What are the other Names for this Condition? (Also known as/Synonyms)

• Urticaria, Acute Spontaneous type

What is Acute Spontaneous Urticaria? (Definition/Background Information)

• Urticaria is a common inflammatory condition of skin that results in weals (red skin sign with itching) and/or angioedema (swelling due to fluid accumulation). It is seen in individuals of a wide age group and may be described as acute or chronic, based on the duration of the signs and symptoms
• Acute urticaria is a common skin condition that usually lasts less than 6 weeks. The signs and symptoms are observed for a short-term; it often resolves between a few minutes to a few days
• Acute Spontaneous Urticaria is a form of spontaneous urticaria that develops as a single episode, usually lasting a few days to a few weeks. The triggers may be known, or mostly unknown; although, the symptoms can develop within a few hours
• The condition may be triggered by potential factors that include common cold and flu (respiratory illnesses), certain medications, and rarely food allergies. In many cases, no cause is established for Acute Spontaneous Urticaria
• Any region of body skin may be affected, but usually the head and neck, chest and back, arms and legs are involved. Intense itching may lead to skin ulceration and scarring, which can cause emotional stress from cosmetic concerns
• Acute Spontaneous Urticaria is treated symptomatically, when required. The treatment may involve the use of steroids, antihistamines, and immunosuppressive medication, in case of severe signs and symptoms. The prognosis with adequate treatment is usually excellent

Who gets Acute Spontaneous Urticaria? (Age and Sex Distribution)

• Acute Spontaneous Urticaria is observed in children and adults
• There is no gender, race, or ethnic preference observed

What are the Risk Factors for Acute Spontaneous Urticaria? (Predisposing Factors)

The risk factors or triggers for Acute Spontaneous Urticaria is not very clear in many cases; however, it may include the following:

• Respiratory infections affecting the upper respiratory tract
• Use of certain medications including antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), and painkillers (opiates)
• Food allergies including peanut allergy and shellfish allergy
• Contact with certain materials

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Spontaneous Urticaria? (Etiology)

Urticaria can be caused by a variety of factors. The condition develops due to the release of chemical substances, such as histamines, platelet activating factor, and cytokines (example bradykinin), from inflammatory cells called mast cells and basophils.

• The triggers for acute urticaria may be known or unknown and may include viral and bacterial infections, use of certain drugs, contact with certain substances, allergies, etc.
• Acute Spontaneous Urticaria is a form of acute urticaria that develops as a single episode, usually lasting a few days to a few weeks. The triggers may be known in some cases, or unknown

What are the Signs and Symptoms of Acute Spontaneous Urticaria?

The signs and symptoms of Acute Spontaneous Urticaria may include:

• Initially, localized itching of skin may be observed; the skin may appear swollen
• Formation of skin rashes or weals (wheals) that are associated with redness (or pinkish discoloration) and intense itching
• The skin surrounding the affected area (weal) may be normal skin color or appear red (erythema)
• The weals may change in shape and size; weals may be spherical, arranged in a random form, or ring-like pattern
• In some individuals, there may be a burning sensation accompanying itching
• Individual weals may vary in size from a few mm to few cm; but, numerous weals covering a large area of the body skin are usually observed
• The weals may last for several minutes to up to a day; few cases are non-itchy
• Urticaria can occur in any part of the body and can be focal or extensive
• In some cases, it can lead to hyperpigmentation (increased skin pigmentation) or hypopigmentation (decreased skin pigmentation)
• When pressure is applied on the hives, it blanches (becomes pale or white in color)
• Scratching can result in worsening of the symptoms and lead to further skin complications such as ulceration and secondary infections
• Angioedema: It may or may not occur with Acute Urticaria
  • Angioedema is swelling due to fluid accumulation in the mucus membranes or deep within the skin. This lasts for up to 3 days, it can be also itchy
  • Angioedema usually occurs focally; most common sites are the head and neck region, hands, feet, and genitalia. In the head and neck region, it can involve the eyelids, lips, or oral cavity
• Pain, pain on touch

In individuals with severe Acute Spontaneous Urticaria, fever, fatigue, painful joints, headaches and body aches, diarrhea, and breathing difficulties may be additionally noted.

How is Acute Spontaneous Urticaria Diagnosed?

Generally, no lab tests are needed and Acute Spontaneous Urticaria condition is diagnosed clinically. In some cases, lab tests are necessary and a diagnosis of the skin condition may involve:

• Physical examination of the skin and medical history evaluation
• Skin allergy test
• Blood test to detect various antibodies against allergens including:
  • Complete blood count (CBC)
  • Antinuclear antibody (ANA) test
  • Erythrocyte sedimentation rate (ESR) test
• Tests to rule-out other underlying conditions/infections (if any necessary)
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: A skin biopsy is usually unnecessary and is performed only in rare cases.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acute Spontaneous Urticaria?

Generally, Acute Spontaneous Urticaria is a self-resolving skin condition and no major complications are noted. However, in some cases, the following complications may be noted:

• Intense scratching may result in skin scarring
• Itching can lead to ulceration of skin, causing superimposed bacterial and fungal skin infections
• Cosmetic concerns in some individuals leading to stress
• If Acute Spontaneous Urticaria is associated with anaphylactic shock, it may be potentially life-threatening

How is Acute Spontaneous Urticaria Treated?

In many individuals, Acute Spontaneous Urticaria resolves on its own and the symptoms get better within a few days (in a majority of individuals) to weeks. If necessary treatment may be provided and this depends upon the severity of the signs and symptoms.

The treatment measures for Acute Spontaneous Urticaria, provided symptomatically, may include:

• Individuals with mild symptoms can be treated using over-the-counter medications
• Cooling the skin using moist towels
• Topical steroid treatment that may include moisturizing creams to soothe the condition; however, many reports indicate that topical applications are not very successful in treating the condition
• Systemic steroids
• Anti-histamine therapy
• In individuals with severe signs and symptoms, immunosuppressive medication may be administered
• Patient education in understanding the condition is beneficial
• Avoidance of suspected triggers (certain medications, foods, etc.)

How can Acute Spontaneous Urticaria be Prevented?

Acute Spontaneous Urticaria may not be prevented. However, the following factors may be considered:

• Treating viral infections early and appropriately
• Avoiding exposure to drugs that cause the condition
• Avoiding the use of materials that cause acute urticaria

What is the Prognosis of Acute Spontaneous Urticaria? (Outcomes/Resolutions)

• The prognosis of Acute Spontaneous Urticaria is excellent, since it is often a self-limiting condition. The condition is known to resolve in a few weeks
• In many individuals, the skin condition gets better without any substantial treatment
• Although, anaphylactic reaction/shock can be fatal without treatment

Additional and Relevant Useful Information for Acute Spontaneous Urticaria:

Please visit our Skin Care Health Center for more physician-approved health information:

http://www.dovemed.com/healthy-living/skin-disorders/