The world of urticaria is a heterogeneous and complex one, “which must always be addressed with great care and attention, as urticaria can be the external and visible manifestation of a pathological condition, whether organ or systemic, which broods silently without giving macroscopic signs appreciable. Several cases of urticaria are caused by allergic reactions, although the triggering agents can be multiple: drugs, foods, pollen, mites, animal hair and dander, fungal spores, chemical substances such as drugs or contrast agents or insect venom or. contacts with stinging herbs will always be appropriate to approach an acute or chronic pattern of urticaria with an approach that is as open as possible to broad clinical options, trying where possible to overcome the often limiting concept of forms defined as ‘idiopathic’ and, in any case, always distrusting and excluding the inconclusive use of fake initiatives of inconclusive and fake intolerance tests, up to fake news”. The immunologist Mauro Minelli, professor of dietetics and human nutrition at the Lum University of Bari, takes stock of urticaria.
How is allergic reaction urticaria treated? “Some patients – the immunologist takes stock – respond well to antihistamine therapy, others may require cortisone treatment. In more complex cases there are reports on the use of biological drugs. In other published studies, patients with urticaria were examined chronic and high D-dimer levels, in which the use of anticoagulants seems to have given good results. And there are also cases of urticaria secondary to focal pathologies (dental granulomas), cases of urticaria in patients with infections such as Helicobacter pylori. , with a fair percentage of remission of urticaria after eradicating therapy. And then there are urticaria caused by parasites (helminths, pinworms, anisakis) and those that can result from physical trauma, the action of additives, dyes, or intense conditions. of emotional stress or even to a non-immunological activation of the complement”.
“On the clinical side, urticaria, which when it regresses within 6 weeks of onset is defined as ‘acute’ – specifies Minelli – is characterized by the sudden appearance of ‘wheals’ which vary in number and location. These are fleeting red and itchy eruptions , of different shapes and sizes ranging from a few millimeters to a few centimeters in diameter. Generally the wheals appear in a rounded shape, or in the form of large rings and patches. They usually disappear more or less quickly and then reappear in bursts subsequent, accompanied by itching, in various body sites, on the eyelids, auricles, genital organs, hands, feet, together with the wheals, swelling of the tissues (angioedema) may coexist which is little or not at all itchy but often painful.” .
“Sometimes extensive urticaria can be associated with systemic manifestations of a cardiovascular type (hypotension up to shock), respiratory (dyspnoea, cough) or gastrointestinal (abdominal pain, diarrhoea, vomiting) – warns the immunologist – In some cases of chronic urticaria it can It may also be useful to explore the thyroid, considering that the thyroid hormones tetra-iodothyronine or thyroxine (T4) and tri-iodothyronine (T3) also play an important role in maintaining normal skin functions, in particular oxygen consumption, protein synthesis , mitoses, skin thickness, hair growth and normal sebum secretion. It follows – concludes Minelli – that any alterations of the skin and its appendages could be associated with malfunctions of the thyroid and in particular with hyperthyroidism or a hypothyroidism, perhaps due to autoimmune diseases affecting the gland”.
