00:03
Let's talk about
Urticaria (Hives).
00:06
So what urticaria (hives),
what does this mean to you?
The IgE-mediated.
00:10
As soon as you hear IgE-mediated
what does that mean to you?
It means that now you've been
exposed to a particular antigen,
in which you have now elicited
a Type 1 hypersensitivity.
00:20
Isotype switching,
IgE then lands upon your
IgE receptors of the mast cell.
00:25
And what did you release?
Ah, histamine.
Histamine, histamine.
00:30
Histamine has what can effect
on your blood vessels?
Vasodilation. Good.
00:36
Welcome to Hives.
00:38
Now once you have
vasodilation taking place
with the histamine being released
by the mast cell
You have an area
that appears what?
Maybe a little edematous.
00:50
Erythematous
caused by food, medication,
exercise, temperature,
vibration, stress.
00:56
Those things that you can expect
in which hives are going to develop.
01:00
And two to three episodes per week,
for six weeks
is a chronic urticaria.
01:06
Be familiar to define,
or how to define chronic urticaria,
which is two to three episodes
per week for six weeks.
01:14
That is extremely cumbersome.
01:18
Morphology:
Rapid development of edematous
enie
Edematous,
why?
Histamine, vasodilation,
edema.
01:27
Erythematous,
wheal formation.
01:30
There are three terms here
that you want to keep in mind:
urticaria, hives,
and wheal formation.
01:35
To you, it's a
type 1 hypersensitivity,
with vasodilation, edema,
and erythema.
01:44
These lesions evolve and dissipate
rapidly within 24 hours.
01:49
And there's every possibility
that if you were to take
a glass slide, for example,
and apply pressure,
apply pressure on this hive
or wheal formation
with vasodilation,
press upon that wheal please
W-H-E-A-L,
what's going to happen?
Blanching.
02:07
Because when you
press upon that wheal,
the fluid edema
is going to then disperse.
02:14
So that erythema that you found
upon what's known as a
diascopic type of examination
is then going to give you your
blanch type of appearance.
02:28
Diagnosis: Rapidly evolution,
clinically distinctive,
and biopsy rarely performed.
02:35
A history is going to tell you
what's going to happen.
02:37
Take a look at the image here,
high formation on the thigh
and the leg of this individual.
03:08
Management:
You need to identify
what's actually causing
the type I hypersensitivity.
03:13
Antihistamines obviously sedating,
such as maybe
diphenhydramine.
03:18
Moderately sedating
will be cetirizine
and non-sedating,
if at all required
based on the patient's
habits and behavior,
Maybe you're thinking about
loratadine.
03:27
but anti-histamine,
you are going after
the histamine,
so that you can take care
of the hives.