babban magani shine nisantar abubuwan kara kuzari. An kuma tabbatar da cewa maganin antihistamines yana taimakawa.[ana buƙatar hujja]</link>[ <span title="This claim needs references to reliable sources. (August 2013)">abubuwan da ake bukata</span> ]

Gudanarwa

[gyara sashe | gyara masomin]

Babban jigon jiyya ga duka m da na yau da kullun amya shine ilimi, guje wa abubuwan da ke haifar da amfani da maganin antihistamines.

Kwayar amya na yau da kullun na iya zama da wahala a magance shi kuma ya haifar da nakasa mai mahimmanci. Ba kamar nau'i mai mahimmanci ba, 50-80% na mutanen da ke fama da amya ba su da wani abin da za a iya ganewa. Amma kashi 50 cikin 100 na mutanen da ke fama da ciwon hanji za su sami gafara a cikin shekara 1. [32] Gabaɗaya, ana yin amfani da magani zuwa ga sarrafa alamomi. Mutanen da ke da amya na yau da kullun na iya buƙatar wasu magunguna ban da maganin antihistamines don sarrafa alamun. Mutanen da suka fuskanci amya tare da angioedema suna buƙatar magani na gaggawa saboda wannan yanayin ne mai haɗari.

An buga jagororin jiyya don kula da amya na yau da kullun. [33] [34] Bisa ga sigogin aikin Amurka na 2014, jiyya ya ƙunshi hanyar da ta dace. Mataki na 1 ya ƙunshi ƙarni na biyu, mai karɓar H1 yana hana antihistamines. Hakanan za'a iya amfani da glucocorticoids na tsarin don cututtukan cututtuka masu tsanani amma bai kamata a yi amfani da su na dogon lokaci ba saboda dogon jerin abubuwan da suka shafi illa. Mataki na 2 ya ƙunshi ƙara adadin maganin antihistamine na yanzu, ƙara wasu magungunan antihistamines, ko ƙara antagonist mai karɓar leukotriene kamar montelukast. Mataki na 3 ya ƙunshi ƙara ko maye gurbin magani na yanzu tare da hydroxyzine ko doxepin. Idan mutum bai amsa matakai na 1-3 ba to ana ɗaukar su da alamun rashin ƙarfi. A wannan lokaci, ana iya amfani da magungunan anti-inflammatory (dapsone, sulfasalazine), immunosuppressants (cyclosporin, sirolimus) ko wasu magunguna kamar omalizumab . An yi bayanin waɗannan zaɓuɓɓuka dalla-dalla a ƙasa.

Magungunan antihistamines na ƙarni na farko, irin su diphenhydramine ko hydroxyzine, ba a ba da shawarar su azaman maganin layi na farko ba yayin da suke toshe duka kwakwalwa da masu karɓar H1 na gefe, suna haifar da tashin hankali. Magungunan antihistamines na ƙarni na biyu, irin su loratadine, cetirizine, fexofenadine ko desloratadine, masu karɓa na H1 masu zaɓaɓɓu antagonize, kuma suna da ƙarancin kwanciyar hankali, ƙarancin anticholinergic, kuma gabaɗaya sun fi son antihistamines na ƙarni na farko. [35] [36] Fexofenadine, sabon antihistamine na zamani wanda ke toshe masu karɓar histamine H1, na iya zama ƙasa da kwanciyar hankali fiye da wasu antihistamines na ƙarni na biyu. [37]

Mutanen da ba su amsa ga matsakaicin adadin maganin antihistamines na H1 na iya amfana daga ƙara yawan adadin, sa'an nan kuma canza zuwa wani maganin antihistamine maras amfani, sa'an nan kuma ƙara antagonist na leukotriene, sa'an nan kuma yin amfani da tsohuwar maganin antihistamine, sa'an nan kuma amfani da steroids na tsarin da kuma A ƙarshe don amfani da cyclosporin ko omalizumab . [35] Sau da yawa ana haɗuwa da ƙwayoyin cuta tare da sake dawo da amya da zarar an daina. [4]

Ana amfani da masu adawa da H2-receptor antagonists wani lokaci ban da H1-antagonists don magance urticaria, amma akwai iyakataccen shaida game da ingancin su. [38]

Nau'in steroids

[gyara sashe | gyara masomin]

Glucocorticoids na baka suna da tasiri wajen sarrafa alamun alamun amya. Duk da haka, suna da jerin abubuwan da ba su da kyau, kamar su hana adrenal, samun nauyi, osteoporosis, hyperglycemia, da sauransu. Saboda haka, amfani da su ya kamata a iyakance ga makonni biyu. Bugu da ƙari, binciken daya ya gano cewa glucocorticoids na tsarin da aka haɗa tare da maganin antihistamines ba su gaggauta lokacin da za a iya sarrafa alamar cututtuka ba idan aka kwatanta da antihistamines kadai. [39]

Leukotriene-receptor antagonists

[gyara sashe | gyara masomin]

Ana fitar da leukotrienes daga ƙwayoyin mast tare da histamine. Magungunan, montelukast da zafirlukast suna toshe masu karɓar leukotriene kuma ana iya amfani da su azaman ƙari akan jiyya ko keɓe ga mutanen da ke da CU. Yana da mahimmanci a lura cewa waɗannan magunguna na iya zama mafi amfani ga mutanen da ke da CU ta NSAID. [40] [41]

Sauran

[gyara sashe | gyara masomin]

Sauran zaɓuɓɓukan don alamun rashin ƙarfi na amya na yau da kullun sun haɗa da magungunan anti-mai kumburi, omalizumab, da magungunan rigakafi. Abubuwan da za su iya hana kumburi sun haɗa da dapsone, sulfasalazine, da hydroxychloroquine. Dapsone wakili ne na sulfone antimicrobial kuma ana tunanin zai hana prostaglandin da ayyukan leukotriene. Yana da taimako a cikin lokuta masu juyayi [42] kuma an hana shi a cikin mutanen da ke da rashi G6PD. Sulfasalazine, wani abin da aka samu na 5-ASA, ana tsammanin zai canza sakin adenosine kuma ya hana IgE tsaka-tsakin mast cell degenranulation, Sulfasalazine wani zaɓi ne mai kyau ga mutanen da ke da anemia waɗanda ba za su iya ɗaukar dapsone ba. Hydroxychloroquine wani maganin zazzabin cizon sauro ne wanda ke danne T lymphocytes. Yana da ƙananan farashi duk da haka yana ɗaukar lokaci fiye da dapsone ko sulfasalazine don aiki.

FDA ta amince da Omalizumab a cikin 2014 ga mutanen da ke da amya 12 da sama da shekaru masu ciwon daji. Yana da maganin rigakafi na monoclonal wanda aka yi wa IgE. An sami ci gaba mai mahimmanci a cikin pruritus da ingancin rayuwa a cikin wani lokaci na III, multicenter, gwajin sarrafa bazuwar. [43]

Immunosuppressants da ake amfani da su don CU sun haɗa da cyclosporine, tacrolimus, sirolimus, da mycophenolate. Masu hana Calcineurin, irin su cyclosporine da tacrolimus, suna hana amsawar salula ga samfuran mast cell kuma suna hana ayyukan ƙwayoyin T. Wasu masana sun fi son su yi maganin cututtuka masu tsanani. [44] Sirolimus da mycophenolate suna da ƙarancin shaida don amfani da su a cikin maganin amya na yau da kullun amma rahotanni sun nuna cewa suna da inganci. [45] [46] Immunosuppressants an tanada gabaɗaya azaman layin jiyya na ƙarshe don lokuta masu tsanani saboda yuwuwar su na haifar da mummunan tasiri.

Hasashen

[gyara sashe | gyara masomin]

A cikin wadanda ke fama da urticaria na yau da kullum, wanda aka bayyana a matsayin ko dai ci gaba ko alamun bayyanar da ke dadewa fiye da makonni 6, 35% na mutane ba su da alamun bayyanar shekaru 1 bayan jiyya, yayin da 29% suna da raguwa a cikin alamun su. [4] Waɗanda ke da tsawon lokaci na cuta yawanci suna da mummunan hasashen, tare da tsananin alamun. [4] Urticaria na yau da kullun yana tare da matsanancin pruritus, da sauran alamomin da ke da alaƙa da raguwar ingancin rayuwa da babban nauyin yanayin cututtukan hauka kamar damuwa da damuwa. [4] [47]

Epidemiology

[gyara sashe | gyara masomin]

Yawancin urticaria na yau da kullun ana ganin su a cikin waɗanda suka girmi shekaru 40, ya fi yawa a cikin mata. [4] Yawan cutar urticaria na yau da kullun shine 0.23% a Amurka. [4]

Bincike

[gyara sashe | gyara masomin]

Ana nazarin Afamelanotide azaman maganin amya. [48]

Masu adawa da Opioid irin su naltrexone suna da shaida na ɗan lokaci don tallafawa amfani da su. [49]

Tarihi

[gyara sashe | gyara masomin]

An fara amfani da kalmar urticaria ta likitan Scotland William Cullen a 1769. [50] Ya samo asali ne daga kalmar Latin urtica, ma'ana gashin gashi ko nettle, kamar yadda gabatarwar gargajiya ta biyo bayan hulɗa tare da tsire-tsire na furanni Urtica dioica . [51] Tarihin urticaria ya koma 1000-2000 BC tare da ambatonsa a matsayin nau'in iska mai ɓoye a cikin littafin The Yellow Emperor's Inner Classic daga Huangdi Neijing . Hippocrates a karni na 4 ya fara bayyana urticaria a matsayin "knidosis" bayan kalmar Helenanci knido don nettle. [52] Gano kwayoyin mast da Paul Ehrlich ya yi a 1879 ya kawo urticaria da makamantansu a karkashin cikakkiyar ra'ayi na yanayin rashin lafiyan. [53]

Duba kuma

[gyara sashe | gyara masomin]
  • Urticarial vasculitis
  • Dermatitis

Manazarta

[gyara sashe | gyara masomin]
  1. ↑ 1.0 1.1 1.2 1.3 1.4 "Hives". Archived from the original on 19 August 2016. Retrieved 10 August 2016.
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 Jafilan, L; James, C (December 2015). "Urticaria and Allergy-Mediated Conditions". Primary Care. 42 (4): 473–83. doi:10.1016/j.pop.2015.08.002. PMID 26612369.
  3. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named Zub2010
  4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 Lang, David M. (1 September 2022). "Chronic Urticaria". New England Journal of Medicine. 387 (9): 824–831. doi:10.1056/NEJMra2120166. PMID 36053507 Check |pmid= value (help). S2CID 251992431 Check |s2cid= value (help).
  5. ↑ 5.0 5.1 5.2 Cite error: Invalid <ref> tag; no text was provided for refs named Gri2016
  6. ↑ 6.0 6.1 Fraser K, Robertson L (Dec 2013). "Chronic urticaria and autoimmunity". Skin Therapy Lett (Review). 18 (7): 5–9. PMID 24305753. Archived from the original on 2016-01-31.
  7. ↑ "Prescribing Information Dexedrine". GlaxoSmithKline. June 2006.
  8. ↑ Tebbe, Beate; Geilen, Christoph C.; Schulzke, Jörg-Dieter; Bojarski, Christian; Radenhausen, Michael; Orfanos, Constantin E. (1996). "Helicobacter pylori infection and chronic urticaria". Journal of the American Academy of Dermatology. 34 (4): 685–6. doi:10.1016/S0190-9622(96)80086-7. PMID 8601663.
  9. ↑ Kolkhir, P.; Balakirski, G.; Merk, HF.; Olisova, O.; Maurer, M. (December 2015). "Chronic spontaneous urticaria and internal parasites – a systematic review". Allergy. 71 (3): 308–322. doi:10.1111/all.12818. PMID 26648083.
  10. ↑ Jedele, Kerry B.; Michels, Virginia V. (1991). "Familial dermographism". American Journal of Medical Genetics. 39 (2): 201–3. doi:10.1002/ajmg.1320390216. PMID 2063925.
  11. ↑ Kontou-Fili, K.; Borici-Mazi, R.; Kapp, A.; Matjevic, L. J.; Mitchel, F. B. (1997). "Physical urticaria: Classification and diagnostic guidelines". Allergy. 52 (5): 504–13. doi:10.1111/j.1398-9995.1997.tb02593.x. PMID 9201361. S2CID 45982469.
  12. ↑ "Gale - Product Login".
  13. ↑ Moore-Robinson, Miriam; Warin, Robert P. (1968). "Some Clikical Aspects of Cholhstergic Urticaria". British Journal of Dermatology. 80 (12): 794–9. doi:10.1111/j.1365-2133.1968.tb11948.x. PMID 5706797. S2CID 58415911.
  14. ↑ Hirschmann, J. V.; Lawlor, F; English, JS; Louback, JB; Winkelmann, RK; Greaves, MW (1987). "Cholinergic Urticaria - A Clinical and Histologic Study". Archives of Dermatology. 123 (4): 462–7. doi:10.1001/archderm.1987.01660280064024. PMID 3827277.
  15. ↑ Nakamizo, S.; Egawa, G.; Miyachi, Y.; Kabashima, K. (2012). "Cholinergic urticaria: Pathogenesis-based categorization and its treatment options". Journal of the European Academy of Dermatology and Venereology. 26 (1): 114–6. doi:10.1111/j.1468-3083.2011.04017.x. PMID 21371134. S2CID 35802279.
  16. ↑ Bito, Toshinori; Sawada, Yu; Tokura, Yoshiki (2012). "Pathogenesis of Cholinergic Urticaria in Relation to Sweating". Allergology International. 61 (4): 539–44. doi:10.2332/allergolint.12-RAI-0485. PMID 23093795.
  17. ↑ "Scombroid fish poisoning. DermNet NZ". Dermnetnz.org. 2011-07-01. Archived from the original on 2012-02-04. Retrieved 2012-02-25.
  18. ↑ Mitchell, John H; Curran, Charles A; Myers, Ruth N (1947). "Some Psychosomatic Aspects of Allergic Diseases". Psychosomatic Medicine. 9 (3): 184–91. doi:10.1097/00006842-194705000-00003. PMID 20239792.
  19. ↑ Uguz, Faruk; Engin, Burhan; Yilmaz, Ertan (2008). "Axis I and Axis II diagnoses in patients with chronic idiopathic urticaria". Journal of Psychosomatic Research. 64 (2): 225–9. doi:10.1016/j.jpsychores.2007.08.006. PMID 18222137.
  20. ↑ Engin, B; Uguz, F; Yilmaz, E; Ozdemir, M; Mevlitoglu, I (2007). "The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria". Journal of the European Academy of Dermatology and Venereology. 22 (1): 36–40. doi:10.1111/j.1468-3083.2007.02324.x. PMID 18181971. S2CID 24060839.
  21. ↑ Yang, Hsiao-Yu; Sun, Chee-Ching; Wu, Yin-Chang; Wang, Jung-Der (2005). "Stress, Insomnia, and Chronic Idiopathic Urticaria – a Case-Control Study". Journal of the Formosan Medical Association. 104 (4): 254–63. PMID 15909063. Archived from the original on 2017-09-08.
  22. ↑ Chung, Man Cheung; Symons, Christine; Gilliam, Jane; Kaminski, Edward R. (2010). "The relationship between posttraumatic stress disorder, psychiatric comorbidity, and personality traits among patients with chronic idiopathic urticaria". Comprehensive Psychiatry. 51 (1): 55–63. doi:10.1016/j.comppsych.2009.02.005. PMID 19932827.
  23. ↑ Chung, Man Cheung; Symons, Christine; Gilliam, Jane; Kaminski, Edward R. (2010). "Stress, psychiatric co-morbidity and coping in patients with chronic idiopathic urticaria". Psychology & Health. 25 (4): 477–90. doi:10.1080/08870440802530780. PMID 20204926. S2CID 44740560.
  24. ↑ Giang, Jenny; Seelen, Marc A. J.; van Doorn, Martijn B. A.; Rissmann, Robert; Prens, Errol P.; Damman, Jeffrey (2018). "Complement Activation in Inflammatory Skin Diseases". Frontiers in Immunology. 9: 639. doi:10.3389/fimmu.2018.00639. ISSN 1664-3224. PMC 5911619. PMID 29713318.
  25. ↑ 25.0 25.1 "Five Things Physicians and Patients Should Question" (PDF). Choosing Wisely. American Academy of Allergy, Asthma, and Immunology. Archived (PDF) from the original on November 3, 2012. Retrieved August 14, 2012.
  26. ↑ 26.0 26.1 Tarbox, James A.; Gutta, Ravi C.; Radojicic, Cristine; Lang, David M. (2011). "Utility of routine laboratory testing in management of chronic urticaria/angioedema". Annals of Allergy, Asthma & Immunology. 107 (3): 239–43. doi:10.1016/j.anai.2011.06.008. PMID 21875543.
  27. ↑ 27.0 27.1 Kozel, Martina M.A.; Bossuyt, Patrick M.M.; Mekkes, Jan R.; Bos, Jan D. (2003). "Laboratory tests and identified diagnoses in patients with physical and chronic urticaria and angioedema: A systematic review". Journal of the American Academy of Dermatology. 48 (3): 409–16. doi:10.1067/mjd.2003.142. PMID 12637921.
  28. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named Andrews p150
  29. ↑ Champion, R. H.; Roberts, S. O. B.; Carpenter, R. G.; Roger, J. H. (1969). "Urticaria and Angio-Oedema". British Journal of Dermatology. 81 (8): 588–97. doi:10.1111/j.1365-2133.1969.tb16041.x. PMID 5801331. S2CID 41089623.
  30. ↑ Shaker, Marcus; Oppenheimer, John; Wallace, Dana; Lang, David M.; Rambasek, Todd; Dykewicz, Mark; Greenhawt, Matthew (July 2020). "Optimizing Value in the Evaluation of Chronic Spontaneous Urticaria: A Cost-Effectiveness Analysis". The Journal of Allergy and Clinical Immunology: In Practice. 8 (7): 2360–2369.e1. doi:10.1016/j.jaip.2019.11.004. PMID 31751758. S2CID 208229213.
  31. ↑ "Hives (Urticaria and Angioedema)". 2006-03-01. Archived from the original on 2007-08-24. Retrieved 2007-08-24.
  32. ↑ Kozel MM, Mekkes JR, Bossuyt PM, Bos JD (2001). "Natural course of physical and chronic urticaria and angioedema in 220 patients". J Am Acad Dermatol. 45 (3): 387–391. doi:10.1067/mjd.2001.116217. PMID 11511835.
  33. ↑ Maurer, M (2013). "Revisions to the international guidelines on the diagnosis and therapy of chronic urticaria". J Dtsch Dermatol Ges. 11 (10): 971–978. doi:10.1111/ddg.12194. PMID 24034140. S2CID 22110680.
  34. ↑ Bernstein, J (2014). "The diagnosis and management of acute and chronic urticaria: 2014 update". J Allergy Clin Immunol. 133 (5): 1270–1277.e66. doi:10.1016/j.jaci.2014.02.036. PMID 24766875.
  35. ↑ 35.0 35.1 Zuberbier, T (January 2012). "A Summary of the New International EAACI/GA2LEN/EDF/WAO Guidelines in Urticaria". The World Allergy Organization Journal. 5 (Suppl 1): S1-5. doi:10.1097/WOX.0b013e3181f13432. PMC 3488932. PMID 23282889.
  36. ↑ Sharma, M; Bennett, C; Cohen, SN; Carter, B (14 November 2014). "H1-antihistamines for chronic spontaneous urticaria". Cochrane Database of Systematic Reviews. 2017 (11): CD006137. doi:10.1002/14651858.CD006137.pub2. PMC 6481497. PMID 25397904.
  37. ↑ Huang, Cheng-zhi; Jiang, Zhi-hui; Wang, Jian; Luo, Yue; Peng, Hua (29 November 2019). "Antihistamine effects and safety of fexofenadine: a systematic review and meta-analysis of randomized controlled trials". BMC Pharmacology and Toxicology. 20 (1): 72. doi:10.1186/s40360-019-0363-1. ISSN 2050-6511. PMC 6884918. PMID 31783781.
  38. ↑ Fedorowicz, Zbys; van Zuuren, Esther J; Hu, Nianfang (2012-03-14). "Histamine H2-receptor antagonists for urticaria". Cochrane Database of Systematic Reviews (in Turanci). 2012 (3): CD008596. doi:10.1002/14651858.CD008596.pub2. ISSN 1465-1858. PMC 7390502. PMID 22419335.
  39. ↑ Kim S, Baek S, Shin B, Yoon SY, Park SY, Lee T, Lee YS, Bae YJ, Kwon HS, Cho YS, Moon HB, Kim TB (2013). "Influence of initial treatment modality on long-term control of chronic idiopathic urticaria". PLOS ONE. 8 (7): e69345. Bibcode:2013PLoSO...869345K. doi:10.1371/journal.pone.0069345. PMC 3720657. PMID 23935990.
  40. ↑ AU Erbagci Z SO (2002). "The leukotriene receptor antagonist montelukast in the treatment of chronic idiopathic urticaria: a single-blind, placebo-controlled, crossover clinical study". J Allergy Clin Immunol. 110 (3): 484–488. doi:10.1067/mai.2002.126676. PMID 12209099.
  41. ↑ Pacor ML, Di Lorenzo G, Corrocher R (2001). "Efficacy of leukotriene receptor antagonist in chronic urticaria. A double-blind, placebo-controlled comparison of treatment with montelukast and cetirizine in patients with chronic urticaria with intolerance to food additive and/or acetylsalicylic acid". Clin Exp Allergy. 31 (10): 1607–1614. doi:10.1046/j.1365-2222.2001.01189.x. PMID 11678862. S2CID 33770584.
  42. ↑ Boehm I, et al. (Jul 1999). "Urticaria treated with dapsone". Allergy. 54 (7): 765–6. doi:10.1034/j.1398-9995.1999.00187.x. PMID 10442538. S2CID 40767363.
  43. ↑ Maurer, Marcus; Rosén, Karin; Hsieh, Hsin-Ju; Saini, Sarbjit; Grattan, Clive; Gimenéz-Arnau, Ana; Agarwal, Sunil; Doyle, Ramona; Canvin, Janice; Kaplan, Allen; Casale, Thomas (2013). "Omalizumab for the Treatment of Chronic Idiopathic or Spontaneous Urticaria". New England Journal of Medicine. 368 (10): 924–35. doi:10.1056/NEJMoa1215372. PMID 23432142.
  44. ↑ Kaplan AP (2009). "What the first 10,000 patients with chronic urticaria have taught me: a personal journey". J Allergy Clin Immunol. 123 (3): 713–717. doi:10.1016/j.jaci.2008.10.050. PMID 19081615.
  45. ↑ Morgan M (2009). "Treatment of refractory chronic urticaria with sirolimus". Arch Dermatol. 145 (6): 637–9. doi:10.1001/archdermatol.2009.13. PMID 19528416.
  46. ↑ AU Shahar E, Bergman R, Guttman-Yassky E, Pollack S (2006). "Treatment of severe chronic idiopathic urticaria with oral mycophenolate mofetil in patients not responding to antihistamines and/or corticosteroids". Int J Dermatol. 45 (10): 1224–1227. doi:10.1111/j.1365-4632.2006.02655.x. PMID 17040448. S2CID 19744425.
  47. ↑ Tat, Tugba Songul (4 January 2019). "Higher Levels of Depression and Anxiety in Patients with Chronic Urticaria". Medical Science Monitor. 25: 115–120. doi:10.12659/MSM.912362. PMC 6329254. PMID 30609422.
  48. ↑ Langan, EA; Nie, Z; Rhodes, LE (Sep 2010). "Melanotropic peptides: more than just 'Barbie drugs' and 'sun-tan jabs'?". The British Journal of Dermatology. 163 (3): 451–5. doi:10.1111/j.1365-2133.2010.09891.x. PMID 20545686. S2CID 8203334.
  49. ↑ Phan, NQ; Bernhard, JD; Luger, TA; Ständer, S (October 2010). "Antipruritic treatment with systemic μ-opioid receptor antagonists: a review". Journal of the American Academy of Dermatology. 63 (4): 680–8. doi:10.1016/j.jaad.2009.08.052. PMID 20462660.
  50. ↑ Volcheck, Gerald W. (2009) Clinical Allergy Diagnosis and Management. London: Springer.
  51. ↑ Poonawalla T, Kelly B (2009). "Urticaria: A review". American Journal of Clinical Dermatology. 10 (1): 9–21. doi:10.2165/0128071-200910010-00002. PMID 19170406. S2CID 35029156.
  52. ↑ McGovern TW, Barkley TM (2000). The electronic textbook of Dermatology. New York: Internet Dermatology Society.
  53. ↑ Juhlin L. (2000) The History of Urticaria and Angioedema. Department of Dermatology, University Hospital, Uppsala, Sweden. ESHDV Special Annual Lecture.

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