Chronic Idiopathic Uticaria

Background

Chronic Idiopathic Uticaria is a disease that causes outbreaks of hives on the skin that are itchy and can last for several weeks. Hives are raised red or skin-colored bumps on the surface of the skin. Hives are a common allergic reaction that occurs when a person is exposed to the substance that they are allergic to. In an allergic reaction, hives last a short time and disappear quickly once the person is no longer exposed to the allergen or is treated with an antihistamine. Patients with chronic idiopathic uticaria experience hives that don't seem to be caused by exposure to an allergen.

Chronic idiopathic uticaria can occur in anyone but is most common in adults between twenty and forty years old. The disease seems to occur twice as often in women than in men. The outbreaks that occur in a patient with chronic idiopathic uticaria are not dangerous or life threatening, but they can be extremely uncomfortable and can disrupt a patient's life.

Causes

It is not known what causes chronic idiopathic uticaria. Hives normally occur as part of the body's natural immune response. When the body comes into contact with something it is allergic to (an allergen), the immune system releases histamine. The release of histamine causes the appearance of hives and the skin to itch. Normally, doctors are able to identify the substance that a patient is allergic to. In patients with chronic idiopathic uticaria, the patient develops outbreaks of hives and itching without being exposed to an allergen.

Symptoms

Patients with chronic idiopathic uticaria may experience the following symptoms:

  • Outbreaks of hives that may be red or colored. Outbreaks tend to occur on the face, chest, back, arms, or legs
  • Itching which can be mild to severe
  • Outbreaks that last for weeks or months

The outbreaks experienced by a patient may appear suddenly, and the appearance and size of the hives may change during the time the outbreak is occurring.

Diagnosis

There is no specific test that doctors can perform to diagnosis chronic idiopathic uticaria. Doctors will generally order blood and allergy tests to attempt to identify what is triggering the outbreaks. The doctor may have the patient avoid certain suspected allergic triggers such as foods, fragrances, cleaning products, or pets to determine if the patient may be allergic to them. Doctors may also order diagnostic tests to rule out certain underlying medical conditions that are associated with the outbreak of chronic hives. In patients with chronic idiopathic uticaria, these allergy and diagnostic tests will be negative.

Treatment

Specialty drug list

The goal of the treatment for chronic idiopathic uticaria is to manage the symptoms and control the itching while the outbreak resolves. There are several treatment options doctors have available to manage an outbreak of hives. Doctors may use antihistamines, oral steroids, immune system suppressants, or injectable antibodies. In some cases, doctors may prescribe more than one medication to control the itching associated with the outbreak.

Side Effects

The medications used to treat the hives may cause side effects. A patient should not stop taking their medication without first consulting with their doctor or pharmacist.

Common side effects of the medication used to treat chronic idiopathic uticaria are:

Antihistamines
Drowsiness, dizziness, dry mouth, and dry eyes
Steroids
Weight gain, increased appetite, anxiety, nervousness, and an increased chance of infections
Immune system suppressants
Nausea, vomiting, diarrhea, and an increased chance of infections
Injectable antibody therapy
Redness or pain at the injection site, headache, joint pain

Resources

There are many resources and organizations available to patients that provide support, advocacy, and information:

Asthma and Allergy Foundation of America

American College of Allergy Asthma and Immunology

References

National Institutes of Health NIAID. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276885/. Accessed September 18, 2015.

National Institutes of Health NIAID. http://www.ncbi.nlm.nih.gov/pubmed/11674926. Accessed September 18, 2015.

National Institutes of Health NIAID. http://www.ncbi.nlm.nih.gov/pubmed/11569322. Accessed September 18, 2015.