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Urticarial lesions are polymorphic, round or unevenly shaped pruritic wheals that choice in size from a few millimeters to several centimeters. Lesions be able to expand wherever on the body and are increase by scratching, combining into large, fiery red patches. Sometimes a vascular steal occurrence reasons lesions to appear hyperemic in the center with a white halo along the circumference.
Angioedema, which be able to happen only or with urticaria, is portrayed by nonpitting, non-pruritic, well defined, edematous growth that involves subcutaneous tissues, abdominal organs, or the upper airway (i.e., larynx). Angioedema tends to occur on the face and may cause significant disfigurement. Laryngeal angioedema is a medical emergency requiring prompt assessment. Acute intestinal and stomach swelling can mimic symptoms of an abdominal surgical emergency.
Acute urticaria also is differentiated from chronic urticaria by ongoing or longstanding urticarial symptoms that trigger an IgE mediated process. Chronic urticaria and angioedema tend to be idiopathic, with no identifiable cause, or to be precipitated by a multitude of endogenous or exogenous factors that can be immunologic or nonimmunologic.
Chronology differentiates subcategories of urticaria. Wheal and flare words last fewer than six weeks in patients with acute urticaria, but chronic urticaria can persist for months or years. In a recent study, 47 percent of patients with chronic urticaria of unknown etiology had spontaneous remission after one year.3 Patients with physical urticaria had more persistent disease, with only 16 percent undergoing spontaneous reduction.
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