皮肤性病学课件：荨麻疹（英文版）

urticariaBasicrequirementsTomasterthecausesandclinicalmanifestionsofurticariaToknowwellabouttherapeuticalwaysToknowabouttheetiologyurticariaDefinition

Urticaria

isaverycommondiseaseandisavascularreactionoftheskincharacterizedbytheappearanceofwheals，whiteorredevanescentplaquesgenerallysurroundedbyaredhaloorflareandassociatedwithsevereitching,stinging,orprickingsensations.EtiologyandpathogenesisEtiologyfoodsEtiologymedicinesEtiologyPhysicalfactors

冷、热

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荨麻疹是由于皮肤、粘膜小血管扩张及渗透性增加而出现的一种局限性水肿反应病因食物药物物理因素感染动植物因素精神因素内脏及全身疾病等等荨麻疹肥大细胞活化是荨麻疹发生的中心环节临床表现

圆形、椭圆形或

不规则形的风团

此起彼伏急性荨麻疹发作迅速、消退不留痕迹，持续时间小于6周急性荨麻疹的非皮肤表现

过敏性休克：心慌、烦躁、恶心、呕吐甚至血压降低。主要因血管突然扩张引起。

胃肠型表现：腹痛、腹泻，伴有里急后重及粘液稀便，酷似急腹症。主要因胃肠粘膜水肿引起。

呼吸道表现：出现呼吸困难、甚至窒息。主要因喉头粘膜水肿引起。慢性荨麻疹临床特点

风团时多时少，反复发作超过6周

全身症状轻

部分患者皮疹发作的时间有规律

病情迁延、病程长

大多数患者不能找到病因

诊断

皮疹为风团

发生及消退迅速

消退后不留痕迹

病因诊断应全面综合分析后再推断

治疗原则

找出病因，排除发病因素；

病因不明者，可对症处理。抗组胺药物的规