皮膚性病學課件：蕁麻疹（英文版）

urticariaBasicrequirementsTomasterthecausesandclinicalmanifestionsofurticariaToknowwellabouttherapeuticalwaysToknowabouttheetiologyurticariaDefinition

Urticaria

isaverycommondiseaseandisavascularreactionoftheskincharacterizedbytheappearanceofwheals，whiteorredevanescentplaquesgenerallysurroundedbyaredhaloorflareandassociatedwithsevereitching,stinging,orprickingsensations.EtiologyandpathogenesisEtiologyfoodsEtiologymedicinesEtiologyPhysicalfactors

冷、熱

日

光

等

Cold，hot，sunlight，friction，pressure…Etiologybacteria

virus

真菌infectionsEtiologyAnimalsanimal’sfurskinStingingofinsects

EtiologyPlantspollen

EtiologySpiritfactors

diseaseofinternalorgan.pathogenesisAllergyThemastcellisthePrimaryeffectorcellinUrticarialreactions.NoallergyMedicinesSomesimplecompoundToxinsFoodLeadtoreleasingofHistaminefrommastcellMastcellactivation,isacentralpartoftheurticariaoccurs.ClinicalmanifestationsWhealsitchingAccordingtothecourseAcuteurticariaChronicurticariaAcuteurticaria

occursabruptlyCanbecuredinashortperiodAcuteurticariaUnevensurfacewithorangepeelItalwaysoccurs

abruptly,itwillevolveoverdaystoweeks,producingevanescentwhealsthatindividuallyrarelylastmorethan12hours,withcompleteresolutionoftheurticariawithin6

weeksofonset.Allergicshock:BloodpressureofpatientsmayfallAbdomenachePanicky,dysphoria,nauseaandvomitusDyspneaHighfever,shiveringAcuteurticariachronicurticaria

Dailyepisodesofurticariaand/orangioedemalastingmorethan6

weeksisdesignatedchronicurticaria.SpecialsortsofurticariaDermatographismcoldurticaria

CholinergicurticariaCholinergicurticariaDuetomotion,heat,emotionaltension,eatinghotdrinksorethanoltotrunkdeepinducedfactorssuchastemperaturerise,promptedbyacetylcholinemastcellsandhappen.SolarurticariaangioedemaDiagnosisandmisdiagnosisDiagnosisTypicalclinicalmanifestations:wheals,fastappearinganddiminishing,notraceafterdiminishingandspecialtiesateveryphase.Itcanbediagnosedeasily,butcause–diagnosisareverydifficultinmanycases.

Theidentificationofregularurticariaandpapulesurticaria.GastrointestinaltypeurticariaandidentificationandtheacutegastroenteritismisdiagnosisTreatmentTreatmentSystemictreatmentAcuteurticaria

Mainstayoftreatmentofacuteurticariaisadministrationofantihistamines.Chronicurticaria

Lookingfortherealreasonisveryimportant.corticoidmustavoid.Anti-histamineisimportant,andtheuseofblockingagentofH1.2receptorisbetterforcombinedtreatment.

Shock

Immediateinjectionwith0.1%adrenalinat0.5mlbysubcutaneouspartmaysavethelife;inspiringwithoxygen;meanwhileintravenousinjectionwithhydrocortisoneat0.2to0.3gin500mlglucoseisnecessary.

useantihistamine蕁麻疹是由于皮膚、粘膜小血管擴張及滲透性增加而出現(xiàn)的一種局限性水腫反應病因食物藥物物理因素感染動植物因素精神因素內(nèi)臟及全身疾病等等蕁麻疹肥大細胞活化是蕁麻疹發(fā)生的中心環(huán)節(jié)臨床表現(xiàn)

圓形、橢圓形或

不規(guī)則形的風團

此起彼伏急性蕁麻疹發(fā)作迅速、消退不留痕跡，持續(xù)時間小于6周急性蕁麻疹的非皮膚表現(xiàn)

過敏性休克：心慌、煩躁、惡心、嘔吐甚至血壓降低。主要因血管突然擴張引起。

胃腸型表現(xiàn)：腹痛、腹瀉，伴有里急后重及粘液稀便，酷似急腹癥。主要因胃腸粘膜水腫引起。

呼吸道表現(xiàn)：出現(xiàn)呼吸困難、甚至窒息。主要因喉頭粘膜水腫引起。慢性蕁麻疹臨床特點

風團時多時少，反復發(fā)作超過6周

全身癥狀輕

部分患者皮疹發(fā)作的時間有規(guī)律

病情遷延、病程長

大多數(shù)患者不能找到病因

診斷

皮疹為風團

發(fā)生及消退迅速

消退后不留痕跡

病因診斷應全面綜合分析后再推斷

治療原則

找出病因，排除發(fā)病因素；

病因不明者，可對癥處理。抗組胺藥物的規(guī)